Physical and Emotional Satisfaction at First Same-Sex Anal Sex in Young Gay and Bisexual Men

Abstract

Research has focused on adolescents’ feelings about their first sexual experiences, but little research has examined this topic in sexual minority adolescents. In this study, we examined how experiencing emotional and physical satisfaction at first same-sex anal sex differed by age of first sex for young gay and bisexual men. We applied the time-varying effect model (TVEM) to data from an internet survey of men who initiated first sex between ages 14–26 (n = 6,401) to examine emotional and physical satisfaction at first same-sex anal sex across continuous age of onset and by partner factors. The majority of men reported satisfaction across all ages; however, satisfaction was generally less likely for men who had first anal sex with a non-relationship partner, an older partner, or a partner they had sex with only once and this was particularly true at earlier ages. Findings suggest that many young gay and bisexual men report satisfaction with their first anal sex and that relationship context can be important in predicting satisfaction, particularly at younger ages.

First sex has been conceptualized as an important, meaningful transition in the lives of adolescents (Kelly, 2010; Tsui & Nicoladis, 2004). However, relatively little research has focused on sexual minority adolescents and young adults’ first sexual experiences with a same-sex partner, and extant studies typically focus on sexual risk rather than understanding how individuals experience the event. Thus, in this study we examined how emotional and physical satisfaction at first same-sex anal sex differs across age of onset and by relationship factors in a large, national sample of young gay and bisexual men.

Sexuality development and first sex

Developing sexual well-being is an important task of adolescence and can consist of feeling positive about the body and pubertal changes, acceptance of sexual arousal, engagement in sexual behaviors (alone or with a partner) and, if sexually active, the practice of safe sex (Brooks-Gunn & Paikoff, 1993). A majority of adolescents, both heterosexual and sexual minority, engage in first partnered sexual behaviors during adolescence (Finer & Philbin, 2013; Savin-Williams. 1998; 2005). All adolescents may face developmental tasks focused on understanding and exploring their sexual feelings. In addition, sexual minority adolescents may face other challenges, as their explorations of sexual behaviors can be linked to their development of a sexual minority identity for which they may face stigma and discrimination (Moreira, Halkitis, Kapadia, & Farzana, 2015; Morgan, 2014). Individuals’ first sexual experiences with others of the same sex can take place at various points during their process of sexual identity development, in which they are making sense of their attraction to individuals of the same sex, exploring more about the gay and lesbian community, and eventually, self-labeling as gay or bisexual (Rosario et al., 1996; Savin-Williams & Diamond, 2000). Qualitative interviews have also suggested that sexual minority individuals may view their early sexual experiences as confirming their sexual minority identity (Morgan, 2014; Savin-Williams, 1998). Because sexual minority adolescents are exploring their sexuality and sexual identity in an environment in which they may have few role models of sexual development, sexual behavior may have different meanings, and subsequently different outcomes, than those experienced by heterosexual adolescents.

The experience of first sex

There is limited theory that makes concrete predictions about adolescents’ perceptions of their first sexual experiences and how they may contribute to development. However, a number of conceptual models of adolescent and emerging adult sexuality from a normative developmental perspective stress the importance of understanding perceptions of sexual behavior and include sexual satisfaction as a component of sexual well-being (Espinosa-Hernández & Vasilenko, in press; Harden, 2014; Russell, 2005; Hensel & Fortenberry, 2013; Horne & Zimmer-Gembeck, 2006; Tolman & McClelland, 2011; Vasilenko, Lefkowitz, & Welsh, 2014; Welsh, Rostosky, & Kawaguchi, 2000). Understanding perceptions is important, as the way individuals interpret their sexual behavior may influence their later behaviors and how their sexual behavior impacts their mental health and well-being (Vasilenko et al., 2014). There has been a considerable amount of recent research examining individuals’ perceptions of their first vaginal intercourse. These findings suggest that experiencing positive physical (e.g., pleasure) and emotional (e.g., love, excitement, happiness) consequences is normative, although experiencing both positive and negative consequences is common (Guggino & Ponzetti, 1997; Higgins, Trussell, Moore & Davidson, 2010; Smiler, Ward, Caruthers, & Merriwether, 2005; Vasilenko, Maas, & Lefkowitz, 2015).

