What the heck does "sexually active" mean?

You’re not the only person confused by this term, so let’s see if we can’t clear it up for everyone once and for all.

When healthcare professionals ask that question, they are asking from a sexual⁠ (sexual: About or relating in some way to sex or sexuality.) health perspective.

In other words, what they are wanting to know is if a patient or client has possibly been at risk of pregnancy⁠ (pregnancy: The state of carrying a developing embryo or fetus within the uterus. Medically, someone is considered to be pregnant when an egg has been fertilized by sperm, cells divide, and the fertilized egg is implanted within the lining of the uterus.) and/or of sexually transmitted infections⁠ (sexually transmitted infections: STIs: illness, infection and/or disease which is often or can be transmitted through sexual or other intimate contact, like HIV, Chlamydia or Herpes. Some people call STIs STDs.) . They’re asking to find out⁠ (out: Short for ‘out of the closet’. When someone’s LGBTQ+ identity is known to other people.) if they should do a pregnancy test⁠ (pregnancy test: What we tell you to take when you ask us if you’re pregnant. A test that can be done at home or by a healthcare provider to determine pregnancy. Usually a urine test, a pregnancy test measures for a specific hormone, hCG, only produced with pregnancy.) , screen for those infections, if it’s time (for people with vaginas) to start pap smears and also to see if you want to discuss or need birth control⁠ (birth control: Any number of methods people use to intentionally prevent unwanted pregnancy, including the condom, the cervical barrier, the implant, the patch, the pill, the rhythm method, the ring, the shot, the IUD, spermicide and withdrawal.) .

Manual sex⁠ (sex: Different things people choose to do to actively express or enact sexuality and sexual feelings; often this involves genitals, but not always. ) – “fingering” or “hand jobs” – can present risks of some sexually transmitted infections, particularly when it isn’t done with latex gloves or freshly washed hands, even though it’s a lot less likely than getting one through vaginal or anal intercourse⁠ (anal intercourse: When a penis is inserted into and held by the anus while partners move their bodies as feels good to them for the purpose of sexual stimulation.) . So, in your case, from a sexual health perspective, you have been sexually active⁠ (sexually active: Someone who has had or is currently having some kind of genital sex with a partner or partners.) , and that’d be the case for someone, of any gender⁠ (gender: Characteristics that are seen or presented as distinguishing between male and female in a society. Gender may or may not include assigned or chosen: social roles, feelings, behaviors and/or presentation or appearance.) , who has engaged in manual sex⁠ (manual sex: Sometimes also called digital sex. Kinds of sex involving the hands and fingers to sexually stimulate the genitals or other parts of the body. Fingering, handjobs or “fisting” (deep manual sex) are some kinds of manual sex.) , oral sex⁠ (oral sex: Use of the mouth, lips or tongue for sexual stimulation. Cunnilingus (“going down on”), fellatio (“blowjobs”) and analingus (“rimming”) are some common kinds of oral sex.) , vaginal or anal sex⁠ (anal sex: Sexual activity involving the anus. Anal sex may include stimulation with fingers, the mouth, a penis, sex toys, or other objects or body parts.) .

Just to give you a rundown from another page at the site, here is a short list of what risks can be presented from those basic sexual activities:

Vaginal or anal intercourse:

• Pregnancy (with opposite-sex couples)
• Bacterial Vaginosis
• Chlamydia
• Cytomegalovirus (CMV)
• Gonorrhea
• Hepatitis⁠ (Hepatitis: A chronic infectious liver disease with several different types. Hepatitis A, B and C are the most common and can all be transmitted sexually. All require medical care. Vaccines are available for hepatitis A and B.)
• Herpes⁠ (Herpes: A viral disease caused by both or either herpes simplex virus type 1 (HSV-1) and/or type 2 (HSV-2).)  Simplex
• Human Immunodeficiency Virus (HIV⁠ (HIV: A virus that attacks cells of the immune system, weakening the body’s ability to fight infections and diseases.) )
• Humanpapilloma Virus (HPV⁠ (HPV: Human papillomavirus, a very common sexually transmitted infection with more than 40 HPV types.) , Warts)
• Molluscum Contagiosum
• Pubic Lice
• Scabies⁠ (Scabies: A skin disease caused by a mite which can be transmitted sexually or by nonsexual contact. It requires medical treatment.)
• Syphilis
• Trichomoniasis⁠ (Trichomoniasis: One of the most common STIs, due to a microscopic parasite which usually lives in the vagina, urethra, or bladder. It requires medical treatment.)

Oral sex:

• Chlamydia
• Cytomegalovirus (CMV)
• Gonorrhea
• Hepatitis
• Herpes Simplex
• Human Immunodeficiency Virus (HIV)
• Molluscum Contagiosum
• Syphilis

Manual sex:

• Bacterial Vaginosis
• Cytomegalovirus (CMV)
• Herpes Simplex
• Humanpapilloma Virus (HPV, Warts)
• Molluscum Contagiosum
• Pubic Lice
• Scabies

So, you can see why being sexually active isn’t just about having vaginal intercourse⁠ (vaginal intercourse: When a penis or sex toy is inserted into and held by the vagina while partners move their bodies as feels good to them for the purpose of either sexual stimulation and/or reproduction.) or not from a sexual health point of view. Your risks from manual sex are obviously lesser than those from intercourse⁠ (intercourse: When people interlock their genitals and move together as feels good to them for the purpose of sexual stimulation and/or reproduction.) , but some do still exist that someone in charge of helping assure you stay healthy may want to be on the lookout for and test for.

The term “virgin” or “virginity” is actually completely meaningless when we’re talking about health and physical (or emotional) risks. People who use those terms tend to define them in different ways, so since it doesn’t really mean any one thing, were you to tell a sexual healthcare provider⁠ (healthcare provider: A qualified person to provide sound physical and/or mental healthcare, such as a doctor, nurse, clinician, counselor, medical assistant, midwife or other healthcare professional.) you were a virgin, that doesn’t give them much information and leaves a lot of room for misunderstandings. Some people who have had anal intercourse, for instance, will identify themselves as virgins even though they have had all the same risks someone having vaginal intercourse has had. And some people who have had vaginal intercourse will also define themselves as virgins based on arbitrary standards.

You can also always specify how you are sexually active for clarity, such as, “Yes, I am, but with manual sex only.” That’s going to tell a doctor, nurse or other clinician that while they might, indeed, want to then offer you a visual genital exam, bimanual exam and pap smear⁠ (pap smear: A medical test (sometimes called a pap test) done by swabbing the cervix which checks for changes/abnormalities of the cervical cells. It can be used to identify changes to those cells due to HPV or cancer or which could lead to cancer.) (as those three things would tend to take care of looking for all the infections manual sex alone can present), you won’t need a pregnancy test. They might ask if you want a birth control method, but know that you aren’t in immediate need of one. Just like with any other aspect of your health or lifestyle factors that do or can impact your health, the more specific you can be with a healthcare provider, the better able they are to do their jobs well.

I know that can seem or feel awkward, but you get used to it in pretty short order. Heck, a lot of things about any kind of sex are or can be awkward, so it’s just one more thing to go in that fumbling, bumbling pile.