Anal sex

An illustration of anal sex

Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person's anus, or anus and rectum, for sexual pleasure.[1][2][3] Other forms of anal sex include fingering, the use of sex toys for anal penetration, oral sex performed on the anus (anilingus), and pegging.[2][4][5] Though the term anal sex most commonly means penile-anal penetration,[1][2][4][6] sources sometimes use the term anal intercourse to refer exclusively to penile-anal penetration, and anal sex to refer to any form of anal sexual activity, especially between pairings as opposed to anal masturbation.[6][7]

While anal sex is commonly associated with male homosexuality, research shows that not all gay males engage in anal sex and that it is not uncommon in heterosexual relationships.[3][8][9][10] Types of anal sex can also be a part of lesbian sexual practices.[11] People may experience pleasure from anal sex by stimulation of the anal nerve endings, and orgasm may be achieved through anal penetration – by indirect stimulation of the prostate in men, indirect stimulation of the clitoris or an area of the vagina associated with the G-spot in women, and other sensory nerves (especially the pudendal nerve).[2][3][12][13] However, people may also find anal sex painful, sometimes extremely so,[14][15] which may be primarily due to psychological factors in some cases.[16]

As with most forms of sexual activity, anal sex participants risk contracting sexually transmitted infections (STIs/STDs). Anal sex is considered a high-risk sexual practice because of the vulnerability of the anus and rectum. The anal and rectal tissues are delicate and do not provide natural lubrication, so they can easily tear and permit disease transmission, especially if lubricant is not used.[1][3][17] Anal sex without protection of a condom is considered the riskiest form of sexual activity,[17][18][19] and therefore health authorities such as the World Health Organization (WHO) recommend safe sex practices for anal sex.[20]

Strong views are often expressed about anal sex. It is controversial in various cultures, especially with regard to religious prohibitions. This is commonly due to prohibitions against anal sex among males or teachings about the procreative purpose of sexual activity.[4][5][7] It may be regarded as taboo or unnatural, and is a criminal offense in some countries, punishable by corporal or capital punishment; by contrast, people also regard anal sex as a natural and valid form of sexual activity that may be as fulfilling as other desired sexual expressions. They may regard it as an enhancing element of their sex lives or as their primary form of sexual activity.[4][5][7]

Anatomy and stimulation

Male genital anatomy, showing the location of the prostate with respect to the rectum

The abundance of nerve endings in the anal region and rectum can make anal sex pleasurable for men or women.[2][3][5] The internal and external sphincter muscles control the opening and closing of the anus; these muscles, which are sensitive membranes made up of many nerve endings, facilitate pleasure or pain during anal sex.[3][5] The Human Sexuality: An Encyclopedia states that "the inner third of the anal canal is less sensitive to touch than the outer two-thirds, but is more sensitive to pressure" and that "the rectum is a curved tube about eight or nine inches long and has the capacity, like the anus, to expand".[5]

Research indicates that anal sex occurs significantly less frequently than other sexual behaviors,[8][21] but its association with dominance and submission, as well as taboo, makes it an appealing stimulus to people of all sexual orientations.[5][22][23] In addition to sexual penetration by the penis, people may use sex toys such as butt plugs or anal beads, engage in fingering, anilingus, pegging, anal masturbation or fisting for anal sexual activity, and different sex positions may also be included.[5][24] Fisting is the least practiced of the activities,[25] partly because it is uncommon that people can relax enough to accommodate an object as big as a fist being inserted into the anus.[5]

In a male receptive partner, being anally penetrated can produce a pleasurable sensation due to the inserted penis rubbing or brushing against the prostate (also known as the "male G-spot") through the anal wall.[2][12][26] This can result in pleasurable sensations and can lead to an orgasm in some cases.[2][12][26] Prostate stimulation can produce a "deeper" orgasm, sometimes described by men as more widespread and intense, longer-lasting, and allowing for greater feelings of ecstasy than orgasm elicited by penile stimulation only.[2][26] The prostate is located next to the rectum and is the larger, more developed male homologue (variation) to the female Skene's glands.[27] However, though the experiences are different, male orgasms by penile stimulation are also centered in the prostate gland.[28] It is also common, and likely most typical, that men will not reach orgasm as receptive partners solely from anal sex.[29]

