YBOP comments – section discussing pornography reported: Our results also show an association between frequent pornography consumption and poorer sexual health, and an association with transactional sex, too high expectations of one’s sexual performance, and dissatisfaction with one’s sex life. Almost half of the population state that their pornography consumption does not affect their sex life, while a third do not know if it affects it or not. A small percentage of both women and men say their pornography use has a negative effect on their sex life.
Section in full:
Seventy percent of men consume pornography, while 70 percent of women do not
Pornography is widely debated, and research has found both negative and positive consequences of pornography consumption. Pornography is said to increase the acceptance of sexuality, sexual identities, and different sexual practices and to act as a source of inspiration. Research has also pointed out negative consequences of frequent pornography consumption on, for example, attitudes, behaviors, and sexual health. Frequent pornography consumption is, among other things, associated with more accepting attitudes toward violence against women, a tendency to want to try sexual activities inspired by pornography, and increased sexual risk taking. This is probably due to the content of pornography today, which to a large extent constitutes violence against women and male dominance. From a public health perspective, the aim of this survey was to explore how pornography consumption affects people’s sex life, sexual well-being, and general health.
The results show that many women and men of all ages use the Internet for sex-related activities such as looking for information, reading sexually arousing texts, or looking for a partner. Almost all activities are most common among younger people and decrease with age. There are few differences in Internet use for sex-related activities among young people. It is more common among older men to use the Internet for sexual activities than among women.
Pornography consumption is much more common among men than among women, and it is more common among younger people compared to older people. A total of 72 percent of men report that they consume pornography, while the opposite is true for women, and 68 percent never consume pornography.
Forty-one percent of men aged 16 to 29 are frequent users of pornography, i.e. they consume pornography on a daily basis or almost on a daily basis. The corresponding percent among women is 3 percent. Our results also show an association between frequent pornography consumption and poorer sexual health, and an association with transactional sex, too high expectations of one’s sexual performance, and dissatisfaction with one’s sex life. Almost half of the population state that their pornography consumption does not affect their sex life, while a third do not know if it affects it or not. A small percentage of both women and men say their pornography use has a negative effect on their sex life. It was more common among men with higher education to regularly use pornography compared to men with lower education.
There is a need for more knowledge on the link between pornography consumption and health. An important preventive piece is to discuss the negative consequences of pornography with boys and young men, and school is a natural place to do this. Education on gender equality, sexuality, and relationships are mandatory in schools in Sweden, and sexuality education is an important part of the preventive work for sexual health for all.
Results from the population survey SRHR 2017
Published: May 28, 2019, by The Public Health Authority
About the publication
The Public Health Authority is responsible for national coordination and knowledge-building within sexual and reproductive health and rights (SRHR) in Sweden. We are also responsible for following developments in the area. In the summer of 2016, the Public Health Authority was commissioned to conduct a population-based national survey study in the area of sexual and reproductive health and rights. The study was named SRHR2017 and was conducted in the autumn of 2017 by the Public Health Authority’s unit for sexual health and HIV prevention, in collaboration with SCB and Enkätfabriken AB.
This publication contains the results of the study and the purpose of the report is to increase knowledge and thereby create better conditions for effective public health work for sexual and reproductive health and rights. This publication contains updated knowledge about sexual harassment and violence, sex life, sex, relationships and empowerment, sexuality and digital arenas, sex against compensation, pornography use and sexual health, reproductive health as well as sex and cohabitation education.
The report is aimed at people who in some way work with SRHR and to an interested public. Responsible project manager has been Charlotte Deogan and the head of unit responsible has been Louise Mannheimer at the Unit for Sexual Health and HIV Prevention, the Department of Infectious Disease Control and Health Protection.
Public Health Authority, May 2019
Britta Björkholm
Head of Department
Summary
New knowledge about SRHR in Sweden
Experience of sexual harassment and assault is common among women
Sexual harassment, assault, and sexual violence constitute serious threats against peoples’ safety and health. Research has shown how common sexual violence is and has identified the many different negative health consequences it brings. Sexual violence affects peoples’ physical, sexual, reproductive, and mental health negatively.
SRHR2017 shows that many different forms of sexual harassment and sexual assaults are common in the population. Women are more often victimized than men, and LGBT persons are more often victimized than the general population. Younger individuals are also more often exposed than older individuals.
