• Posted April 9, 2026

America's Sexual Health Report Card Contains Some Surprises

Americans are becoming more comfortable with sexuality, with nearly all wanting and gaining pleasure from sex, a new study says.

But they’re also engaging in risky behaviors that could increase their odds of sexually transmitted infections (STIs) and unintended pregnancies, researchers report in the Journal of Sex & Marital Therapy.

About 89% of Americans wanted their last sexual encounter and 87% derived pleasure from it, according to a new survey of 2,555 Americans age 18 to 94.

More men (93%) derived pleasure from their last encounter than women (82%) or gender-diverse people (86%), the survey found.

Women and gender-diverse people also were more likely to report being the victims of sexual violence — 22% and 39% respectively versus 12% for men, the study found. These numbers add up to a culture becoming more comfortable with talking about both positive and harmful sexual experiences, researchers said.

“The apparent contradiction between high rates of ‘wanted’ sex and continued reports of non-consensual experiences suggests a growing public awareness of sexual consent and a decline in stigma — an encouraging signal of cultural change,” said lead researcher Jessie Ford, an assistant professor of sociomedical sciences at Columbia University Mailman School of Public Health.

Slightly more people supported same-sex relationships than have in the past – 71%, up from 66% to 69% in national estimates, the study says.

There’s also increased support for abortion rights, with 48% expressing support versus 40% previously, researchers said.

More people also are rejecting societal norms regarding female sexuality.

In all, 25% of people agreed with the statement, “Men naturally have more sexual needs than women,” down from 40% previously, researchers said.

However, many disparities and shortcomings remain.

The survey found that women (22%) and gender-diverse people (39%) were more likely than men to feel unsafe in public places.

Results also showed that many people aren’t talking about sexual health, with only 49% saying they’d discussed it with their partner and 31% with a health care provider.

Only 50% had been tested for HIV and 47% for STIs, the survey found.

Further, only 60% had used any precautions or protection during their last sex, including 57% of men, 62% of women and 60% of gender-diverse people.

Other adverse outcomes included unintended pregnancy (40%); teen pregnancy (19%); and HIV infection (3%). The study noted that the rate of teen pregnancy found in this survey was nearly double the reported national average of less than 10%.

“Despite growing awareness of consent and people’s increased willingness to discuss negative sexual experiences, the disconnect between public health goals and lived realities remains stark, underscored by low STI and HIV testing rates, high unintended pregnancy and discomfort discussing sexual health with providers,” Ford said in a news release.

These results indicate that the U.S. would benefit from a national sexual health strategy that would promote a positive approach to sexual well-being, researchers said.

Right now, most sexual health messaging focuses on avoiding diseases. 

Americans might benefit from messages that focus on personal choice, consent, pleasure and healthy relationships from a person’s sexual awakening through to their old age, researchers said.

“We recognize that achieving [these] goals in today’s political environment is challenging,” Ford said. 

“Funding for sexual and reproductive health has been reduced in many areas, access to abortion and gender-affirming care is increasingly restricted, and broader anti-rights movements — including intensified debates over sex education, contraception and LGBTQ+ inclusion — pose significant barriers,” she said. 

“Even so, these objectives remain important and valid,” Ford concluded.

More information

The American Sexual Health Association has more about sexual health.

SOURCES: Columbia University, news release, April 6, 2026; Journal of Sex & Marital Therapy, April 6, 2026