Less research has focused on same-sex sexual experiences in gay and bisexual men, with much of the extant research focusing on sexual risk. Some qualitative studies have examined the contexts and circumstances of first same-sex sexual experiences (including, but not limited to, anal intercourse) in gay men. For example, young gay men typically have their first same-sex sexual experiences in middle adolescence, though they initiate at a range of ages from late childhood to early adulthood (Savin-Williams, 1998; 2005). First same-sex sexual experiences with friends, romantic partners, and non-relationship partners were all common (Savin-Williams, 1998). Most quantitative research has focused on associations between first same-sex sexual experiences and later HIV risk behaviors such as condom use (Arrington-Sanders, Morgan, et al., 2016; Balthasar, Jeannin, & Dubois-Arber, 2009), number of sexual partners (Nelson, Gamarel, Pantaline, Carey, & Simoni, 2016), and exchange sex (Outlaw et al, 2011). Similarly, research that has explored the effects of relationships and relationship characteristics among gay and bisexual men has also largely focused on HIV-risk behaviors as outcomes (Cuervo & Whyte, 2015; Starks & Parsons, 2014). A small number of studies have examined how young gay and bisexual men experience their first same-sex sexual experiences. For example, sexual minority adolescents generally, and gay and bisexual male adolescents more specifically, were relatively satisfied with their first same-sex sexual experiences, although experiencing both positive and negative reactions was common (Dewaele, Van Houtte, Symons, & Buysse, 2017; Herdt & Boxer, 1993; Savin-Williams, 1998).

Thus, the limited extant research suggests that gay and bisexual men experience their first same-sex sexual experiences relatively positively. However, there is likely variability in how individuals experience this event, with factors like age and relationship status likely to play a role. For example, a recent study of first same-sex anal sex found greater physical and emotional satisfaction for men who had a smaller age difference with their partner and those who had sex with a friend or romantic partner as compared to another type of partner (Arrington-Saunders, Rosenberger, Matson, Novak, & Fortenberry, 2016). However, this study did not examine how the effect of these relationship characteristics differed by age at first sex. A better understanding of how perceptions of first anal sex vary by age, and how these patterns differ by relationship status, is important, as qualitative research has suggested different experiences and contexts of first sex for gay men at different ages. For example, younger individuals tend to report relatively positive experiences with a same-sex friend, whereas middle adolescents report more mixed experiences with romantic partners and young adults are more likely to have sex with non-relationship partners (Savin-Williams, 1998). Additional research is needed to understand the interplay of age and relationship status on individuals’ perceptions of first sex, such as whether negative effects of non-relationship sex are stronger at younger ages. This information can provide critical information relevant to sexuality development that is inclusive of more diverse individuals and sexual experiences.

A new approach to examining first sexual experiences at different ages

Most research that has examined age of first sex and health and well-being has divided individuals into age groups (e.g., early, late, and normative timing). However, dividing individuals into discrete age groups can obscure patterns that may be more accurately represented by continuous age (Vasilenko, Kugler, & Rice, 2016). For example, it may make it more difficult to determine at what specific ages engaging in first sex may be associated with positive or negative outcomes. Recently, a new analytic approach, the time-varying effect model (TVEM; Tan, Shiyko, Li, Li, & Dierker, 2012), has been used to better determine how outcomes of first sex vary by continuous age, allowing for identification of precise periods of change. One study examined how outcomes (adult STI and depressive symptoms) vary as a function of age of first intercourse using TVEM (Vasilenko, Kugler et al., 2016). This study identified first vaginal intercourse prior to age 16 as a period marked by greater than average odds of STIs and clinical levels of depression (Vasilenko, Kugler et al., 2016), which suggests the utility of this approach for determining at what ages sexual behavior may be more healthy or risky. However, this approach has not yet been used to examine perceptions of sexual behavior at different ages of onset, or to examine sexual behavior in sexual minority adolescents or young adults.

