Reprinted by Permission

All societies maintain some kind of social control over sexuality in order to avoid chaotic conditions for children born and to prevent erotic degradation of adults.

A major social trend of our times is a change in society's method of its control of the consequences of sex. Roughly speaking, the old means of control consisted of restrictive social norms and a programmatic restriction of sexual knowledge. Explicit norms prohibited pre-marital and extra-marital sex relations. A conspiracy of silence about sex was in effect. The latter had the more lasting consequences in that children, adolescents and adults alike, having repeatedly encountered the attitude "this is not talked about" learned to continually watch their words when approaching the topic of sex. Awareness of sexuality became experienced as a burden, sexual thoughts were repressed from consciousness and inhibitions resulted. Needless to say, much of this pattern is still with us.

Nowadays another pattern of social control of the consequences of sexuality has developed: the mass practice of technical or medical contraception. In modern societies the new contraceptive methods are in varying degrees instrumental in controlling potentially harmful consequences of sexual life. In all important respects the motivations for the new pattern are the same as the old motivation for the old one, i.e. the desire to avoid personal tragedies and the desire to avoid chaotic and unstable conditions for the children who are born.

Of special interest to opinion researchers is the circumstance that this shift removes sex from the area of conversational taboos and, thus, makes it amenable to study through ordinary interviewing methods. The shift has gone a long way in Sweden. It is not a coincidence that the first government to commission a representative survey about the sex life of an entire nation was the Swedish government in 1966. A Royal Commission on Sex Education charged with making a general review and reorganization of sex instruction in schools and in adult education programs commissioned the work. We conducted the survey through the facilities of The Swedish Institute for Opinion Research (SIFO) in 1967 and 1968.

The very fact that a survey was done is a noteworthy piece of information that fits into a large pattern. For centuries, the government in Sweden, as in other countries has concerned itself with the sexual life of its subjects. This has happened through legislation that forbade certain sexual relations and acts. In Sweden, the concern has also been effected by the state church — a Lutheran "High" Church — which more or less energetically has imposed its norms of propriety and chastity.

The interest of the present day authorities in the sexual life of the nation, however, represents something quite different and also something very new. The emphasis is no longer on legislation and sexual discipline, but on information and service. The most important instrument of the government is no longer the church, but the school and the national health service.

The shift in attitude of the authorities has happened very rapidly so much so that one could call it an about face. The old pattern of social control has given way to the new one. Until 1938, public information about contraceptives and the sale thereof was prohibited by law. What was then a highly "private enterprise", even illegal activity has since been expanded and developed. The government has not only condoned this development to some degree, but it has contributed to it. In 1964, a law was passed to the effect that pharmacies were obliged to sell contraceptives to anyone who asked for them, even to teenagers. In 1956, all schools were required to provide sex education, and the previous right of local school authorities to decide whether sex education should be offered was voided. Even prior to these dates, the government had been in a position to support family education within the framework of state-supported adult education programs. Medical treatment of sexual ailments are paid for by the compulsory health insurance. Since the 1940's, public maternity centers have fitted diaphragms. Another example of the recent interest in the part of the government is that at the time of this study, approximately 5 per cent of the Swedish foreign aid went to family planning programs.

Our study aimed at outlining the sexual norms, attitudes, knowledge and behavior of the Swedish population. It is the first investigation of its kind that has been conducted on a national scale in all age-groups. This is the reason for the broad character of the study: we were assigned to sketch an over-all picture.

Our findings were reported earlier this year in a book issued by The Royal Commission on Sex Education (USSU) ¹⁾. The English version of the report will soon be published under the title The Contraceptive Society (hardcover edition: Bedminster Press and paperback edition: Charles Scribners’ Sons). [This publication plan did not materialize.]

1) H.L. Zetterberg, Om sexuallivet i Sverige, SOU, Stockholm 1969.

