Receptive anal intercourse (RAI) includes any sexual activity in which one partner inserts their body part (finger, penis, tongue) or object (sexual aids) into their partner’s anus and is more common than many may think. Approximately 36% of heterosexual women and 44% of heterosexual men have reported engaging in anal sex with a partner in their lifetime, and even more bisexual, lesbian, and gay men and women.

In June 2020, researchers attempted to determine rates of RAI, orgasm experience with RAI, and areas inside the rectum that are most pleasurable to stimulate for those who partake in RAI:

• 498 cisgender adult women and 466 cisgender adult men were surveyed with RAI-related questions.
• A diagram was provided for labelling where the most pleasure from RAI is derived.
• Responses were then compared based on age, sexual orientation, (heterosexual, bisexual, or gay), and gender identity (cisgender women or cisgender men).

Behavioral Patterns Among All Demographics

• Between genders: Women were more likely to engage in RAI than men (33% vs. 23%, respectively).
• Among sexual orientations: Gay women, bisexual men, and gay men were more likely to report engaging in RAI (40%, 78%, and 39%, respectively), and heterosexual men were less likely (17%).
• Among ages: Middle-aged women (40-59 y/o) were more likely to have engaged in RAI, while older men (>59 y/o) were less likely (40% vs. 26%, respectively).

Because a large portion of both men and women reported engaging in RAI, researchers suggest it is a common experience that many engage in, regardless of sexual orientation or age. They also note that LGB individuals appear more likely to engage in RAI than heterosexual individuals.

Previous research shows that most respondents reported having their first experience with RAI around age 18, and the frequency of RAI increased with each age group. This suggests that anal activity might become a more common part of sexual activity as people age. However, the researchers note that older men and women may report lower rates, likely influenced by societal stigma around anal activity during their younger years.

Researchers propose that fewer men are likely to engage in RAI due to societal stigmatizations of RAI as being a homosexual activity, which may lead some heterosexual cisgender men to avoid partaking in the activity due to the fear that in doing so, they may be perceived as gay (homohysteria). Additionally, they emphasize that even if someone has tried RAI, they may not have enjoyed the experience or chosen to participate.

Orgasmic Tendencies in Relation to Pleasurable Zones

More women than men reported having never orgasmed from RAI, regardless of other stimulation occurring simultaneously (32% vs. 16%, respectively). Additionally, around the same proportion of women and men required simultaneous stimulation to achieve orgasm through RAI (49% vs. 47%). Most respondents reported they felt more pleasure in the upper front (superficial anterior) area of the rectum. There are several theories as to why this might be:

• Orgasm is heavily influenced by mental factors. For example, with more exposure to RAI as a primary sexual practice, men may learn to orgasm from RAI more easily.
• Women naturally have unpredictable orgasmic patterns, which may contribute to their not having orgasmed from RAI.
• The pudendal nerve runs through the perianal skin and external sphincter and can contribute to increased pleasure from anal play.
• The superficial anterior area is near the “legs” of the clitoris, which can contribute to increased pleasure with other clitoral stimulation (orally, from sexual aids, etc.).
• While not fully proven, the superficial anterior area is near the prostate and the other nerves nearby which send pleasure signals to the brain, so pressure from an inserted object may spark a more pleasurable experience for men.

Key Points

Overall, women are more likely than men to have engaged in RAI across all ages and sexualities, however men are more likely than women to achieve orgasm from RAI. Additionally, most respondents reported the superficial anterior area of the rectum as the area which provides the most pleasure. These results are likely related to a combination of societal and physiological factors. Understanding these conclusions may help clinicians know how to better counsel patients who engage in RAI.

References:

Zaliznyak, M., Walton, A. B., Stelmar, J., Isaacson, D., Gaither, T. W., Knudson, G., & Garcia, M. M. (2025). Anal sex practices and rectal erogenous zone maps among men and women of diverse sexual orientations: An anatomic-map based questionnaire study. Sexual Medicine, 13(3). https://doi.org/10.1093/sexmed/qfaf037