Prejudices about sex and its practice are not only responsible for the discriminatory situation of women, but also for many psychological problems of the couples that fill psychology consultations (Guardiola, 2021; Herrera, 2020).

Many studies have focused on identifying or distinguishing the people with sexual dysfunctions from those who do not have any dysfunction (e.g., Basson, 2005; Rosen et al., 2000), considering dysfunction to be the woman not reaching orgasm or not being satisfied in a sexual relationship, without considering the characteristics of this relationship or the cultural factors that intervene in the female orgasm. These studies have focused on exploring the causes of these dysfunctions, from medical/physiological point of view, however they have not analyzed the relationship of false cultural beliefs and prejudices on these dysfunctions, and here is where this work is justified. Consequently, this paper does not pretend to be one more that addresses the causes of these sexual dysfunctions from the usual perspective, but the presence of false cultural beliefs (myths and fallacies) and attitudes of "machismo" in sexual relations, and in the sexual encounter (in particular), and how they cause (imagined) dysfunctions. These false beliefs generate expectations that are impossible or difficult to fulfil in sexual relationships with a partner, which lead individuals to feelings of failure, incapacity, guilt, and the belief that they may have a dysfunction or disorder.

Knowledge related to heterosexual intercourse is partly based on historical information that has been passed on as true, as well as erroneous beliefs, fallacies and myths related to intercourse, the female orgasm, male premature ejaculation, or female frigidity (Elberdin, 1999). These beliefs are mainly due to a lack of knowledge, conditioned by the fact that sexuality is still taboo in our modern societies (Akalin & Ozkan, 2021; Blackey & Aveyard, 2017; Fennell & Grant, 2019). Beliefs that continue being portrayed in films, pornographic and non-pornographic, in TV series (such as "Sex and the City"), in pseudo-scientific magazines, and in the media in general, which present an unrealistic concept of sexuality.

By other hand, the Spanish word "machismo", which comes from “macho” (male), in its traditional sense, refers to a cultural phenomenon or attitude that promotes and glorifies traditional masculinity, often accompanied by a belief in male dominance and the subordination of women. From this traditional position, it could be translated into English as "male chauvinism" or "sexism". These terms capture the traditional idea of the belief in male superiority and the enforcement of traditional gender roles, and the rejection of people who do not fulfill those roles (Hirai et al., 2018).

However, from a more modern point of view, these translations would not be accurate, since the modern meaning of the expression "machismo" in current Spanish culture encompasses a much broader meaning (Arciniega et al., 2008). The current meaning not only includes misogynist blatant attitudes and behaviors (typical of past times and that today have either diminished or are hidden) but also subtle beliefs and behaviors of (unconscious) discrimination against women, as well as the belief that women plays a different role from men. For example, those people who, believing they are defending equality, affirm that men have to help women with housework (unconsciously attributing the responsibility of that task to women), or those people who think that there are jobs that are more suitable for men,….

In addition, although we have found works that associate machismo with risky sexual behaviors (e.g. Christianson et al, 2007; Gavin & Jeff, 2014) we have not found works that addresses "machismo" in the context of the usual sexual practices between heterosexual couples. This study does (such as holding the woman responsible for not reaching orgasm with penetration, or that hetero men should not feel pleasure with anal stimulation, or that there are behaviors, initiatives, or actions, also desires, that are not seen as appropriate in women as in men when they want to have or are having sexual relations). Which are subtle manifestations of the broad meaning that the Spanish word "machismo" has. Because we believe that there is no word in English that reproduces the full meaning of the term, that is why we have used the term in Spanish, and with this we intend to standardize its use in the bibliography.

In this study, we intend to analyze to what extent these beliefs, myths, and/or fallacies are present in Spanish society, and especially during sexual practices, using a broad sample of the Spanish population. This analysis will serve as an indicator as to whether or not they persist in the population or have been replaced by truthful or realistic knowledge, in accordance with the Western cultural model currently followed by psychologists and sexologists (Elberdin, 1999; Lameiras et al., 2013; O'Connell et al., 2005). We will also delve into the false beliefs that we have addressed in this study, and their origin.