In this study we applied TVEM to data from a large, national sample of young gay and bisexual men to determine how physical and emotional satisfaction at first same-sex anal sex differed across ages of onset from 14–26 and how these age-varying trends differed by relationship factors. We had two specific aims:

1. To examine how experiencing emotional and physical satisfaction at first same-sex anal sex differs across ages of onset from 14–26 among young gay and bisexual men.

2. To examine whether these trends in emotional and physical satisfaction at first same-sex anal sex across age of onset differ by relationship with first sexual partner, whether the individual had sex with this partner more than once, and having an older sexual partner.

Method

Participants and Procedure

Data were collected through a partnership with the operators of Internet websites for men who seek social or sexual connections with other men (see Rosenberger et al., 2011 for more information). A recruitment email was sent to users of the company’s two largest websites. Emails contained information about the study and a link to the study website, and all users of the website residing in the 50 U.S. States or Washington D.C. were eligible to participate. Individuals who clicked on the link were asked to complete informed consent and an online survey which took about 20 minutes. 32% of men who received emails visited the study website, and nearly 60% of these men completed the survey, resulting in a sample of 32,831 individuals. In this study, we focused on young men in order to reduce recall bias and cohort effects; thus we included participants if they were between 18 and 30 years of age and reported a gay or bisexual sexual identity. Consistent with prior research (e.g., Arrington-Saunders, Rosenberger, et al., 2016) we focused on HIV-negative participants, as HIV infection may influence individuals’ recollection of their sexual experiences. Our analytic sample contained 6,401 young men (78% white, 9% Latino, 5% Black, 4% Asian, 4% other; 82% gay, 18% bisexual, Mage = 24.5, SD = 3.4).

Measures

Emotional and Physical Satisfaction.

Our primary outcomes were measures of emotional and physical satisfaction. Participants completed a single item for both physical and emotional satisfaction (“After you had anal intercourse the first time, how [EMOTIONALLY/PHYSICALLY] satisfying was the experience?”) rated on a 5-point scale. Because both variables were skewed toward greater satisfaction, we dichotomized the variables to indicate satisfaction (Extremely Satisfying, Somewhat Satisfying) compared to no satisfaction (Neither Satisfying or Dissatisfying, Somewhat Dissatisfying, Extremely Dissatisfying). Emotional satisfaction was reported by 52% of men, and physical satisfaction by 70%.

Age of First Sex.

We examined how these outcomes differed over continuous age of onset of first sex. Participants were asked two questions about insertive and receptive first anal anal intercourse (i.e., “How old were you the first time that you inserted your penis into another man’s anus (topped)?; How old were you the first time that another man inserted his penis into your anus (bottomed)?); if these two were different, we counted the younger of the ages of these two behaviors. Because of the scarcity of data on first sex that occurred prior to age 14 and after age 26, we only included individuals who had first anal sex between ages 14 and 26. Mean age of onset was 18.5 years old (SD = 2.7).

Relationship Moderators.

We examined how emotional and physical satisfaction differed by 3 different relationship factors. Relationship with first partner was constructed from a 7-level variable indicating the participant’s relationship with their first male anal sex partner. We recoded this to three levels; romantic relationship partner (i.e., boyfriend/significant other, dating partner or spouse/domestic partner; 43%), friend (23%) and stranger (i.e., someone I just met, paid sex partner; 34%). Participants also indicated whether they had anal sex with partner after the first time (60% yes). Finally, we examined sex with an older partner based on a question asking about the partner’s age. We subtracted the participant’s age at first anal sex from the partner’s age, and then dichotomized to indicate whether the partner was younger or up to 4 years older compared to 5+ years older (33%), using an age cutoff similar to other studies (e.g, Balthasar, et al., 2009; Dewaule et al., 2016).

Statistical Analyses

We used time-varying effect models (TVEMs; Tan, et al., 2012) to examine age-varying prevalence of physical and emotional satisfaction at first anal sex across age of onset. TVEM is a flexible, non-parametric method that estimates the rates of an outcome and its associations with predictors as a function of continuous time. Time can be conceptualized in a number of different ways, and TVEM has been used to examine outcomes as a function of age of onset of a behavior (e.g., Lanza & Vasilenko, 2015; Vasilenko et al., 2016). Because curves do not have to take on a parametric form, TVEM can be used to identify precise periods of change; in this example, we can estimate precisely what ages of onset are associated with greater proportions of individuals experiencing satisfaction and at what ages differences are in these outcomes by relationship factors are significant.