General statistics indicate that 70–80% of women require direct clitoral stimulation to achieve orgasm.[26][30][31] The clitoris is composed of more than the externally visible glans (head). With its glans or body as a whole estimated to have around 8,000 sensory nerve endings,[3][32] the clitoris surrounds the vagina and urethra,[33] and may have a similar connection with the anus.[34] The vagina is flanked on each side by the clitoral crura, the internal "legs" of the clitoris, which are highly sensitive and become engorged with blood when sexually aroused.[33][35][36] In addition to nerve endings present within the anus and rectum, women may find anal stimulation pleasurable due to indirect stimulation of these "legs".[37] Indirect stimulation of the clitoris through anal penetration may also be caused by the shared sensory nerves, especially the pudendal nerve, which gives off the inferior anal nerves and divides into two terminal branches: the perineal nerve and the dorsal nerve of the clitoris.[2]

The Gräfenberg spot, or G-spot, is a debated area of female anatomy, particularly among doctors and researchers,[38][39][40] but it is typically described as being located behind the female pubic bone surrounding the urethra and accessible through the anterior wall of the vagina; it and other areas of the vagina are considered to have tissue and nerves that are related to the clitoris.[33][38][39] Besides the shared anatomy of the aforementioned sensory nerves, orgasm by indirect stimulation of the clitoris or G-spot area through anal penetration is possible because of the close proximity between the vaginal cavity and the rectal cavity.[13][25] Achieving orgasm solely by anal stimulation is rare among women.[41][42] Direct stimulation of the clitoris, a G-spot area, or both, during anal sex can help some women enjoy the activity and reach orgasm from it.[3][13]

Stimulation from anal sex can additionally be affected by popular perception or portrayals of the activity, such as erotica or pornography. In pornography, anal sex is commonly portrayed as a desirable, painless routine that does not require personal lubricant; this can result in couples performing anal sex without care, and men and women believing that it is unusual for women, as receptive partners, to find discomfort or pain instead of pleasure from the activity.[6][43][44][45] By contrast, each person's sphincter muscles react to penetration differently, the anal sphincters have tissues that are more prone to tearing, and the anus and rectum, unlike the vagina, do not provide natural lubrication for sexual penetration. Researchers say adequate application of a personal lubricant, relaxation, and communication between sexual partners are crucial to avoid pain or damage to the anus or rectum.[3][15][46] Additionally, ensuring that the anal area is clean and the bowel is empty, for both aesthetics and practicality, may be desired by participants.[4][25]

Male to female

Behaviors and views

1892 lithograph by Paul Avril depicting male-to-female anal sex

The anal sphincters are usually tighter than the pelvic muscles of the vagina, which can enhance the sexual pleasure for the inserting male during male-to-female anal intercourse because of the pressure applied to the penis.[1][13][22] Men may also enjoy the penetrative role during anal sex because of its association with dominance, because it is made more alluring by a female partner or society in general insisting that it is forbidden, or because it presents an additional option for penetration.[5][22]

While some women find being a receptive partner during anal intercourse painful or uncomfortable, or only engage in the act to please a male sexual partner, other women find the activity pleasurable or prefer it to vaginal intercourse.[6][13][47][48] The vaginal walls contain significantly fewer nerve endings than the clitoris and anus, and therefore intense sexual pleasure, including orgasm, from vaginal sexual stimulation is less likely to occur than from direct clitoral stimulation in the majority of women.[38][39][49] However, anal sexual stimulation is not necessarily more likely to result in orgasm than vaginal sexual stimulation; the types of nerves and how they interact with each other are factors,[2] as the belief that there is complete separation between the vagina and clitoris is a misconception aided by misunderstandings of what and how big the clitoris actually is.[33][34][39]

In a 2010 clinical review article of heterosexual anal sex, the term anal intercourse is used to refer specifically to penile-anal penetration, and anal sex is used to refer to any form of anal sexual activity. The review suggests that anal sex is exotic among the sexual practices of some heterosexuals and that "for a certain number of heterosexuals, anal intercourse is pleasurable, exciting, and perhaps considered more intimate than vaginal sex".[6]

Anal intercourse is sometimes used as a substitute for vaginal intercourse during menstruation.[5] The likelihood of pregnancy occurring during anal sex is greatly reduced, as anal sex alone cannot lead to pregnancy unless sperm is somehow transported to the vaginal opening. Because of this, some couples practice anal intercourse as a form of contraception, often in the absence of a condom.[5][43][50]