Historically, some authors such as Freud or Marie Bonaparte have marked certain beliefs that today are known to be incorrect, but which have had and still have a great impact. Freud stated that women are divided into two groups according to the origin of their sexual pleasure: "clitoral women" and "vaginal women". This affirmation has become a dogma in our society (Elberdin, 1999). However, in 1998, very recently, Helen O'Connell described the female organ anatomically, revealing that the clitoris is the female organ exclusively destined to provide sexual pleasure (Lameiras et al., 2013), with the majority of women achieving orgasm through its stimulation and peno-vaginal intercourse being insufficient to achieve it (with rare exceptions) (Bhat & Shastry, 2020).

Freud indicated that "clitoral women" have not managed to develop successfully. He explained that during adolescence the origin of pleasure should shift from the clitoris (organ that he considered "male") to the vagina (female organ). Women who did not achieve this were labelled “infantile” (Elberdin, 1999).

Along the same lines, Marie Bonaparte, a psychoanalyst who followed Freud, would affirm that “clitoral women” were “frigid” and rejected men and their own feminine role, leading them to a “masculinity complex” (Elberdin, 1999). These and other authors would give rise to the idealization and importance of coitus leaving the female sexual apparatus and, therefore, the female orgasm to be ignored.

In contrast to this information, it has been proven that external stimulation of the clitoris is the fastest and most effective trigger to reach orgasm in women, so there would be no such division of women according to their type of orgasm (Shaeer et al., 2020). Likewise, it is known that many of the women who reach orgasm during intercourse do so thanks to the simultaneous stimulation of the clitoris, although there are still many women who do not perform this practice due to the prejudices associated with female masturbation (Elberdin, 1999).

These prejudices are based on certain cultural myths, maintained by pseudo-scientific magazines, which report that women do not have this habit, given that it is considered a "man's thing" and it is vulgar for women to practice such thing, supporting again that penetration is the ideal way to reach orgasm. However, because of new available information, more and more women masturbate, and we find that among younger women there are fewer who have never masturbated (Elberdin, 1999).

This idealization of intercourse has caused men to be relied on as the leaders of the sexual encounter and responsible for their partner reaching orgasm through penetration. It has been assumed that factors such as time are responsible for many women not reaching orgasm and conclusions have been drawn regarding premature ejaculation in men or slow orgasm in women. In addition, simultaneous orgasm is even considered to be the "ideal" finish for the sexual encounter, and that achieving this is a sign of an emotional adjustment between partners (Elberdin, 1999).

However, it has been shown that the duration of intercourse does not correlate with the female sexual response, that is, a woman’s orgasm does not depend on the duration of intercourse. It has also been shown that women who reach orgasm during penetration do not do so because of longer intercourse (Bhat & Shastry, 2020; Elberdin, 1999). The estimated average time for women to reach orgasm in a heterosexual relationship is 13.41 min, but always with the help of certain positions and manoeuvres, not only with penetration, which again indicates that the problem of the absence of female orgasm is not time, but inadequate or insufficient stimulation (Bhat & Shastry, 2020). As for "premature ejaculation" it is again a consequence of the responsibility that the man assumes over the sexual relationship. In this case, the concern is directed at their “poor control”. This fact is seen as selfishness, and even machismo, because they do not "give the woman the time she needs to reach her orgasm" (Elberdin, 1999). Despite this, we know that the need for men to control their own ejaculation in order to give women pleasure is not based on a real anatomical-physiological need (Elberdin, 1999). In studies of men with suspected non-organic erectile dysfunction, the characteristics of the relationship and the female partner were found to have contributed to this problem. More specifically, possible causes regarding initiation and maintenance are relationship problems, female psychosexual dysfunction, and the effect of high levels of sexual interest on her part, in addition to the belief of the partners in male sexual myths (Speckens et al., 1995). For all these reasons, some professionals state that “premature ejaculation does not exist, it is an invention of culture” (Cristóbal, 2012).