Sexuality is still a private matter although it is becoming easier to talk about. Interviewers in a gallup-type poll have been trained to gather information in areas where conversation flows easily — consumer habits, hobbies, political views, etc. They have not been trained to gather information about matters protected by the set of social norms that govern what we usually understand by "the sanctity of private life". We therefore had to modify our techniques for collecting data. We resorted to a simple solution and divided the questioning in the homes of the respondents into two parts: regular oral interviews conducted by the interviewer and written questionnaires filled in privately and deposited in a portable ballot box brought by the interviewer.

The considerable skill and experience of. the interviewers in gaining access to a home, and in establishing friendly contact was made use of in the oral interviews. The latter dealt only with questions more easily talked about: questions regarding marital status, number of children, education, general attitudes toward welfare, children born out of wedlock, pornography, etc. After that, the interviewer handed out a questionnaire to be filled out privately. This contained the intimate questions about sex practices and contraceptives. The questionnaire was then sealed and put in a box that the interviewer had brought along, but that he was not allowed to open.

A general rule for the fieldwork to which we did not allow any exceptions was that men interviewed men and women interviewed women.

The subjects to be interviewed were randomly selected from among the 18 to 60 years old listed in the population registry from the 117 communes that constitute the basic sample frame of the Swedish Institute for Opinion Research. Certain groups that are listed in the census returns — e.g. persons who are mentally ill, deaf and mute, or do not speak Swedish — were excluded.

Of 2156 persons scheduled for interviews, 10 could not be located because they had moved and their new addresses could not be established. Their moving had not been reported to the census agency and the pariah registrar's office, no forwarding address had been left with the post office, and no information about their whereabouts could be obtained from their former neighbors. There were 34 persons who could not be reached during the two months of fieldwork, in spite of frequent visits and telephone calls. There were 153 who refused to answer. The results of two interviews failed to reach the Institute and 5 were too incomplete to be of any value in our analysis. This amounts to a total non-response of 204 individuals, or 9.5 per cent.

This sampling mortality rate is neither higher nor lower than the rates usually found in studies of far less delicate topics.

The number of respondents who completed the more or less conventional oral interview, but refused to answer the more intimate questions in the private questionnaire is in itself quite interesting. If we had found that a large number of the population refused to participate, in spite of the protective circumstances created, this would have indicated to anyone engaged in education and counseling that one could not count on any mutual communication with the general public in any form of sex education that goes into intimate matters.

As it turned out, the participation of the subjects was almost complete: 98.4 of those who were interviewed orally went on to the private questionnaire.

Of course, the success of the fieldwork also depended on the fact that the questions asked had been thoroughly tested. Different wordings of question were tried in the field until they became simple and unambiguous and non-threatening. This pre-testing made it clear that one could not use the popular terminology for sex in a serious interview. Several arrangements of the internal order of questions were also tested to find a sequence that would facilitate the flow of the interview.

The field work went on for two months and during this time no publicity whatsoever was given the investigation. No public complaints were made. No newspaper reporters managed to get a copy of the questionnaire or to write a story about any of the interviews.

* * * * *

Extrapolating from our interview data, we calculated that approximately 9.7 million acts of sexual intercourse took place in Sweden during one month in the winter of 1967. Nine months later 8800 babies were born. In a contraceptive society like Sweden, there is thus a ratio of about 1100 acts of sexual intercourse per child born. It is evident that the direct and natural relationship assumed by legal statutes and traditional morality between sexual intercourse and children no longer holds in the age of contraception.

An overwhelming majority has come to accept that all young people should find out how to use contraceptives. This is an opinion held by

95% of all men in the younger generation (18-30 years old)
95% of all women in the younger generation
89% of all men in the older generation (30-60 years old)
84% of all women in the older generation

Half of the population usually has contraceptives at home, and this applies throughout in higher occupational classes (50%), and in the working class (48%), among those with lower education (46%) as well as to the highly educated (56%). One fourth of the unmarried population (25%) are in the habit of bringing contraceptives with them when they go out.

A new commandment has apparently won acceptance among the population: Thou shalt not have sexual intercourse without contraceptives, except when planning to have a child. Our interview subjects said thus:

Let us examine to what extent these ideas about contraceptives were put into practice in the last act of sexual intercourse the interview subjects participated in, prior to being interviewed. To all who had had intercourse within the year prior to the interview, we asked "In your last sexual intercourse, what did you do to avoid getting children?"

