Introduction: Despite recent media coverage in the topic of sexless marriages in East Asia, population-based studies examining the absence of sexual activity among nonelderly married individuals are scant. Previous studies have not simultaneously examined sociodemographic, physiological, and lifestyle predictors of sexless marriages.
Aims: To determine the prevalence of past-year sexlessness and the associated factors among the married Chinese adults in Hong Kong.
Methods: An anonymous, population-based telephone survey was conducted on 2,846 married Chinese men and women between the ages of 25 and 59 in Hong Kong.
Main outcome measures: The prevalence of past-year sexlessness and the associated factors and mental health symptoms were examined.
Results: The prevalence of past-year sexlessness between the ages of 25-34 years, 35-44 years and 45-59 years was 5.5, 5.1, and 17.0%, respectively, among married males, and 8.3, 12.4, and 31.6%, respectively, among married females. Older age and poor spousal relationship were associated with sexlessness for females, whereas lack of interest in sex, older age, and lower education were significant factors for males. Married women demonstrated statistically significant associations between sexlessness and poorer mental health indicators, such as lower quality of life and being bothered by the unavailability of a sex partner.
Conclusions: Sexlessness is prevalent among certain subgroups of urban Chinese couples in Hong Kong, and the large discrepancy in sexlessness between married men and women in each age strata suggests a high prevalence of extramarital relationships. Contrary to commonly held beliefs, there was a stronger association between sexlessness and poorer psychosocial symptoms among married females than males. Sexless marriages are an underappreciated phenomenon among urban Chinese individuals.