Despite all this, many men experience sexuality as performance and responsibility and feel guilty in the face of female anorgasmia (Elberdin, 1999). However, the study by Shaeer et al. (2020) found that 90% of women reported having a good emotional connection with their partners, a willingness to have sexual intercourse, satisfaction with the size of the partner's penis, and satisfaction with erectile function and ejaculatory control. A total of 70% of these women reached orgasm frequently. This shows us that, on many occasions, their worries and guilt are not related to their own experience (Shaeer et al., 2020).

Another myth associated with our society is the fallacy of children, despite the fact that in practice it is known that there is no correlation between having children, or the number of them, and the ease of reaching orgasm during penetration (Elberdin, 1999; Witting et al., 2008).

On the other hand, we must mention the stigma associated with male anal stimulation. It is based on the fact that anal sex is for homosexual men, but it has been shown that men of any sexual orientation enjoy this stimulation, given that a known point of male pleasure can be found in the prostate. However, many men do not engage in this practice for fear of being perceived as homosexual, although these attitudes are changing (Wignall et al., 2020).

Finally, we want to talk about the existing prejudices surrounding sex toys. They are considered "dirty", that is, they do not have a good reputation because they are considered a resource for sexual problems. However, it has been proven that a “deeper, fuller and broader sexual sensation” can be achieved with these toys (Quilliam, 2007).

The main objective of this work was to assess the knowledge of the Spanish population regarding heterosexual intercourse, and to what extent sexual myths and fallacies are present in said practice and expectations. In a complementary way, as secondary objectives, we compared said knowledge in terms of gender (women and men) and in terms of age (participants from 17 to 30 years old and over 30).

We compare by gender because, as we have seen, much of the knowledge associated with the female orgasm, intercourse, and women's responsibility for their own pleasure is associated with the women's revolution, so we want to see if they are more up to date with such knowledge (Elberdin, 1999). In addition, the expectations of adolescent men and women regarding what a good sexual life implies differ, given that our society, although committed to equality, presents contradictions such as those offered by pornography, which is generally full of machismo (DeMiguel-Álvarez, 2021).

Furthermore, we assess the effect of age by referring to the generational change. Young people have more information at their fingertips, being able to present fewer prejudices and a higher level of adequate knowledge (Elberdin, 1999).

In addition, the concept of sex in our culture is changing, with women currently having greater sexual freedom within their heterosexual relationships (Ginsberg et al., 1972), which could affect both the comparison by gender, given that it is women who are undergoing changes, and the comparison by age, given that it is the new generations that are experiencing this new concept. It is necessary to have information on sexual practice for it to be satisfactory (Ginsberg et al., 1972).

Method

Development of the Interview Questionnaire (K4SA)

To conduct this study, we had to prepare a questionnaire that collected these myths and fallacies (questionnaire on Knowledge and Attitudes for Sexual Activity, hereinafter we will refer to it as K4SA), using the hetero and couple model (between two people of different sexual identity) as a reference, although many of the fallacies and prejudices that we address in the survey can be extended to general sexual relationships (hetero or homo, between two or more people, or with oneself).

We based the questions (items) on the most frequent consultations requested by clients of psychological and sexuality clinics in Spain, most of them collected in the work of Elberdin (1999).

We adapted these consultations or reasons for consultation to a question format, which constituted the items of the scale. These items respond to the following types of prejudice:

  1. 1.

    Beliefs and expectations about the role of sexual intercourse:

    In these items, the idea that people have about the main function of sexual intercourse is investigated, that is, we explore what they believe the main reason for having sex is, if it is to procreate or for pleasure. This helps us characterize a society by understanding what the majority thinks about this topic.

  2. 2.