Almost half of women (42 percent) in Sweden have been subjected to sexual harassment, as have 9 percent of Swedish men. The proportion among women aged 16–29 is more than half (57 percent). More than every third woman (39 percent) and almost every tenth man (9 percent) have been subjected to some form of sexual assault. As with sexual harassment, more than half of women aged 16–29 (55 percent) have been the victim of some form of sexual assault.
Eleven percent of women and one percent of men have been victims of attempted rape through physical violence or threat of violence. LGBT people have experienced this to a higher degree than heterosexuals, and about 30 percent of lesbians and 10 percent of gay men have experienced this.
There are differences related to level of educational attainment. Women with lower education are more often subjected to sexual harassment and to sexual assault compared to women with higher education. These distinctions are probably due to differences in knowledge about and awareness of the meaning of sexual harassment.
Women with lower educational level are also more often the victims of rape enforced by physical violence or threat of violence compared to women with higher educational level.
The majority are satisfied with their sex life, but there are large differences between the genders
Human sexuality is an important part of life and has a significant effect on health. Our sexuality is linked to our identity, integrity, and intimacy. These in turn affect, among other things, our self-esteem, our well-being, and our resiliency. Measuring experiences of peoples’ sex lives and sexual habits is not without its difficulties. Earlier studies have focused on how often people have sex, sexual transmitted infections, and sexual risk taking. The current study has a broader focus on SRHR and examined, among other things, sexual satisfaction and sexual dysfunctions.
The results show that the majority of the Swedish population is satisfied with their sex life, find sex important, and have had sex during the past year. The youngest men (aged 16–29) and the oldest men and women (aged 65–84) were the least satisfied.
Sexual experiences and sexual dysfunctions differed depending on gender. It was more common among men to be without a sex partner compared to women. It was also more common among men to have had premature orgasms, to not have had sex the way they wanted to, and to want more sex partners. Seventeen percent of men reported erectile dysfunctions. On the other hand, women more often reported lack of interest in sex, low sex drive, lack of feelings of pleasure, lack of sexual arousal, pain during or after sex, and lack of orgasms.
Considerably more women reported to have been too tired or too stressed to have sex during the past year, especially in the age span of 30–44 years. Eight percent of the population reported health problems or physical problems that negatively affected their sex life, and 13 percent had sought health care for their sexual problems.
Another influencing factor is sexual identity and transgender experience. Regardless of sexual identity, the majority reported being satisfied with their sex life. However, both bisexual women and men reported more often that they were dissatisfied with their sex life compared to other groups. Most LGBT people and heterosexuals had had sex in the past year, although every fourth trans and every fifth bisexual man reported not to have had sex. A lower percentage of trans people were satisfied with their sex life, but trans people aged 45–84 were more satisfied than the younger age groups.
Women’s and men’s experiences of their sex life differ, and the differences are most pronounced during the reproductive years. Deeper analyses are needed to better understand these differences and to improve knowledge on what consequences these can have on relations, life in common, and people’s well-being. The need of support in relation to sexuality ought to be met by accessible and needs-oriented information, counseling, and care.
Women feel freer to take initiative and to say no to sex than men
Integrity, voluntariness, and sexual consent are prerequisites for good sexual health. Free decision making over one’s body is also a human right. The concept of sexual empowerment describes an individual’s perception of autonomy and decision making over when, how, and with whom to have sex.
The results show that a majority of the population think sex is important in a romantic relationship, feel free to take sexual initiative, can say no to sex, know how to suggest to a partner how they want to have sex, and know how to say no if a sex partner wants to do something they do not want to do. Approximately half of women and men reported that they and their partner equally often decide when and where to have sex. It was more common for men to report that their partner decided where and when to have sex. A larger percentage women, as compared to men, most often feel free to take sexual initiatives, know how to say no to having sex, know how to suggest how to have sex, and know how to say no if a sex partner want to do something they do not want to do.
Men with shorter education feel freer to say no to having sex compared to men with lower educational level. Women with university education are more likely to find sex to be important in relationships, know how to take the sexual initiative, and tend to more often be able to tell a partner how they want to have sex.