We estimated all models using the weighted TVEM macro (Dziak, Li, & Wagner, 2017). This macro has options that allow for estimating prevalence or level of an outcome (e.g., emotional satisfaction) at different ages for different groups (e.g., individuals who had sex with a relationship v. non-relationship partner) without the loss of statistical power that would occur when running stratified analyses. Although these data did not include population weights, entering a weight of 1 for each individual allowed us to use the full sample through the procedures in this macro. Thus, we estimated precise estimates of emotional and physical satisfaction across age (with corresponding 95% confidence intervals) stratified by partner factors, allowing for examination of dynamic moderation (see Vasilenko, Linden-Carmichael, Lanza, & Patrick, 2017 for a further discussion of moderation in weighted TVEM).

For our first aim, we examined how experiencing physical and emotional satisfaction differed across age of onset using intercept-only TVEM. For analyses examining the role of partner factors (Aim 2), we subdivided the sample by relationship characteristics (e.g., older partner v. not older partner) and ran stratified intercept-only TVEMs by each level of the relationship factors using the “domain” and “which” statements in weighted TVEM (Dziak et al., 2017). Results are presented as figures, and significant differences between groups can be ascertained by when their confidence intervals do not overlap.

Results

First, we examined the estimated proportion experiencing emotional and physical satisfaction by age of first anal sex (Figure 1) using intercept-only logistic TVEMs. Proportions experiencing emotional and physical satisfaction were relatively constant by age of onset. About 50% of individuals reported emotional satisfaction at all ages from 14.5–24; however prevalence of emotional satisfaction did increase slightly with age of onset after age 24, peaking at about 57% experiencing emotional satisfaction with an age of onset of 26. About 70% of individuals reported physical satisfaction at all ages of onset, with only a slight increase after age 24, peaking at around 74% at age 26. As a sensitivity analysis, we also examined whether the estimated proportions experiencing satisfaction by age of onset differed by race/ethnicity by running stratified models (white v. non-white). The age-varying patterns were very similar for both groups, with no significant differences in emotional satisfaction. White participants had a significantly higher estimated proportion reporting physical satisfaction between ages of onset 16–20 compared to non-white participants (e.g., 70% v. 66% at age 19). However, the general pattern of similar rates of satisfaction across age of onset was consistent across both white and non-white participants

Figure 1.

Estimated proportion of participants reporting emotional and physical satisfaction at first same-sex anal sex, by age of first initiation of first sex. Thicker lines indicate estimated proportion; thinner lines indicate 95% confidence intervals.

Next we examined how emotional and physical satisfaction differed for individuals who engaged in first anal sex with a romantic partner, friend, or stranger (Figure 2). At all ages of onset, about 60% of those who initiated sex with a relationship partner reported emotional satisfaction. This was significantly greater than those who experienced emotional satisfaction with a friend between ages of onset 14–24 (ranging from 43–55%); however, emotional satisfaction was not significantly different for those who had sex with a friend compared to those who had sex with a romantic partner at age 24. Sex with a stranger was associated with the least emotional satisfaction (about 40% at all ages); this was significantly lower than for sex with both a romantic partner and a friend at all ages of onset. There were no differences in physical satisfaction between those who initiated with a romantic partner and a friend; however, physical satisfaction was lower with a stranger between ages of onset between 14 and 20 (about 75% for romantic partner/friend v. 60% for stranger); however, there were no significant differences after age 20.

Figure 2.

Estimated proportion of participants reporting physical and emotional satisfaction at first same-sex anal sex, by age and relationship with partner. Thicker lines indicate estimated proportion; thinner lines indicate 95% confidence intervals.

We then examined differences in physical and emotional satisfaction based on whether the participants had sex with this partner more than once. For those who had sex with a partner on more than one occasion, there was little difference in emotional satisfaction by age of onset (about 60% at all ages of onset). For those who only had sex with this partner on one occasion, only about 30–35% were emotionally satisfied from ages of onset between 14–23, after which emotional satisfaction increased peaking at about 50% at age 26. At age of onset of 26 there was no longer a significant difference between these groups. Physical satisfaction followed a similar pattern, with differences based on whether the individual had sex with the first partner more than once significant until an age of onset of 25.

