What is sex and sexual activity?

Sexual activity looks different for different people. It might include kissing, touching, oral sex, mutual masturbation, vaginal sex, anal sex, or other forms of intimate contact. There is no single “right” way for sex to look, as long as everyone involved is safe, respected, and freely consenting. 

it’s important to understand that what is considered sex may vary based on culture, personal beliefs, and individual preferences. Generally, when people talk about sex, they are referring to activities where there is physical contact with the genitals for the purpose of pleasure, making babies, or bonding.

Some people define sex based on:

• Penetration: This typically refers to vaginal or anal intercourse, but can also include penetration with fingers or other object
• Non-penetrative acts: Some people consider oral sex or mutual masturbation as forms of sex because they involve intimate sexual behavior and can lead to sexual pleasure.
• Genital contact: This may include touching, rubbing, oral sex, or other contact involving genitals
• Pleasure and intimacy: Some people define sex by the level of intimacy, arousal or sexual meaning involved, rather than by one specific act.

It’s important to remember that sex is something personal, and people should feel comfortable with their own definitions of what it is, as well as respecting others’ boundaries and choices.

Sex should also be mutually respectful and, ideally, mutually enjoyable. In some heterosexual relationships, people may assume that sex “ends” when the man ejaculates. It does not have to work that way. Sex is not just about one person’s orgasm or ejaculation. It should be a shared experience where people communicate, check in with each other, and stop when everyone involved wants to stop. This may be after orgasm, before orgasm, or without anyone orgasming at all.

Queer sex refers to sexual activity between people who identify as queer or part of the LGBTQIA+ community. "Queer" is an umbrella term that can include a variety of sexual orientations, gender identities, and expressions, such as being gay, lesbian, bisexual, pansexual, non-binary, and more.

Queer sex can look different for different people, and it's not limited to one specific type of sexual activity. It can include:

Queer sex can include:

Same-gender sexual activity: For example, sex between two females, two males, or people of the same or similar genders.

Sex beyond traditional gender roles: Queer sex may not follow assumptions about who “leads”, who receives, what bodies are involved, or what counts as sex.

Different kinds of intimacy: This may include oral sex, genital touching, mutual masturbation, penetration, use of sex toys, sensual touch, or other forms of sexual connection.

Just like any other kind of sex, queer sex should be based on consent, respect, communication, safety and mutual enjoyment. The most important thing is not whether sex fits someone else’s idea of “normal”, but whether everyone involved feels safe, respected, and able to make their own choices.

There’s a lot of pressure around “losing your virginity” – but real first-time sex can look very different from what you see in movies or online. We prefer not to use the term virginity, and instead discuss your Sexual Debut (aka the first time you have sex)

What to know:

• It’s normal to feel nervous, unsure, or even awkward.
• It might not be “perfect” – and that’s OK.
• There may be some discomfort (especially if there’s not enough lubrication or communication).
• You can stop at any time if you’re not feeling ready.

As we have already discussed, sex means different things to different people. It can include touching, kissing, cuddling, oral sex, masturbation, mutual masturbation, vaginal sex, anal sex, using sex toys, sensual touch, fantasy, flirting, emotional intimacy, or other kinds of sexual connection.

Sex is not only about penetration. It is not only about orgasm. It is not only for people with certain bodies, abilities, relationships or identities. Disabled people are sexual people too, if that is something they want for themselves.

For some disabled people, sex may look different from what is often shown in movies, pornography, social media or school sex education. It may involve different positions, slower pacing, communication aids, mobility supports, medication planning, pain management, sensory needs, rest breaks, personal care routines, or support to create privacy and safety. These differences do not make sex less real, less valid or less meaningful.

Sex should be about consent, respect, pleasure, safety and choice. Consent means everyone involved understands what is happening, wants to take part, and can say yes, no, pause, slow down or stop at any time. Consent can be spoken, signed, written, shown through communication aids, or expressed through clear body language. If someone is unsure, overwhelmed, distressed, silent, frozen, asleep, intoxicated, pressured or unable to communicate clearly, the safest response is to stop and check in.

Sex can also involve planning. A person might need to think about pain, fatigue, spasms, continence, medication effects, skin care, communication, sensory overload, privacy, transport, positioning, or whether they want a trusted person nearby before or after. Planning does not make sex less romantic or less spontaneous; it can help people feel safer, more relaxed and more in control.

Support workers, carers, whānau and health professionals should not assume that disabled people are not interested in sex or relationships. They should also not pressure someone into sexual activity, relationships, contraception, pregnancy decisions or sterilisation. Support should be about giving people accurate information, protecting their rights, supporting privacy and safety, and helping them make their own decisions wherever possible.

Sex in the context of disability is not about trying to copy what non-disabled people do. It is about recognising that every person has their own body, needs, preferences, boundaries and ways of experiencing pleasure and connection.

Good sex is not defined by how it looks from the outside. Good sex is sex that is wanted, consensual, respectful, safe enough, and enjoyable for the people involved.

Painful sex means pain or discomfort before, during or after sexual activity. The medical word often used for painful intercourse is dyspareunia, but people may experience sexual pain in many different ways.

Pain may happen with genital touch, attempted penetration, vaginal sex, anal sex, oral sex, erection, ejaculation, orgasm or pelvic muscle tension. It may be sharp, burning, aching, stinging, cramping, deep, superficial, or feel like pressure or tightness.