All sexual activity is to be voluntarily in Sweden, and it is a criminal offence to force someone to partake in sexual activities against their will. Sexual consent and voluntariness are prerequisites for good sexual health. It is important to spread information to young people, and schools are an important arena for this. Schools are a place where one early on can discuss ethics and basic human values and the right of all humans to make decision over their own bodies.
Most people know how to communicate if and how they want to have sex
Sexual communication and consent can be complicated to handle in practice because it is dependent on, for example, the context and the people involved. The ability to communicate in sexual situations might lead to different health outcomes. In the same government assignment, the study “Sexual communication, consent and health” was performed via the Novus Sverigepanel and included 12,000 participants.
The results show that most people reported that they have the ability to communicate if and how they want or do not want to have sex. Women, younger people, and those who live in a relationship reported this more often. The most common ways to communicate were verbally or with body language and eye contact. Sexual communication varied based on gender, education, and relationship status, among other things.
One third of the respondents think that their communication skills do not affect their wellbeing. One quarter feel that their communication skills make them feel better, and another quarter reported that these skills make them feel safer in sexual situations. One tenth feel insecure and stressed in sexual situations as a result of their communication skills.
Twice the number of women as men have complied with having sex
The Novus survey also shows that 63 percent of women and 34 percent of men have complied with having sex at least once even though they did not really want to. Reasons to comply were they did it for their partner’s sake, for the relationship, or due to expectations. This was especially true for women. More women than men also ended ongoing sex. Bisexual women have more often complied with having sex even though they did not really want to compared to lesbians and heterosexual women. It was also more common among gay men and bisexual men to comply with having sex compared to heterosexual men.
Men stated to a greater extent that it has not been relevant to express that they do not want to have sex or that they do not want to have sex in a certain way, to comply with having sex, or to end ongoing sex.
The results therefore show that how one communicates what one wants and does not want to do when one has sex depends on gender, relationship status, educational attainment, age, sexual identity, and the situation itself. More knowledge is needed on how sexual communication is affected by masculinity and femininity norms together with other power structures such as heteronormativity.
Seventy percent of men consume pornography, while 70 percent of women do not
Pornography is widely debated, and research has found both negative and positive consequences of pornography consumption. Pornography is said to increase the acceptance of sexuality, sexual identities, and different sexual practices and to act as a source of inspiration. Research has also pointed out negative consequences of frequent pornography consumption on, for example, attitudes, behaviors, and sexual health. Frequent pornography consumption is, among other things, associated with more accepting attitudes toward violence against women, a tendency to want to try sexual activities inspired by pornography, and increased sexual risk taking. This is probably due to the content of pornography today, which to a large extent constitutes violence against women and male dominance. From a public health perspective, the aim of this survey was to explore how pornography consumption affects people’s sex life, sexual well-being, and general health.
The results show that many women and men of all ages use the Internet for sex-related activities such as looking for information, reading sexually arousing texts, or looking for a partner. Almost all activities are most common among younger people and decrease with age. There are few differences in Internet use for sex-related activities among young people. It is more common among older men to use the Internet for sexual activities than among women.
Pornography consumption is much more common among men than among women, and it is more common among younger people compared to older people. A total of 72 percent of men report that they consume pornography, while the opposite is true for women, and 68 percent never consume pornography.
Forty-one percent of men aged 16 to 29 are frequent users of pornography, i.e. they consume pornography on a daily basis or almost on a daily basis. The corresponding percent among women is 3 percent. Our results also show an association between frequent pornography consumption and poorer sexual health, and an association with transactional sex, too high expectations of one’s sexual performance, and dissatisfaction with one’s sex life. Almost half of the population state that their pornography consumption does not affect their sex life, while a third do not know if it affects it or not. A small percentage of both women and men say their pornography use has a negative effect on their sex life. It was more common among men with higher education to regularly use pornography compared to men with lower education.
There is a need for more knowledge on the link between pornography consumption and health. An important preventive piece is to discuss the negative consequences of pornography with boys and young men, and school is a natural place to do this. Education on gender equality, sexuality, and relationships are mandatory in schools in Sweden, and sexuality education is an important part of the preventive work for sexual health for all.