Finally, we examined differences in emotional and physical satisfaction based on partner age (younger or within 4 years v. 5+ year or older). Participants who had sex with an older partner were less emotionally satisfied at ages of onset between 15 and 21, after which they did not differ from individuals with a partner closer in age. At ages of onset between 14 and 16 individuals who had sex with an older partner reported less physical satisfaction; however, there were no significant differences in physical satisfaction based partner age after age of onset of 16.

Discussion

This study examined how emotional and physical satisfaction at first same-sex anal sex and their correlates differed by age of onset for young gay and bisexual men. We found that overall rates of satisfaction were relatively high, with more than half of men reporting that their first anal sex was emotionally satisfying and more than two-thirds reporting it was physically satisfying. This is consistent with research on first vaginal intercourse in adolescence, which has also found relatively high rates of satisfaction or positive consequences (O’Sullivan & Hearn, 2008; Smiler et al., 2005; Tsui & Nicoladis, 2004; Vasilenko et al., 2015). Notably, there was little difference by age of onset in overall rates of physical and emotional satisfaction. According to several conceptual models of adolescent and emerging adult sexual well-being, these findings suggest that many gay and bisexual men’s first same-sex sexual experiences may contribute positively to their sexual development, well-being, and mental health (Espinosa-Hernández & Vasilenko, in press; Harden, 2014; Hensel & Fortenberry, 2013; Vasilenko et al., 2014). In addition, they suggest that despite potentially experiencing stigma and discrimination related to their sexual identity, gay and bisexual adolescents and young men are still able to experience physical and emotionally satisfying sexual relationships, even at relatively early ages in adolescence (Moreira, Halkitis, Kapadia, & Farzana, 2015; Morgan, 2014). In addition, young gay and bisexual men may view early sexual experiences as a way of confirming their sexual identity (Morgan, 2014; Savin-Williams, 1998). Thus, it is possible that positive first sexual experiences may aid individuals in their processes of identity development, and may contribute to a more positive sense of self and better well-being for sexual minority individuals. Future research should examine potential links between perceptions of sexual experiences and identity development and well-being in sexual minority individuals.

Although there were few overall differences in physical and emotional satisfaction by age of onset, there were differences in the role of partner relationship factors at different ages of onset. In general, men who reported greater physical or emotional satisfaction at first anal sex when they were in a relationship with their first partner, had sex with them on more than one occasion, and had a first partner close to their own age. These findings are also in line with research suggesting that sex within committed relationships and with an emotional connection are what gay men see as being most important for their ideal sex life (Bourne, Hammond, Reid, Schmidt, & Weatherburn, 2013). However, some of these differences were only significant at earlier ages of onset; in particular, most relationship status differences were non-significant for those who initiated in the early to mid-twenties, and differences in emotional satisfaction by partner age were only significant for ages of initiation in the teens to early twenties. These findings suggest that sexual behavior outside of a relationship context may be more acceptable at later ages of onset. The findings related to partner age are also particularly important, given that sex with an older partner may be more common among young sexual minority men, who have fewer potential same-age partners and see older partners as a way of connecting to the gay community (Arrington-Sanders, Leonard, Brooks, Celentano, & Ellen, 2013). In addition to the potentially increased HIV risk with older partners (Hurt et al., 2010), first anal sex with an older partner may be less emotionally satisfying for adolescents, although it is generally no less physically satisfying than sex with a partner closer in age.

