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Anal Sex Prep Practices: How Do Gay Men and Straight Women Compare?

February 05, 2018 by Dr. Evan Goldstein

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Sex may be something that nearly everyone does, but the way each person prepares for it is not necessarily the same. When it comes to anal sex particularly, the type of preparation can be even more specific and can vary by the role of the person participating. Some people use cleansers, supplements, or nothing at all. Whether a top, bottom, or vers, or whether male or female, the difference in pre-sex ritual (or lack of one) can be quite distinct and can have health implications.

With this in mind, we decided to conduct a survey to find out how people prepare for anal sex. Using an online survey, we asked over 600 Americans of all ages a variety of questions about their methods for preparation. To get a targeted set of insights, half of the respondents were self-identified gay men, and half were self-identified straight women. Below are our findings in detail, broken out for each group.

Gay Male Respondents

To start, our survey focused on getting a background of the respondents. One of the first questions we asked was about the person’s preferred sexual position for anal sex. Interestingly, the result was not an even distribution among the three options. The data revealed that most gay men prefer to be a top (39%), followed by vers (33%) and bottom (29%).

We also asked about the frequency of anal sex, and the results showed that it is a regular part of most gay men’s life. We found that 39% of homosexual men have anal sex a couple times each week, and 24% a couple times each month. 13% report having anal sex daily. Put another way, 5 in 6 gay men have anal sex at least few times each year. Only 1 in 6 partake less than once each year. This information has implications: it confirms that the topic of anal sex preparation is something that impacts many people. Plus, if it’s something that most people don’t do properly, it’s a issue about which people need to be educated.

When looking at how common sex preparation practices are, we found quite a bit of variance. Only 42% of gay male respondents report always or frequently using an anal cleanser beforehand, while 38% rarely or never do. 21% sometimes do so. Interestingly, gay men who have anal sex daily are 1.3 – 2.1 times more likely to always use an anal cleansing product, compared to those who do it less often. We found that, generally speaking, the less frequently someone has anal sex, the more likely they are to never use an anal cleansing product.

We also wanted to analyze the type of product used. The data tells us that the most common preparation method is a water-based enema, which 25% of gay male respondents who use a cleanser prefer. Followed closely behind are saline enemas (20%) and shower adaptors (18%).

Understandably, the idea of sex prep can be more for personal cleanliness than health practices for certain people. With that in mind, we asked a few questions related to the topic. First, we found that 78% of gay men think about hygiene always or most of the time during anal sex, while only 9% never do. Additionally, 61% of gay men reported that they would feel more comfortable (or cleaner) if they used an anal cleanser post-sex. This tells us that hygiene is an important consideration both during and after sex.

We were also interested in a few other related topics, such as condom use, tearing, and sex toy use. The results tell us that only 37% of gay men always use a condom when having anal sex, while 21% occasionally do and 16% never do. Although pregnancy isn’t a concern, STD transmission and considerations about hygiene may impact these numbers. Furthermore, we found that 41% of gay men have experienced tearing or other damage from anal sex. Finally, the data tells us that 45% of gay men don’t use a sex toy for anal sex at all, while 41% use one at least to prepare. 55% use one for pleasure, to prepare, or both. It’s possible that those who use a toy to prepare may be doing so to avoid tearing or other damage.

Straight Female Respondents

For women, the preferred sexual position during anal sex wasn’t a consideration for obvious reasons, but otherwise we asked the same set of questions. We found that 56% of straight women report having anal sex less than once per year. However, 1 in 4 straight women do so at at least a couple times each month, while 2 in 5 partake at least few times each year. Although female anal sex may still be taboo, it’s clearly a relevant topic to a notable percentage of straight women.

When it comes to anal cleansers, straight women are much less likely to use them than gay men. In fact, 61% of women surveyed rarely or never use these products before sex. Only 27% always or frequently do, compared to 42% of gay men. Similar to the male respondents, however, the more often women have anal sex, the more often they tend to use anal cleansers.

Interestingly, the top three anal cleansing products used by straight women were the same as those used by gay men other than the third choice. Water-based enemas were first at 23%, followed by saline enemas (19%) and other (16%). The rank of the other category tells that women’s anal cleansing methods are less closely associated with common products. This may suggest that straight women, even those who use these cleansers, may be less familiar with the products available to them.

Cleanliness during or after anal sex is also a large consideration for many straight women. What’s interesting is that 75% of straight women reported that they think about hygiene always or most of the time during anal sex, compared to 78% of gay men. Only 16% of women surveyed never think about it. Furthermore, 72% of straight women said they would feel more comfortable (or cleaner) if they used an anal cleanser post-sex. This compares to 61% of men surveyed. So, while gay men are more likely to think about hygiene during anal sex, they’re less likely to feel cleaner from using a cleanser post-sex. This likely is tied to the fact that they are more likely than straight women to use a product pre-sex.

Finally, we wanted to cover the additional sex-prep-related topics for straight women as well. First, the data told us that 57% of straight women never use a condom when having anal sex, compared to only 37% of gay men. Only 22% of women surveyed always use one. Additionally, the results showed that 22% of them have experienced tearing or other damage from anal sex. Finally, we learned that 62% of straight women don’t use a sex toy for anal sex at all, while 29% use one at least to prepare. 38% use one for pleasure, to prepare, or both. Gay men are more likely to use a toy for anal sex than straight women, we found, which may relate to women’s anal sex still being somewhat of a taboo topic as a consequence, sex toy use for it is even less commonly discussed.


At Bespoke Surgical, we aim to draw insights from research that are impactful, reliable, and engaging. In this survey, we sought to learn more about the sex preparation practices of gay men and straight women, and we now have a broad understanding of how each group compares. With analyses like this one, our goal is to establish ourselves as an authority on proper sexual health practices and representation of LGBTQ+ voices. We hope that by shedding light on these topics, we can improve the position of those who are impacted by them.

Bespoke Surgical’s Dr. Evan Goldstein is an anal surgeon that performs procedures such as anal reconstruction, botox, skin tag surgery and more.

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About the Author

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.

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