Almost 10 percent of men have paid for sex
Transactional sex is used to describe a situation where a person gets, or is offered, compensation or reimbursement in exchange for sex. The compensation can be money, clothes, gifts, alcohol, drugs, or a place to sleep. Since 1999 it is illegal to buy sex in Sweden, while selling sex is not.
To pay or in other ways reimburse someone in exchange for sex is mainly a male phenomenon. Almost 10 percent of men – but fewer than one percent of women – reported to have at least once paid for sexual favors. It was more common to have paid for sex abroad, and 80 percent of men who paid for sex did so abroad. No differences were found between men with different educational levels. Gay men and bisexual men had more often paid for sex compared to heterosexual men (nearly 15 percent and 10 percent, respectively).
One of the purposes when criminalizing the buying of sex was to change attitudes towards paying for sex. Changing these attitudes is part of the broader work for gender equality that has to be undertaken in every corner of society in order to reduce women’s vulnerability. To decrease the demand for prostitution is part of the overall goal to discontinue men’s violence against women.
The results also show that it is rare to accept payment in exchange for sex. Nevertheless, it is more common among LGBT people. It is also more common to accept payment in exchange for sexual favors in Sweden among both women and men than to do so abroad.
The reasons for accepting payment in exchange for sexual favors are diverse. Prevention should therefore include different actions from public authorities, the education sector, and the health care sector. Those concerned should be offered social support and social interventions that encourage good sexual, physical, and psychological health regardless of sex or sexual identity.
Reproductive health: results on contraceptives, pregnancy, abortion, miscarriage, children, and child delivery
Reproduction is a central part of life. Contraceptive use, thoughts about children, and reproductive experiences such as pregnancy, abortion, miscarriage, and child delivery are important parts of our reproductive health and are also closely linked to our psychological, sexual, and general health.
The results show that fewer women aged 16–29 use birth-control pills among those with higher income compared to women with lower income as well as among women with higher education compared to those with lower education. The differences in use are probably due to differences in knowledge and fear of hormones and their side effects.
A third of all women reported they have had at least one abortion. This proportion, as well as the percentage who have experienced a miscarriage, has remained unchanged since the 1970s.
When women reported about their child deliveries, 26 percent said they had entailed physical consequences, 17 percent reported psychological consequences, and 14 percent reported sexual consequences. These consequences differ depending on age and educational attainment. Partners participating during the delivery of their child were also affected psychologically, physically, and sexually, although to a lesser extent. The majority of women with experience of child delivery had had an episiotomy or a spontaneous laceration, while 4 percent had a rupture involving the anal sphincter (grade 3 or 4). Approximately one tenth had sought care for problems related to the episiotomy or spontaneous lacerations in relation to delivery. Neither age, education level, nor income affected the seeking or receiving of care or problems related to child delivery.
Most people reported that they have the number of children that they want, except for men with lower education. Three percent are involuntarily childless, whereas 5 percent in all age brackets do not want children. Approximately 7 percent of both women and men aged 30 to 84 have become parents without wanting to.
In conclusion, SRHR2017 showed that use of contraceptives among women in Sweden varies depending on age and need, but also on income and educational level. Reproductive experiences such as pregnancy, abortion, miscarriage, and child delivery vary depending on a range of factors such as age, income, education, sexual identity, and sometimes region. Further knowledge on associations with more variables is needed to know how to best go about addressing inequities in reproductive health.
SRHR – an issue of gender equality and equity
SRHR2017 showed differences in sexual and reproductive health and rights between different groups in the population. The answers to almost all questions in the survey differed between women and men, and the greatest gender differences were seen for:
- sexual harassment and sexual violence
- experiences of payment in exchange for sex
- pornography use
- several different experiences in people’s sex lives
This reflects different gender conditions regarding sexual and reproductive health. Further, the results show greater vulnerability among women, younger people, non-heterosexuals, and trans people and to a certain degree among people with lower income and education.
A majority of the population have good sexual health, which of course is a positive result. At the same time, sexuality and people’s sex lives differ, sometimes a lot, between women and men. For example, women more often experience low sex drive because of fatigue and stress compared to men. Why men less often feel free to say no to sex needs to be studied further. There are strong norms in our society regarding sex and sexuality, and gender roles, norms regarding femininity and masculinity, and norms regarding heterosexuality affect to what extent people feel free to live their lives as they see best.