Male-to-female anal sex is commonly viewed as a way of preserving female virginity because it is non-procreative and does not tear the hymen; a person, especially a teenage girl or woman, who engages in anal sex or other sexual activity with no history of having engaged in vaginal intercourse is often regarded among heterosexuals and researchers as not having yet experienced virginity loss. This is sometimes termed technical virginity.[51][52][53][54] Heterosexuals may view anal sex as "fooling around" or as foreplay, a view that "dates to the late 1600s, with explicit 'rules' appearing around the turn of the twentieth century, as in marriage manuals defining petting as 'literally every caress known to married couples but does not include complete sexual intercourse'".[51]


In 1992, a study conducted by the U.S. Centers for Disease Control and Prevention (CDC) found that 26% of men 18 to 59 and 20% of women 18 to 59 had engaged in heterosexual anal sex; a similar 2005 survey (also conducted by the U.S. Centers for Disease Control and Prevention) found a rising incidence of anal sex relations in the American heterosexual population. The survey showed that 40% of men and 35% of women between 25 and 44 had engaged in heterosexual anal sex.[55] In terms of overall numbers of survey respondents, seven times as many women as gay men said that they engaged in anal intercourse, with this figure reflecting the larger heterosexual population size.[56]

In a 2007 report regarding the prevalence and correlates of heterosexual anal and oral sex among adolescents and adults in the United States, a National Survey of Family Growth (NSFG) found that 34% men and 30% women reported ever participating in heterosexual anal sex. The percentage of participants reporting heterosexual anal sex was significantly higher among 20- to 24-year-olds and peaked among 30- to 34-year-olds.[57] A 2008 survey focused on a younger demographic of teenagers and young adults, aged 15–21. It found that 16% of 1350 surveyed had had this type of sex in the previous 3 months, with condoms being used 29% of the time.[58] However, given the subject matter, the survey hypothesized the prevalence was probably underestimated.

In Kimberly R. McBride's 2010 clinical review on heterosexual anal intercourse and other forms of anal sexual activity, it is suggested that changing norms may affect the frequency of heterosexual anal sex. McBride and her colleagues investigated the prevalence of non-intercourse anal sex behaviors among a sample of men (n=1,299) and women (n=1,919) compared to anal intercourse experience and found that 51% of men and 43% of women had participated in at least one act of oral–anal sex, manual–anal sex, or anal sex toy use.[6] The report states the majority of men (n=631) and women (n=856) who reported heterosexual anal intercourse in the past 12 months were in exclusive, monogamous relationships: 69% and 73%, respectively.[6] The review added that "most research on anal intercourse addresses men who have sex with men (MSM), with relatively little attention given to anal intercourse and other anal sexual behaviors between heterosexual partners" and "[r]esearch is quite rare that specifically differentiates the anus as a sexual organ or addresses anal sexual function or dysfunction as legitimate topics. As a result, we do not know the extent to which anal intercourse differs qualitatively from coitus."[6]

According to a 2010 study from the National Survey of Sexual Health and Behavior (NSSHB) that was authored by Debby Herbenick and other researchers, although anal intercourse is reported by fewer women than other partnered sex behaviors, partnered women in the age groups between 18–49 are significantly more likely to report having anal sex in the past 90 days.[59] As of 2011, this survey provides the most up to date data about anal sex at the population level.

Figures for prevalence can vary among different demographics, regions and nationalities. A 1999 South Korean survey of 586 women documented that 3.5% of the respondents reported having had anal sex.[60] By contrast, a 2001 French survey of five hundred female respondents concluded that a total of 29% had engaged in this practice, with one third of these confirming to have enjoyed the experience.[61]

Figures for the prevalence of sexual behavior can also fluctuate over time. Edward O. Laumann's 1992 survey, reported in The Social Organization of Sexuality: Sexual Practices in the United States, found that about 20% of heterosexuals had engaged in male-to-female anal sex. Sex researcher Alfred Kinsey, working in the 1940s, had found that number to be closer to 40% at the time. A researcher from the University of British Columbia in 2005 put the number of heterosexuals who have engaged in this practice at between 30% and 50%.[62] According to Columbia University's health website Go Ask Alice!: "Studies indicate that about 25 percent of heterosexual couples have had anal sex at least once, and 10 percent regularly have anal penetration."[8] The increase of anal sexual activity among heterosexuals has also been linked to the increase in anal pornography, especially if a person views it more regularly than a person who does not.[4][44][45][63]