Nine per cent wanted a child, and for that reason they did not use any contraceptives. In six per cent of the cases, the women were already pregnant, and in 20 per cent, involving mostly older persons, they were unable to conceive.

The remainder became the basis for the following calculations: Three per cent considered it wrong to use contraceptives and hence did not use any in their most recent intercourse. Ten per cent disliked contraceptives, probably because they found them unpleasant to use, and none were used in their most recent intercourse. As many as 16 per cent were careless and could only say that they had not bothered to use contraceptives. Two per cent gave more than one reason why they had not used contraceptives. This amounts to a total of 27 per cent who should have used contraceptives according to the new social norm, but refrained from doing so.

There were others who relied on what in Sweden are considered inadequate methods of contraception: 4 per cent relied on so-called safe periods ²⁾, 17 per cent interrupted coitus, and 2 per cent douched afterwards. Four per cent reported that they had used more than one method. This is a total of 19 per cent who used less than reliable methods. There are many older women in this group.

The rest, i.e. a majority, used one of the following more adequate methods:

These more adequate methods were used by 60%. Two per cent used more than one method of contraception. The pill is the method preferred by the younger generation: 27 per cent of those under 30 used the pill, as opposed to 8 per cent of the older.

The use of adequate methods in various categories of the population is distributed as follows:

2) The term "safe period" is misleading and should be replaced by another term in any instructional material prepared for schools and popular education.

We see that there were more individuals in the younger generation who used recommended contraceptives, than there were in the older generation. This number was also higher among unmarried than among married individuals. In the older generation it was higher among those who had received (more) education, whereas this difference almost disappears in the younger generation.

We can conclude that a majority, but hardly an overwhelming majority, of the Swedish population live up to the new norm regarding the use of contraceptives, and that they choose methods of contraception according to the recommendations of experts. But this norm is ignored by a minority who thereby expose themselves, their sexual partners, and the environment to risks that are as great as they are unnecessary.

A child is more welcome in some situations than in others. We asked the respondents who were married, engaged or going steady, in what ways their lives would be affected if they would find themselves expecting a child in their present situation. The answers were:

Clearly, a large part of the population think of a pregnancy as involving housing problems and economic restriction. Half of the older women reported that their health would suffer. Half of the unmarried women believe that they would have to give their jobs, and the same is true of a third of the married women. For some the use of leisure time and social life would change. In the case of three per cent of the married population, a child would be born in a situation where the parents had otherwise intended to get a divorce. Twelve per cent of the men, and five per cent of the women who were going steady would feel obliged to continue their, relationship if they had a child, although they would otherwise have preferred to part ways.

All these answers came from people who were married, engaged or going steady, that is to say people who are fully entitled to sexual relations according to current moral standards in Sweden. They bring up a host of issues about social welfare: the housing problem, daycare centers for children, child allowance, etc. They also reflect the structural reasons why people in general are so ready to subscribe to the new norm about contraceptives, and why contraceptive measures are so generally taken.

A more basic reason for the acceptance of contraception was revealed in a multivariate analysis (according to Coleman's method) of general sexual satisfaction. To know about and to have personally used recommended contraceptive measures (condoms for men, diaphragm, spiral or pill for women) stand out as an important factor in people's general satisfaction with their sexual autobiography.

We found that contraceptive experience, and competence rendered an a_i value of 23, that is accounted for 23% of the difference between men with high general sexual satisfaction and men without high general satisfaction when influence from age, education, class, number of partners, age at first sexual intercourse, and attitudes toward pre-marital and extra-marital sex were rendered separately. The corresponding figure for women was 11, again a fairly high figure for a single factor in this kind of analysis.

We have here a reflection of the rewards involved in contraceptive practices. The new norms and habits prevail also because they are rewarded. Those who are competent at contraception have more satisfactory sex lives.

Copyright © SIFO 1969