Sexual harassment, assault, and sexual violence and how these affect our health is an important public health issue. The prevalence and the consequences do not just affect the victimized individual; they are also a marker for how equal a society is.
Based on the results of SRHR2017, there appears to be a need for more discussions and analyses on sexuality regarding support, advice, and education. For young people we have youth clinics and maternity health care centers where issues related to sex also can be discussed – but that mainly target women – and there are few places where older people can turn to receive help regarding their sex life and sexuality. There is a need to systematically monitor and evaluate these preventive institutions, especially youth clinics, also because of the need of men for support, advice, and care related to their sexuality. We need to emphasize the reproductive rights and health of men and discuss men’s rights to reproductive health, the path to having children, their use of contraceptives, treatment for sexually transmitted diseases, and general sexual health.
In SRHR2017, we see that women and men of all ages use digital arenas for sexual purposes. Young people are more active online, and differences between the sexes are small among young people. UMO.se is an online youth clinic and a good example of how to handle sexuality issues in way that reaches many and with high quality.
Schools are important arenas for improving gender equality and equity regarding health, and the sex education in schools constitutes an important part of SRHR. Sex education in schools and school health care are to provide information to all students about structural perspectives, like legislation and norms, and individual perspectives, such as the physical body, sexual health, relationships, and sexuality. Studies show that students receive more information on sexual health, pregnancy, and contraceptive use than about gender equality, LGBT perspectives, and relationships even though sex education has been subjected to improvements such as integration into other subjects. The improvement work with sex education is supported by a quality assessment from the School Inspection, improvements from the School Authority, and international guidelines regarding sex education from UNESCO and WHO Europe.
SRHR in Sweden – how to proceed
Sweden has a unique opportunity to reach gender-equal sexual and reproductive health and rights based on Swedish legislation, UN conventions, and established policy documents. Sweden has a strong political consensus, which is also reflected in Agenda 2030.
Sexuality is a determinant of health, and the interplay between structural, socioeconomic, demographic, and biological factors influences sexual health. Sexuality and sexual health are dependent on many other aspects of health and lifestyle factors, such as mental health and the use of alcohol and drugs.
In conclusion, our results confirm our prior understanding of SRHR, namely that social prerequisites are crucial for people’s freedom and sense of control over their sexuality and reproduction and to have good sexual, reproductive, mental, and general health. Gender differences exist due to structures, norms, and expectations on both the individual level and societal level, and this creates patterns that affect people’s sex life, communication, relationships, and family life in relation to health.
An important public health issue is sexual harassment, assault, and sexual violence and how this negatively affects health. Harassment, assault, and sexual violence have to stop.
We need further knowledge on differences due to gender, socioeconomic status, and sexual identity in order to improve gender equality and equity. The conditions for and the rights to sexual health need to be monitored and analyzed.
SRHR is coordinated on a national level by The Public Health Agency of Sweden, which works to improve knowledge and national cooperation. In the monitoring of the sustainable development goals, the Swedish gender equality policy, and the strategy to end men’s violence against women, the SRHR issues and specific items from this material are essential. The knowledge generated by this study is a starting point for further public health improvements within the field of SRHR in Sweden.
To examine sexual and reproductive health and rights
The Public Health Agency of Sweden coordinates SRHR nationally, builds knowledge, and monitors SRHR in Sweden. The purpose with the government’s assignment for the agency to perform a population survey on SRHR was to increase knowledge and by doing so create better conditions for SRHR in Sweden.
Paradigm shift in sexuality issues
The link between sexuality and health has been investigated previously. Sweden performed the first population-based sexuality survey in the world in 1967. After ten years of preparation, the former Public Health Institute of Sweden undertook, on assignment from the government, the study “Sex in Sweden” in 1996. This study is often cited concerning sexuality and health issues, largely due to the lack of larges studies on the topic.
During the past 20 plus years since 1996, several important changes and reforms have been passed. In the time line below, we show a selection of these societal changes. Some of the greatest changes are the introduction of the Internet, improved rights for LGBT people, and Sweden’s membership in the EU, which together with increased globalization have increased the mobility of people and services.
Figure 1. Time line with some of the changes in the SRHR field since 1996.
