The latest research conducted by Inserm-ANRS on sexualities and sexual health in 2023 reveals trends that reflect developments observed over the past several decades. However, significant changes have emerged since the early 21st century, especially among women, within a context of increased social and economic autonomy, the advancement of gender and sexual equality, and the ongoing transformation of family structures. These changes also take place against a legislative backdrop that has evolved considerably in recent years. The 2013 law on same-sex marriages and the 2021 law on assisted reproductive technologies for female couples and single women have played a crucial role in reducing institutional discrimination against individuals with same-sex partners in their pursuit of marriage and parenthood.

The initial results illuminate what could be termed the “contemporary paradox of sexuality.” This paradox is characterized by greater diversity alongside a decreased intensity of sexual activity with a partner. The diversification of sexual activity is evident through the increase in the number of opposite-sex and same-sex partners, the extension of sexual activity into older ages, and the broadening of sexual repertoires, including masturbation. This trend is not new, but has intensified in recent years, particularly among women. At the same time, individuals report having engaged in sexual intercourse in the past twelve months less frequently than in 2006, especially those who are not in a relationship, and the frequency of sexual intercourse over the past four weeks has decreased regardless of relationship status. These trends are also observed in other countries, including Germany, the United States, Finland, the United Kingdom, and Japan.

The factors driving these trends are multifaceted. Firstly, women and men under 69 in France are less likely to be in a relationship today compared to previous decades (Rault and Réigner-Loilier 2015). As a result, periods without a stable partner have become more common in 2023 than in the past. The rise of digital spaces for sexual expression also contributes to this shift, particularly among younger individuals, as sexual experiences not only involve physical settings but also occur online. Additionally, research indicates that the COVID-19 pandemic, especially during lockdowns, has adversely affected the mental health of young people in the long term (Hazo and Costemalle 2021), potentially altering their expectations regarding sexuality.

Furthermore, these changes occur within a broader context that challenges traditional perceptions of women’s sexual availability. The results indicate a decline since 2006 in the frequency of sexual encounters women accept to please their partner, even when they themselves are not interested. Today, younger generations seem to view a lack of sexual activity as less problematic than in the past. Similarly, the belief that men have "naturally" greater sexual needs than women, which prevailed in 2006, no longer holds true in 2023. Notably, these shifts do not appear to diminish the sexual satisfaction of either women or men, as both groups continue to report similar levels of satisfaction with their sex lives as they did in 2006.

The CSF-2023 survey also highlights an increasing challenge to the heterosexual norm in attitudes and practices. Social acceptance of non-heterosexual sexualities has grown significantly over time, although notable resistance still exists, and discrimination against individuals with same-sex partners, particularly against transgender people, remains frequent, negatively impacting their mental health. Among individuals who have had same-sex partners, only half (56.1% of women and 50.6% of men) report having used a condom during their first sexual encounter with a new partner. Furthermore, these individuals exhibit a higher prevalence of STIs compared to the general population, reaching 1.4% for women and 2.4% for men aged 18-59.

The CSF-2023 findings suggest that it is ultimately the contours of sexuality that are evolving, as heterosexual penetrative sexuality gradually gives way to a more diverse practices, less focused on vaginal penetration and increasingly occurring in digital spaces, and is notably less frequent but more often desired.

This shift can be viewed in relation to the ongoing increase in reports of sexual violence, a trend that began well before the #MeToo movement. The growing social mobilization against all forms of sexual violence has transformed the normative frameworks of sexual consent. The rise in reported incidents reflects both an acknowledgment by respondents of events that were previously not considered violent and a greater capacity to denounce such occurrences. However, the results of this new survey paint a concerning picture of the extent of these violences, and statistics regarding younger generations illustrate the continued prevalence of the issue.

The survey also shows that transidentity and questioning gender binary norms remain stigmatized, significantly more so than homosexuality, and individuals who have considered changing their gender report considerably poorer mental health outcomes than others. Nevertheless, social acceptance of transgender and non-binary individuals is evolving, as evidenced by more favorable attitudes from younger generations. It is also among the youngest age groups that a greater number of individuals have thought about changing their gender at some point in their lives. These results indicate a growing reflexivity among individuals regarding their own gender, which is no longer simply experienced as a biological given.

Even though gender inequalities remain pronounced from the onset of sexual activity through to older ages, and discrimination against individuals with same-sex partners and transgender individuals remains common, the developments highlighted by the 2023 survey overall reflect a growing trend toward gender and sexual equality in French society. The results also shed light on the issues related to the prevention of risks associated with sexuality. The use of condoms during first sexual encounters has declined in recent years, and the protection observed during initial sexual encounters with new partners falls significantly short of the recommendations set forth by the national sexual health strategy. Additionally, vaccination coverage for hepatitis B and the papillomavirus (HPV) remains low, particularly among men. While contraceptive coverage is generally very high, the types of methods used have evolved considerably. The results confirm a decreasing reliance on the pill, a trend observed since 2005 that intensified following the media crisis of 2012, particularly among young people, who are increasingly turning to the intrauterine device (IUD) and condoms, although the pill remains the most commonly used method in this age group. Among women aged 18-49, the IUD has become the most widely used method in 2023. Meanwhile, non-medical methods are on the rise, with one in ten women remaining without contraceptive protection. The survey also notes an increase in unintended pregnancies among young women, reflecting the rise in the incidence of voluntary terminations of pregnancy observed since 2016. These findings call for a reconsideration of prevention programs for STIs and unintended pregnancies, while integrating digital tools that can help expand access to care, provided they adhere to the same quality standards as other health care sources. The digitalization of sexual health represents a broader challenge of de-medicalizing sexual health in France, which is still in its early stages compared to policies implemented in other countries, such as England and the United States.

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Numerous analyses are currently underway, which will provide a deeper understanding of the results presented here, taking into account the detailed social characteristics of individuals. The ongoing analyses also focus on emotional and sexual trajectories, the use of pornography, paid sexual exchanges, norms and representations of sexuality, feminism and sexuality, sexuality in older age, consent, the links between sexuality and diseases, prevention practices, and medical violence, among other topics. These analyses will cover both metropolitan France and the overseas territories (Martinique, Guadeloupe, Guyana, Réunion). They will also allow for international comparisons with countries that have conducted similar types of surveys based on WHO protocols, such as Canada and England.

Results will be published in 2025 in a special issue of the journal Perspectives on Sexual and Reproductive Health, and in-depth analyses will be presented in a forthcoming book to be published in 2026 by La Découverte.

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