Painful sex is common, but it should not be ignored. Sex should not be something someone has to “put up with” or push through. Pain is a signal to pause, slow down, change what is happening, or seek medical advice.

Painful sex can be described in different ways.

Superficial or entry pain: Pain felt around the vulva, vaginal opening, anus or skin at the point of touch or penetration.

Deep pain: Pain felt deeper inside the pelvis, lower abdomen, vagina, rectum.

Pelvic floor pain: Pain or tightness caused by muscles in the pelvis contracting, guarding or not relaxing easily.

Physical, emotional and psychological factors can all contribute to painful sex. More than one factor can be present at the same time.

Some common causes or associated conditions include: 

Vaginal dryness or reduced lubrication: This can happen for many reasons, including not feeling aroused or ready, hormonal changes, breastfeeding, menopause, some medications, stress, or not enough time spent on pleasurable touch before penetration.

Vestibulodynia or localised provoked vulvodynia: Pain, burning or stinging around the vaginal entrance or vestibule, often triggered by touch, tampons, sex or pelvic examination.

Vulvodynia: Ongoing vulval pain, burning or discomfort that may affect one area or the wider vulva, often without an obvious visible cause.

Vaginismus or pelvic floor overactivity: Involuntary tightening or guarding of the pelvic floor muscles, which can make penetration painful, difficult or impossible.

Infections: Thrush, bacterial vaginosis, herpes, other STIs, urinary tract infections or pelvic inflammatory disease can cause pain, burning, irritation, discharge or pelvic pain.

Skin conditions: Eczema, dermatitis, lichen sclerosus, lichen planus or other vulval skin conditions can cause itching, tearing, burning or pain with touch.

Endometriosis or pelvic conditions: Deep pain with sex can be associated with endometriosis, ovarian cysts, fibroids, pelvic inflammatory disease, adhesions or other pelvic conditions.

Scarring or injury: Pain may occur after childbirth, surgery, sexual trauma, genital injury or procedures.

Painful sex can also affect males and people with a penis. Pain may be felt in the penis, foreskin, head of the penis, testicles, perineum, pelvis, urethra, anus or lower abdomen. It may happen during sex, with erection, with ejaculation, after orgasm, or when passing urine after sex.

Possible causes include:

Friction or lack of lubrication: Sex can be painful if there is not enough lubrication, if the skin is irritated, or if there is too much friction. Lubricant and changing pace, position or type of sexual activity may help.

Tight foreskin or short frenulum: A tight foreskin may pull, split, tear or become painful during erection or sex. A short frenulum can also cause pain, pulling or tearing underneath the head of the penis.

Balanitis or inflammation: Inflammation of the head of the penis or foreskin can cause soreness, redness, swelling, itching, discharge, odour or pain with sex.

STIs or urinary infections: Infections can cause burning, discharge, sores, pain passing urine, testicular pain, pelvic pain or pain with ejaculation.

Prostatitis or chronic pelvic pain syndrome: Inflammation or irritation involving the prostate or pelvic region can cause pelvic, genital, rectal or lower back pain, urinary symptoms and pain with ejaculation.

Peyronie’s disease: Scar tissue in the penis can cause a curve or bend during erection. This may be painful and may make penetrative sex difficult.

Pelvic floor muscle tension: The pelvic floor muscles can become tense or overactive in men too. This can contribute to pelvic pain, penile pain, testicular discomfort, urinary symptoms or pain with ejaculation.

Skin conditions or allergies: Irritation from soaps, lubricants, condoms, latex, spermicides, fungal infections or skin conditions can cause burning, itching or pain.

Stop or pause if sex hurts: Pain is not something you have to push through. Continuing through pain can make the body tense up more and may make pain worse over time.

Communicate with your partner: Talk about what feels good, what hurts, what you want to avoid, and what helps you feel safe and relaxed.

Use lubricant: A good-quality water-based or silicone-based lubricant can reduce friction and discomfort. Avoid products that sting, burn or irritate.

Take penetration off the table for a while if needed: Sex does not have to involve penetration. Kissing, touching, massage, oral sex, mutual masturbation, sensual touch and other forms of intimacy may feel more comfortable.

Try different positions or pace: Some pain is affected by angle, depth, speed, pressure or muscle tension. Slower sex, shallower penetration or different positions may reduce pain.

Do not assume it is “just anxiety”: Stress, fear and previous painful experiences can affect the body, but pain can also come from infections, inflammation, skin conditions, hormones, pelvic floor dysfunction or other medical causes.

Seek medical support: A GP, NP, sexual health clinician, gynaecologist, urologist, pelvic floor physiotherapist or other health professional can help identify possible causes and treatment options.

Treatment depends on the cause. It may include infection treatment, vulval or penile skin treatment, hormone treatment, pelvic floor physiotherapy, pain management, counselling, sex therapy, medication changes, or referral to a specialist.

Seek urgent medical advice if there is:

• Sudden severe pelvic, testicular or abdominal pain
• Testicular swelling or a testicle sitting higher than usual
• An erection lasting more than four hours
• Penile injury during sex, especially with sudden pain, swelling or bruising
• Fever, feeling very unwell, or severe pelvic pain
• Heavy bleeding
• New genital ulcers, blisters or sores
• Pain with passing urine plus fever or flank pain
• Inability to pass urine
• Blood in urine or repeated blood in semen
• A new lump in the testicle or penis.

Painful sex is treatable for many people. The first step is taking the pain seriously and getting support rather than trying to ignore it.

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