Male to male

Behaviors and views

19th-century erotic interpretation of Hadrian and Antinous (detail), by Paul Avril

Historically, anal sex has been commonly associated with male homosexuality. However, many gay men and men who have sex with men in general (those who identify as gay, bisexual, heterosexual or have not identified their sexual identity) do not engage in anal sex.[8][10][64][65] Among men who have anal sex with other men, the insertive partner may be referred to as the top and the one being penetrated may be referred to as the bottom. Those who enjoy either role may be referred to as versatile.[66][67]

Gay men who prefer anal sex may view it as their version of intercourse and a natural expression of intimacy that is capable of providing pleasure.[23][64][68] The notion that it might resonate with gay men with the same emotional significance that vaginal sex resonates with heterosexuals has also been considered.[68][69] Some men who have sex with men, however, believe that being a receptive partner during anal sex questions their masculinity.[70][71]

Men who have sex with men may also prefer to engage in frot or other forms of mutual masturbation because they find it more pleasurable or more affectionate, to preserve technical virginity, or as safe sex alternatives to anal sex,[64][66][72][73] while other frot advocates denounce anal sex as degrading to the receptive partner and unnecessarily risky.[69][72][74]


Reports with regard to the prevalence of anal sex among gay men in the west have varied over time. Magnus Hirschfeld, in his 1914 work The Homosexuality of Men and Women, reported the rate of anal sex among gay men surveyed to be 8%, the least favored of all the practices documented.[75] By the 1950s in the United Kingdom, it was thought that about 15% of gay males had anal sex.[76]

Similar to the Hirschfeld study, scholars state that oral sex and mutual masturbation are more common than anal stimulation among gay men in long-term relationships.[8][64] They say that anal intercourse is generally more popular among gay male couples than among heterosexual couples, but that "it ranks behind oral sex and mutual masturbation" among both sexual orientations in prevalence.[21] Wellings et al. reported that "the equation of 'homosexual' with 'anal' sex among men is common among lay and health professionals alike" and that "yet an Internet survey of 18,000 MSM across Europe (EMIS, 2011) showed that oral sex was most commonly practised, followed by mutual masturbation, with anal intercourse in third place".[10] A 2011 survey by The Journal of Sexual Medicine found similar results for U.S. gay and bisexual men.[77]

Various older studies on male-to-male anal sex differ significantly. The 1994 Laumann study suggests that 80% of gay men practice anal sex and 20% never engage in it at all.[78] A survey in The Advocate in 1994 indicated that 46% of gay men preferred to penetrate their partners, while 43% preferred to be the receptive partner.[66] A survey conducted from 1994 to 1997 in San Francisco by the Stop AIDS Project indicated that over the course of the study, among men who have sex with men instead of solely gay men, the proportion engaging in anal sex increased from 57.6% to 61.2%.[79] The National Institutes of Health (NIH), with their report published in the BMJ in 1999, stated that two thirds of gay men have anal sex.[9] Other sources suggest that roughly three-fourths of gay men have had anal sex at one time or another in their lives, with an equal percentage participating as tops and bottoms.[66]

Female to male

A woman wearing a strap-on dildo about to engage in anal sex with a man.

Women may sexually stimulate a man's anus by fingering the exterior or interior areas of the anus; they may also stimulate the perineum (which, for males, is between the base of the scrotum and the anus), massage the prostate or engage in anilingus.[5][25][80] Sex toys, such as a dildo, may also be used.[5][25] The practice of a woman penetrating a man's anus with a strap-on dildo for sexual activity is called pegging.[24][81]

Commonly, heterosexual men reject the idea of being receptive partners during anal sex because they believe it is a feminine act, can make them vulnerable, or contradicts their sexual orientation (for example, that it is indicative that they are gay).[25][71] National Institutes of Health (NIH) information published in the BMJ in 1999, however, states:

There are little published data on how many heterosexual men would like their anus to be sexually stimulated in a heterosexual relationship. Anecdotally, it is a substantial number. What data we do have almost all relate to penetrative sexual acts, and the superficial contact of the anal ring with fingers or the tongue is even less well documented but may be assumed to be a common sexual activity for men of all sexual orientations.[9]

Reece et al. reported in 2010 that receptive anal intercourse is infrequent among men overall, stating that "an estimated 7% of men 14 to 94 years old reported being a receptive partner during anal intercourse".[82]

Female to female

A woman performing anilingus (anal–oral sex) on another woman.

