In this Danish cohort study, lesbians exhibited no unusual burden of sexual risk indicators and had fewer sexual dysfunctions, whereas gay men and bisexuals of both sexes reported significantly more risky sexual behaviors, sexual victimization, sexual dysfunctions, and other adverse outcomes.
Lesbians were less likely to have had sex with another person in the last year compared to heterosexual women.
Gay and bisexual men and bisexual women reported higher numbers of sex partners and greater frequencies of masturbation and pornography consumption compared to heterosexuals.
Premature ejaculation was significantly less common among gay and bisexual men compared to heterosexual men.
Erectile dysfunction was significantly more common among gay men, both in the last 4 weeks and the last year, and also more common among bisexual men in the last year.
Gay men more often reported orgasmic dysfunction compared to heterosexual men.
Overall female sexual dysfunction was less common among lesbians and bisexual women, though vaginal cramp dysfunction was more common in bisexual women.
Sexual victimization was reported at substantially higher rates among gay men, bisexual men, and bisexual women compared to their heterosexual counterparts.
Gay and bisexual men more often reported dissatisfaction with the appearance of their bodies and genitals compared to heterosexual men.
The Project SEXUS study was a large national cohort with broad age coverage but had a modest response rate that may limit representativeness.
This research used data from nearly 60,000 Danish people aged 15 to 89 to compare the sexual health, behaviors, and experiences of gay, bisexual, and heterosexual individuals. The study found that lesbians generally fared similarly to or better than heterosexual women on many sexual health measures — they were less likely to experience overall female sexual dysfunction and did not show an elevated burden of risky sexual behaviors or victimization. In contrast, gay men and bisexual individuals of both sexes faced a notably higher burden of sexual health challenges, including more sexual dysfunctions, more risky sexual behaviors, and dramatically higher rates of reported sexual victimization. Specifically, gay men were about three times more likely to experience erectile dysfunction in the past four weeks compared to heterosexual men, and nearly six times more likely to report sexual victimization. Bisexual women, while less likely to have overall sexual dysfunction, were more than twice as likely to report vaginal cramp dysfunction and nearly three times more likely to report sexual victimization. Gay and bisexual men also more frequently reported dissatisfaction with the appearance of their bodies and genitals. This research suggests that gay men and bisexual individuals may face distinct and significant sexual health challenges that warrant greater attention from healthcare providers and researchers. The study's large, nationally representative Danish sample is a strength, though its modest response rate of 34.6% and potential for self-selection bias are important limitations. The authors note that findings may not generalize to other countries, and call for further investigation and increased clinical attention to these disparities.
Schweizer F, Dalgaard L, Graugaard C, Andersson M, Frisch M. (2025). Sexual health and behaviors in homosexual, bisexual and heterosexual Danes: baseline findings in the Project SEXUS cohort study.. The journal of sexual medicine. https://doi.org/10.1093/jsxmed/qdaf220