When the Public Health Agency in 2017 conducted the survey described here, it was done in a new context for SRHR. This is most evident regarding gender equality and feminism, norm awareness, improved LGBT rights, and of course the Internet. In addition, the Guttmacher–Lancet commission for sexual and reproductive health and rights developed a thorough and evidence-based agenda with priorities for SRHR in 2018. Their definition of SRHR is:
Sexual and reproductive health is a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity. Therefore, a positive approach to sexuality and reproduction should recognize the part played by pleasurable sexual relationships, trust and communication in promoting self-esteem and overall well-being. All individuals have a right to make decisions governing their bodies and to access services that support that right.
Achieving sexual and reproductive health relies on realizing sexual and reproductive rights, which are based on the human rights of all individuals to:
- have their bodily integrity, privacy, and personal autonomy respected
- freely define their own sexuality, including sexual orientation and gender identity and expression
- decide whether and when to be sexually active
- choose their sexual partners
- have safe and pleasurable sexual experiences
- decide whether, when, and whom to marry
- decide whether, when, and by what means to have a child or children and how many children to have
- have access over their lifetimes to the information, resources, services, and support necessary to achieve all of the above free from discrimination, coercion, exploitation, and violence
To monitor SRHR
The global goals of Agenda 2030 focus on improved gender equality and equity and on strengthening people’s sexual and reproductive health and rights. Many of the goals in Agenda 2030 are related to SRHR, foremost goal number 3 about health and well-being for all ages and goal number 5 about gender equality and the empowerment of all women and girls.
Following the development of SRHR in Sweden is central to being able to fulfill the global goals. This is largely due to the great gender differences and the differences between age groups. The definition of SRHR summarizes the key reasons for why women, children, and young adults are the focus in order to reach the global goals. Several authorities and other operators continually work with these issues together with the health care sector, the social services, and the schools as central arenas.
Table 1. The most relevant global goals and targets for SRHR.
| Targets | |
| 3. Good health and wellbeing | 3.1 Reduce maternal mortality |
| 3.2 End all preventable deaths under age 5. | |
| 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases. | |
| 3.7 By 2030, ensure universal access to sexual and reproductive health-care services – including family planning, information, and education – and the integration of reproductive health into national strategies and programs. | |
| 5. Gender equality | 5.1 End all forms of discrimination against all women and girls everywhere. |
| 5.2 Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation. | |
| 5.3 Eliminate all harmful practices, such as child, early, and forced marriage and female genital mutilation. | |
| 5.6 Ensure universal access to sexual and reproductive health and reproductive rights. | |
| 10. Reduced inequalities | 10.3 Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discrimination. |
Method
The population-based survey SRHR2017 was a survey among the Swedish general population that was carried out by the Public Health Agency in collaboration with Statistics Sweden and Enkätfabriken AB. The survey included questions on general and sexual health, sexuality and sexual experiences, sexuality and relations, the Internet, payment in exchange for sexual favors, sexual harassment, sexual violence, and reproductive health. Therefore, the scope of SRHR2017 was much broader compared to that of “Sex in Sweden” from 1996. The SRHR2017 study was approved by the ethical committee in Stockholm (Dnr: 2017/1011-31/5).
The survey was sent by mail to a representative stratified sample of 50,000 individuals with help from the Total Population register. The response rate was 31 percent. The dropout rate was higher among people with lower education and among those born outside of Sweden. The percentage of dropouts was slightly higher than in general surveys about health, but similar to other surveys about sexuality and health. We used calibration weights to adjust for non-response and to be able to draw inferences to the total population. Still, the results should be interpreted carefully. SRHR2017 is the first population-based study on SRHR in Sweden, and the results are presented by sex, age-group, educational level, sexual identity, and in some cases for trans people.
In addition, the Public Health Agency performed a web survey during the fall of 2018 about sexual communication, sexual consent, and health among approximately 12,000 respondents from the Novus Sverigepanel. This panel contains 44,000 individuals who are randomly selected for different surveys. According to Novus, their panel is representative of the Swedish population regarding sex, age, and region within the age-bracket 18–79. The panel surveys often reach a response rate of 55–60 percent, and our survey had a response rate of 60.2 percent. For further information, please see the report ”Sexuell kommunikation, samtycke och hälsa” by the Public Health Agency of Sweden.
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