With regard to lesbian sexual practices, anal sex includes fingering, use of a dildo or other sex toys, or anilingus.[11][83] Some lesbians do not like anal sex,[84] and anilingus is less often practiced among female same-sex couples.[85][86]

There is less research on anal sexual activity among women who have sex with women compared to couples of other sexual orientations. In 1987, a non-scientific study (Munson) was conducted of more than 100 members of a lesbian social organization in Colorado. When asked what techniques they used in their last ten sexual encounters, lesbians in their 30s were twice as likely as other age groups to engage in anal stimulation (with a finger or dildo).[3] While author Tom Boellstorff, when particularly examining anal sex among gay and lesbian individuals in Indonesia, stated that he had not heard of oral-anal contact or anal penetration as recognized forms of lesbian sexuality but assume they take place,[87] author Felice Newman, in The Whole Lesbian Sex Book, cites anal sex as a part of lesbian sexual practices.[11] A 2014 study of partnered lesbian women in Canada and the U.S. found that 7% engaged in anal stimulation or penetration at least once a week; about 10% did so monthly and 70% did not at all.[88]

Health risks

General risks

Mucous membranes of the rectum

Anal sex can expose its participants to two principal dangers: infections due to the high number of infectious microorganisms not found elsewhere on the body, and physical damage to the anus and rectum due to their fragility.[17][19] Unprotected penile-anal penetration, colloquially known as barebacking,[89] carries a higher risk of passing on sexually transmitted infections (STIs/STDs) because the anal sphincter is a delicate, easily torn tissue that can provide an entry for pathogens.[17][19] The high concentration of white blood cells around the rectum, together with the risk of tearing and the colon's function to absorb fluid, are what place those who engage in anal sex at high risk of STIs.[19] Use of condoms, ample lubrication to reduce the risk of tearing,[3][46] and safer sex practices in general, reduce the risk of STI transmission.[19][90] However, a condom can break or otherwise come off during anal sex, and this is more likely to happen with anal sex than with other sex acts because of the tightness of the anal sphincters during friction.[19] As with other sexual practices, people without sound knowledge about the sexual risks involved are susceptible to STIs; for example, because of their definitions of sexual activity and virginity loss, teenagers may consider vaginal intercourse riskier than anal intercourse and believe that a STI can only result from vaginal intercourse.[91][92]

Unprotected receptive anal sex (with an HIV positive partner) is the sex act most likely to result in HIV transmission.[17][18][19] Other infections that can be transmitted by unprotected anal sex are human papillomavirus (HPV) (which can increase risk of anal cancer[93]); typhoid fever;[94] amoebiasis; chlamydia;[18] cryptosporidiosis; E. coli infections; giardiasis; gonorrhea;[18] hepatitis A; hepatitis B; hepatitis C; herpes simplex;[18] Kaposi's sarcoma-associated herpesvirus (HHV-8);[95] lymphogranuloma venereum; Mycoplasma hominis; Mycoplasma genitalium; pubic lice;[18] salmonellosis; shigella; syphilis;[18] tuberculosis; and Ureaplasma urealyticum.[96]

There are a variety of factors that make male-to-female anal intercourse riskier for a female than for a male. For example, besides the risk of HIV transmission being higher for anal intercourse than for vaginal intercourse,[1][97][98] the risk of injury to the woman during anal intercourse is significantly higher than the risk of injury to her during vaginal intercourse because of the durability of the vaginal tissues compared to the anal tissues.[1][99][100] Additionally, if a man moves from anal intercourse immediately to vaginal intercourse without a condom or without changing it, infections can arise in the vagina (or urinary tract) due to bacteria present within the anus; these infections can also result from switching between vaginal sex and anal sex by the use of fingers or sex toys.[1][3][101]

Though anal sex alone does not lead to pregnancy, pregnancy can still occur with anal sex or other forms of sexual activity if the penis is near the vagina (such as during intercrural sex or other genital-genital rubbing) and its sperm is deposited near the vagina's entrance and travels along the vagina's lubricating fluids; the risk of pregnancy can also occur without the penis being near the vagina because sperm may be transported to the vaginal opening by the vagina coming in contact with fingers or other non-genital body parts that have come in contact with semen.[102][103]

