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Sex is ?? ?????? ??????? ???????? ?? ???????one of life’s greatest pleasures and yet, in 2019, NATSAL (National Surveys of Sexual Attitudes and Lifestyles), reported that sexual frequency was in decline. Answers surrounding why we aren’t having as much sexare more complicated than just what the data is telling us. So perhaps we need to pose a new question. Should we be treating this trend as a public health concern? And, what could we learn about our health if we did?

You’d be forgiven for thinking that the world of late currently resembles something of a Margaret Atwood dystopia. Across the globe, we’ve been dished out once-in-a-lifetime event after once-in-a-lifetime event. There's an ongoing climate crisismaking predictions of certain doom a hot, sticky reality; the ever-present COVID-19 pandemic, on top of 14 years of austerity measures; devastating yet reoccurring stories of violence against women and people of marginalised genders; monkeypox; the cost of living crisis;and the biggest drop in the standard ofliving since the ‘50s.

It’s easy to see why many of us might be feeling disinterested in sex. If you’re feeling a little less frisky than usual yourself, know you’re in good company. Between 34 and 35.6 percent of women have reported that a lack of interest in sex is one of the most common sexual problem they face, according to a studyconducted by the International Journal of Sexual Health in 2019. In fact, our urge to jump under covers has steeply declined since 2008. 

Collectively, we’ve had it rough. With a consistent stream of new-normals (that feel anything but normal) paired with rising rates of depression and anxiety, it’s easy to see how these macro events are impacting us personally. It’s been pretty unforgiving, for all of us*. Well, mostly, (*cough cough — party gate — cough*). 

But, what can we learn about these reports of declining sexual frequency? Simply put, the decline in sexual frequency points to a disquieting trendwith wider implications associated with public health. 

Why sexual frequency matters in public health

Public health is made up of numerous markerssuch as reports of disease, injury, mental health, and healthcare resources. These help to determine changes and trends like rising birth rates, the state of mental health, the greying of the population (i.e. how many people are getting older and living in old age), and life expectancy. So, where does sexual frequency fit into this?

"Sexual frequency is a marker that one can use for measuring public health," says Dr. Olwen  Williams, consultant in sexual health and HIV medicine at Betsi Cadwalader University Health Board. Williams suggests that, for a complete health picture, we need to include sexual health and quality of sex to understand public health better.

Sex is one of the most natural of human urges. It’s how we express love, passion, desire and companionship. We communicate through sex with our partners and with ourselves. It impacts our sense of self, affecting things like our self-esteem and self-image, both positively and negatively.

Sex is a spectrum of experiences, ranging from sensual touching and threesomes to solo play, mutual masturbation, anal sex, and so much more. Pleasure is the measure of quality sex, though it doesn’t always need to involve climax. Orgasms are without a doubt earth-shatteringly fantastic, but they’re not the be-all and end-all of sex. Pleasure and sex can involve vibrators, slippery lubes, and deliciously filthy language. So, when researchers say fewer people are having sex, they include all of this really great stuff too. And, that matters. 

The connection between sexual frequency and public health is symbiotic, according to Williams. If reports of holistic sexual frequency are high, it points to a society that has good standards of care, stable living standards, and a general sense of feeling safe. Vice versa, if people aren’t having as much hashtag-good-sex, it could mean the populous is generally under immense mental and physical health strains. Focusing our attention on when people are having satisfying sex could help us predict more than just how people feel. Data is already proven to help NHS and governments prepare for health trends and provide better care for thingslike depression and anxiety,two of the largest mental health contributors to presenteeism and absenteeism, which costs the UK’s economy  £15.1 billion a year. So, why should information about the quality of our sex lives be forgotten if it has the potential to aid in better understanding our full wellness profile?

Sex is a missing part of the public health puzzle

For things to change our social discourse surrounding sex, however, shame and judgement need a reckoning. Education and campaigning for more authentic education surrounding sexual encounters has proven to dismantle shame, judgement and more serious matters, such as assaults, which disproportionately affect marginalised genders, Black and POC womenfrom low-income households. However, initiatives that offer moretransparent education surrounding sexhave previously been met with pearl-clutching-protest— despite the benefits, and despite reports by the Sex Education Forumthat young people have shocking gaps in their knowledge when it comes to sex and relationship education. 

But it’s not just young people experiencing concerning levels of social censorship, as Williams explains: "I think probably most people are very ‘British’ and they don't talk about their sexual desires and needs as they get older, and therefore if they don't have those conversations there is an unmet need. This can cause distress," she tells Mashable. 

She’s not wrong. According to studies by condom brand Durex, 63 percent of people they surveyed say that self love and sex toys are taboo topics, while ​half of those surveyed wouldn’t dream of telling their partner(s) about masturbation needs. However, 47 percent wished that they had more confidence to achieve what they wanted sexually. There is a clear disconnect between what we want and what we’re willing to admit to wanting.

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So, how can we make it better? Williams thinks the first step is that all health practitioners — regardless of specialty — need to get comfortable discussing patients' sexualities. Williams works in sexual health, so that's typical in her field. 

"In all areas where people might visit with psychological or physical problems that are related to a person's sexuality and their psychological wellbeing," Williams explains.

The key to this understanding, Williams suggests, is more data that is truly representative of desire and libido, as well as actual sexual activity that is inclusive of the good, the bad, and the ugly. 

"We need to understand what sexual activity looks like," she says. "I think people forget that we’re inherently sexual beings. By doing extensive surveys of the general population across the board, we’d really get that bottom line of what people are actually up to. How we express our sexuality and gain pleasure is fundamental to us as humans. We need to know if the 70-year-old single woman still uses her vibrator. We might think she's a sexually inactive person, but she might actually be having a whale of a time."

Understanding a fuller health picture that includes sexual frequency, intimacy and what pleasure looks like to different people could be part of the puzzle we’re missing when it comes to figuring out how to be a healthier, happier society. 

But, one thing’s for certain: without dismantling the structures that prevent a renaissance-like reexamination of public health, sexual frequency will remain a footnote in our societal wellbeing story.