Finally, it is important to note that while this study and other studies of adolescents and young adults have found that experiencing satisfaction and other positive consequences of first sex is common (Dewaele et al., 2016; Herdt & Boxer, 1993; O’Sullivan & Hearn, 2008; Smiler et al., 2005; Tsui & Nicoladis, 2004; Vasilenko et al., 2015), a sizable minority of individuals in this study were not physically or emotionally satisfied. Mixed or negative responses to first sex may, in part, reflect apprehension due to lack of experience with a new behavior (Vasilenko et al., 2015). However, negative messages adolescents receive about their sexual behavior may also play a role. For example, most sexuality education programs in the United States are focused on avoiding risks, a focus which may stigmatize sexual behaviors and not fully provide adolescents models by which to achieve sexual health and satisfaction (Bay-Cheng, 2003). This may be particularly true for LGBT young people who, in addition to growing up in a context in which their sexual orientation is stigmatized (Saewyc, 2011), are exposed to sexuality education programs that do not reflect their experiences or the sexual behaviors they engage in (Bay-Cheng, 2003; Pingel, Thomas, Harmell, & Bauermeister, 2013; Schalet etl al., 2014). Thus, programs that are more comprehensive and inclusive to differing sexual orientations may not only help in preventing risk behaviors, but may help adolescents have a more positive and satisfying sexual life by reducing stigma around sexual behaviors.

There are a number of limitations of this study that provide areas for future research. First, this study was retrospective, with young men recalling their first sexual experiences that occurred at different ages. Although this is common in studies of first sex (e.g., Higgins et al., 2010; Smiler et al., 2005; Tsui & Nicoladas, 2004), there may be differential recall bias depending upon the amount of time that passed between the survey and the event. Second, although research suggests individuals report mixed feelings about their first experience of vaginal sex (Smiler et al., 2005; Vasilenko, Espinosa-Hernández, & Halgunseth, 2016; Vasilenko et al., 2015), this study did not examine any potential negative emotional consequences of first anal sex, providing only a partial view of the experience. Because young men in this study were recruited from a sexual networking website the sample may not be representative of all young gay and bisexual men, thus limiting the generalizability of these findings. For example, it is possible that the data underrepresent gay and bisexual men who are in committed monogamous relationships, and it is possible that their experiences of first sex differ. In addition, although we were able to report on average age trends for our sample, there is likely heterogeneity in these responses by factors like sexual identity and current relationships or sexual behavior, and future research should consider these possibilities. Because of the relatively small percentage of racial/ethnic minority participants in the sample, we were unable to examine race/ethnicity as a moderator of all effects. Our preliminary results suggest relatively similar age-varying patterns of physical and emotional satisfaction for both white and racial/ethnic minority individuals. However, white individuals may have higher rates of satisfaction during late adolescence and emerging adulthood, and these patterns should be further examined in a sample with more racial/ethnic minority participants.

Data used for these analyses only included a satisfaction assessment for first anal intercourse. However, some gay men consider oral sex to constitute first sex or loss of virginity (Carpenter, 2005). Further, some gay and bisexual men may have their first sexual experience with women. Thus, restricting our study to first same-sex anal sex may not be capturing gay and bisexual men’s first sexual experiences. Future work should examine first sex more comprehensively through the evaluation of first experiences of oral sex, vaginal sex, and other behaviors with both men and women among young gay and bisexual men. In addition, this study only examined satisfaction with first anal sex, and future research could examine the impact of this event on future mental health or sexual functioning. We only examined experiences of gay and bisexual men, and future research should examine the first sexual experiences of sexual minority women and transgender individuals.

Despite these limitations, this study contributes to literature on the experience of first sexual behaviors in a number of ways. First, it uses a large, national sample of young gay and bisexual men, and suggests that many experience their first same-sex anal sex positively. Second, it examines the relationship contexts of first same-sex anal sex, suggesting the important role of the relationship with the first sexual partner in physical and emotional satisfaction, particularly at younger ages of onset. This suggests that similar factors influence sexual experiences in both heterosexual and sexual minority adolescents, providing support for calls to examine sexual behaviors in sexual minority adolescents as part of a broader framework of adolescent sexuality development (Halpern, 2011).

Figure 3.

Estimated proportion of participants reporting physical and emotional satisfaction at first same-sex anal sex, by age and whether or not they had sex with first sex partner more than once. Thicker lines indicate estimated proportion; thinner lines indicate 95% confidence intervals.

Figure 4.

Estimated proportion of participants reporting physical and emotional satisfaction at first same-sex anal sex, by age and age of first intercourse partner. Dashed lines indicate 95% confidence intervals.