Pain during receptive anal sex among gay men (or men who have sex with men) is formally known as anodyspareunia.[15] One study found that about 12% of gay men find it too painful to pursue receptive anal sex, and concluded that the perception of anal sex as painful is as likely to be psychologically or emotionally based as it is to be physically based.[104] Another study that examined pain during insertive and receptive anal sex in gay men found that 3% of tops (insertive partners) and 16% of bottoms (receptive partners) reported significant pain.[105] Factors predictive of pain during anal sex include inadequate lubrication, feeling tense or anxious, lack of stimulation, as well as lack of social ease with being gay and being closeted. Research has found that psychological factors can in fact be the primary contributors to the experience of pain during anal intercourse and that adequate communication between sexual partners can prevent it, countering the notion that pain is always inevitable during anal sex.[15][16][104][105]

Physical damage and cancer

Anal sex can exacerbate hemorrhoids and therefore result in bleeding; in other cases, the formation of a hemorrhoid is attributed to anal sex.[1][106] If bleeding occurs as a result of anal sex, it may also be because of a tear in the anal or rectal tissues (an anal fissure) or perforation (a hole) in the colon, the latter of which being a serious medical issue that should be remedied by immediate medical attention.[1][106] Because of the rectum's lack of elasticity, the anal mucous membrane being thin, and small blood vessels being present directly beneath the mucous membrane, tiny tears and bleeding in the rectum usually result from penetrative anal sex, though the bleeding is usually minor and therefore usually not visible.[19] By contrast to other anal sexual behaviors, anal fisting poses a more serious danger of damage due to the deliberate stretching of the anal and rectal tissues; anal fisting injuries include anal sphincter lacerations and rectal and sigmoid colon (rectosigmoid) perforation, which might result in death.[5][107]

Repetitive penetrative anal sex may result in the anal sphincters becoming weakened, which may cause rectal prolapse or affect the ability to hold in feces (a condition known as fecal incontinence).[1][106] Rectal prolapse is relatively uncommon, however, especially in men, and its causes are not well understood.[108][109] Kegel exercises have been used to strengthen the anal sphincters and overall pelvic floor, and may help prevent or remedy fecal incontinence.[1][110] A 1993 study indicated that fourteen out of a sample of forty men receiving anal intercourse experienced episodes of frequent fecal incontinence.[111] However, a 1997 study found no difference in levels of fecal incontinence between gay men who engaged in anal sex and heterosexual men who did not, and criticized the earlier study for its inclusion of flatulence in its definition of fecal incontinence.[112]

Most cases of anal cancer are related to infection with the human papilloma virus (HPV). Anal sex alone does not cause anal cancer; the risk of anal cancer through anal sex is attributed to HPV infection, which is often contracted through unprotected anal sex.[93] Anal cancer is relatively rare, and significantly less common than cancer of the colon or rectum (colorectal cancer); the American Cancer Society states that it affects approximately 7,060 people (4,430 in women and 2,630 in men) and results in approximately 880 deaths (550 in women and 330 in men) in the United States, and that, though anal cancer has been on the rise for many years, it is mainly diagnosed in adults, "with an average age being in the early 60s" and it "affects women somewhat more often than men."[93] Though anal cancer is serious, treatment for it is "often very effective" and most anal cancer patients can be cured of the disease; the American Cancer Society adds that "receptive anal intercourse also increases the risk of anal cancer in both men and women, particularly in those younger than the age of 30. Because of this, men who have sex with men have a high risk of this cancer."[93]

Other cultural views


Depiction of anal sex on 510 BC Attic red-figure kylix
Suzuki Harunobu, A shunga print depicting an older and a younger man

Different cultures have had different views on anal sex throughout human history, with some cultures more positive about the activity than others.[5][63][113] Historically, anal sex has been restricted or condemned, especially with regard to religious beliefs; it has also commonly been used as a form of domination, usually with the active partner (the one who is penetrating) representing masculinity and the passive partner (the one who is being penetrated) representing femininity.[5][7][63] A number of cultures have especially recorded the practice of anal sex between males, and anal sex between males has been especially stigmatized or punished.[7][68][114] In some societies, if discovered to have engaged in the practice, the individuals involved were put to death, such as by decapitation, burning, or mutilation.[5]

Although anal sex has been more accepted in modern times, and is often considered a natural, pleasurable form of sexual expression,[5][7][63][113] with some people, men in particular, only interested in anal sex for sexual satisfaction,[63] engaging in the act is still punished in some societies.[7][115] For example, regarding LGBT rights in Iran, Iran's Penal Code states in Article 109 that "both men involved in same-sex penetrative (anal) or non-penetrative sex will be punished" and "Article 110 states that those convicted of engaging in anal sex will be executed and that the manner of execution is at the discretion of the judge".[115]

Ancient and non-Western cultures

The term Greek love has long been used to refer to anal intercourse, and in modern times, "doing it the Greek way" is sometimes used as slang for anal sex.[116] Ancient Greeks accepted romantic or sexual relationships between males as a balanced sex life (having males and women as lovers), and they considered this "normal (as long as one partner was an adult and the other was aged between twelve and fifteen)".[117]

Male-male anal sex was not a universally accepted practice in Ancient Greece; it was the target of jokes in some Athenian comedies.[118] Aristophanes, for instance, mockingly alludes to the practice, claiming, "Most citizens are europroktoi (wide-arsed) now."[119] The terms kinaidos, europroktoi, and katapygon were used by Greek residents to categorize men who chronically[120] practiced passive anal intercourse.[121] While pedagogic pederasty was an essential element in the education of male youths, these relationships, at least in Athens and Sparta, were expected to steer clear of penetrative sex of any kind. There are few works of pottery or other art that display anal sex between men and adolescent boys, let alone between adult men. Greek artwork of sexual interaction between men and boys usually depicted fondling or intercrural sex, which was not condemned for violating or feminizing boys,[122] while male-male anal intercourse was usually depicted between males of the same age-group.[123] Intercrural sex was not considered penetrative and two males engaging in it was considered a "clean" act.[118] Some sources explicitly state that anal sex between men and boys was criticized as shameful and seen as a form of hubris.[122][124] Nonetheless, evidence suggests that the younger partner in pederastic relationships (i.e., the eromenos) did engage in receptive anal intercourse so long as no one accused him of being 'feminine'.[125]

Two Roman males on the Warren Cup, British Museum

In later Roman-era Greek poetry, anal sex became a common literary convention, represented as taking place with "eligible" youths: those who had attained the proper age but had not yet become adults. Seducing those not of proper age (for example, non-adolescent children) into the practice was considered very shameful for the adult, and having such relations with a male who was no longer adolescent was considered more shameful for the young male than for the one mounting him; Greek courtesans, or hetaerae, are said to have frequently practiced male-female anal intercourse as a means of preventing pregnancy.[126]

A male citizen taking the passive (or receptive) role in anal intercourse (paedicatio in Latin) was condemned in Rome as an act of impudicitia (immodesty or unchastity); free men, however, frequently took the active role with a young male slave, known as a catamite or puer delicatus. The latter was allowed because anal intercourse was considered equivalent to vaginal intercourse in this way; men were said to "take it like a woman" (muliebria pati, "to undergo womanly things") when they were anally penetrated, but when a man performed anal sex on a woman, she was thought of as playing the boy's role.[127] Likewise, women were believed to only be capable of anal sex or other sex acts with women if they possessed an exceptionally large clitoris or a dildo.[127] The passive partner in any of these cases was always considered a woman or a boy because being the one who penetrates was characterized as the only appropriate way for an adult male citizen to engage in sexual activity, and he was therefore considered unmanly if he was the one who was penetrated; slaves could be considered "non-citizen".[127] Although Roman men often availed themselves of their own slaves or others for anal intercourse, Roman comedies and plays presented Greek settings and characters for explicit acts of anal intercourse, and this may be indicative that the Romans thought of anal sex as something specifically "Greek".[128]

Man and woman having anal sex. Ceramic, Moche Culture. 300 C.E. Larco Museum Collection

In Japan, records (including detailed shunga) show that some males engaged in penetrative anal intercourse with males,[129] and evidence suggestive of widespread male-female anal intercourse in a pre-modern culture can be found in the erotic vases, or stirrup-spout pots, made by the Moche people of Peru; in a survey, of a collection of these pots, it was found that 31 percent of them depicted male-female anal intercourse significantly more than any other sex act.[130] Moche pottery of this type belonged to the world of the dead, which was believed to be a reversal of life. Therefore, the reverse of common practices was often portrayed. The Larco Museum houses an erotic gallery in which this pottery is showcased.[131]

19th century anthropologist Richard Francis Burton theorized that there is a geographical Sotadic zone wherein penetrative intercourse between males is particularly prevalent and accepted; moreover he was one of the first writers to advance the premise that such an orientation is biologically determined.[132]

Western cultures

In many western countries, anal sex has generally been taboo since the Middle Ages, when heretical movements were sometimes attacked by accusations that their members practiced anal sex among themselves.[133] At that time, celibate members of the Christian clergy were accused of engaging in "sins against nature", including anal sex.[134]

The term buggery originated in medieval Europe as an insult used to describe the rumored same-sex sexual practices of the heretics from a sect originating in Bulgaria, where its followers were called bogomils;[135] when they spread out of the country, they were called buggres (from the ethnonym Bulgars).[135] Another term for the practice, more archaic, is pedicate from the Latin pedicare, with the same meaning.[136]

The Renaissance poet Pietro Aretino advocated anal sex in his Sonetti Lussuriosi (Lust Sonnets).[137] While men who engaged in homosexual relationships were generally suspected of engaging in anal sex, many such individuals did not. Among these, in recent times, have been André Gide, who found it repulsive;[138] and Noël Coward, who had a horror of disease, and asserted when young that "I'd never do anything – well the disgusting thing they do – because I know I could get something wrong with me".[139]


François-Rolland Elluin, Sodomites provoking divine wrath, from Le pot-pourri (1781)
Further information: Sodomy
Ottoman illustration depicting two young men having sex (from Sawaqub al-Manaquib)


The Mishneh Torah, a text considered authoritative by Orthodox Jewish sects,[140] states "since a man’s wife is permitted to him, he may act with her in any manner whatsoever. He may have intercourse with her whenever he so desires and kiss any organ of her body he wishes, and he may have intercourse with her naturally or unnaturally [traditionally, unnaturally refers to anal and oral sex], provided that he does not expend semen to no purpose. Nevertheless, it is an attribute of piety that a man should not act in this matter with levity and that he should sanctify himself at the time of intercourse."[141]


Christian texts may sometimes euphemistically refer to anal sex as the peccatum contra naturam (the sin against nature, after Thomas Aquinas) or Sodomitica luxuria (sodomitical lusts, in one of Charlemagne's ordinances), or peccatum illud horribile, inter christianos non nominandum (that horrible sin that among Christians is not to be named).[142][143][144]


Liwat, or the sin of Lot's people, which has come to be interpreted as referring generally to same-sex sexual activity, is commonly officially prohibited by Islamic sects; there are parts of the Quran which talk about smiting on Sodom and Gomorrah, and this is thought to be a reference to unnatural sex, and so there are hadith and Islamic laws which prohibit it.[145] While, concerning Islamic belief, it is objectionable to use the words al-Liwat and luti to refer to homosexuality because it is blasphemy toward the prophet of Allah, and therefore the terms sodomy and homosexuality are preferred,[146] same-sex male practitioners of anal sex are called luti or lutiyin in plural and are seen as criminals in the same way that a thief is a criminal, meaning that they are giving in to a universal temptation.[146][147]


The most common formulation of Buddhist ethics is the Five Precepts. These precepts take the form of voluntary, personal undertakings, not divine mandate or instruction. The third of the Precepts is "To refrain from committing sexual misconduct".[148] However, "sexual misconduct" (Sanskrit: Kāmesu micchācāra, literally "sense gratifications arising from the 5 senses") is subject to interpretation relative to the social norms of the followers.[149] Buddhism, in its fundamental form, does not define what is right and what is wrong in absolute terms for lay followers. Therefore, the interpretation of what kinds of sexual activity are acceptable for a layman is not a religious matter as far as Buddhism is concerned.[150]


Although Hindu society does not formally acknowledge sexuality between men, it formally acknowledges and gives space to sexuality between men and third genders as a variation of male-female sex (meaning a part of heterosexuality, rather than homosexuality, if analyzed in western terms). Hijras, Alis, Kotis, etc. (the various forms of third gender that exist in India today) are all characterized by the gender role of having receptive anal and oral sex with men. However, sexuality between males (as distinct from third genders) has thrived, mostly unspoken and informally, without being seen as different in the way it is seen in the west; young men involved in "such relationships do not consider themselves to be 'homosexual' but conceive their behavior in terms of sexual desire, opportunity and pleasure".[151]

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