    Information about risks:

    These statements are aimed at finding out the population’s opinion regarding the information they need or have, checking whether they consider that talking and learning about sex is necessary or not. At the same time, we can see if they are aware of the consequences of unprotected sex and lack of information.

  3. 3.

    Fallacies and ignorance about anatomy and erogenous zones:

    These items address anatomical-physiological knowledge. Questions about the characteristics and zones of the vagina and penis, as well as other erogenous zones of the body. Specifically, it asks about the location, shape or size, function, sensitivity and structure of these parts or areas. In this way, we can see how accurately women and men know their bodies, genitals, and erogenous zones, as well as those of the opposite sex.

  4. 4.

    Fallacies about the duration of intercourse:

    In this dimension, we want to evaluate the myths and beliefs that people have regarding the importance of the duration of the sexual act, specifically penetration. For the most part, the questions are related to the female orgasm, evaluating the belief that it is achieved or not depending on how long the man manages to "last" during the penetration stage until his own orgasm. Knowledge about the difficulty of achieving female orgasm itself and the myth of the problem of premature ejaculation is also evaluated.

  5. 5.

    Fallacies about vaginal orgasm:

    In this subgroup, the knowledge of the female orgasm is questioned, linking it to the expectations or beliefs that it is through the vagina and, generally, thanks to penetration that one should reach orgasm. In this way, we can investigate the concept of sexual intercourse that the population has and the knowledge about the female orgasm and the appropriate ways to achieve it.

  6. 6.

    Fallacy of simultaneity:

    This subgroup consists of two items, which clearly represent this fallacy. They evaluate the belief that, for sexual intercourse to be satisfactory, both partners must reach orgasm at the same time, given that their orgasms will be connected in this way.

  7. 7.

    Guilt and fallacy of failure:

    This set of items considers the beliefs that not achieving orgasm during penetration is a failure. In addition, it evaluates the effect that the myths about both people climaxing at the same time and during penetration have on feelings of failure, guilt, and abnormality in the relationship.

    We explore to what extent, when this does not happen, they feel guilty, or consider the relationship as unsatisfactory, unsuccessful, abnormal, or "sick", which justifies seeking treatment.

  8. 8.

    Fallacy of male initiative:

    Beliefs about the man's responsibility to lead a successful sexual encounter are contemplated here. That is, that the responsibility of the female orgasm belongs to the man and not achieving it is a symptom of failure, of disregard for women and even a subtle sign of machismo. We want to know if people think that the man should wait for the woman, if he should take her into account, and if not doing it (“not waiting for her”) could be a manifestation of disregard for her, and even of “machismo”.

    This type of fallacy is related to the previous dimension (guilt), but here we are trying to understand to what extent people continue to hold the belief that it is the man who should know how to perform the sexual act and take the initiative, and also check if society classifies those men who consider that they are not capable of giving women a "good" orgasm to be incompetent.

  9. 9.

    Fallacy of premature ejaculation

    Here we address the fallacy of premature ejaculation as a cause of failure, the belief that men are quicker to reach orgasm, and the belief that women are slower or have a harder time reaching orgasm than men.

  10. 10.

    Fallacies about female masturbation:

    In this subgroup, we want to see the fallacies related to female masturbation, with the aim of verifying, on the one hand, if this topic is still stigmatized for women in society, and on the other, if it is a socially accepted practice, and in what situations it would be considered justified. Especially if it is accepted that women masturbate while having a partner, or that they do so during intercourse.

  11. 11.

    Fallacy of motherhood (fallacy of children):

    This fallacy addresses the belief that a woman who has been pregnant and has given birth to one or more children has an easier time reaching orgasm during intercourse.

  12. 12.

    Use of toys:

    Here we assess the fallacy regarding the use of sex toys as a sign that something is wrong with sex. We want to check if there is a belief that moving away from conventional sex is considered a failure, that is, that using sexual accessories is not part of the fun but is a necessity in the face of underperformance.

  13. 13.

    Sexual attraction to others:

    These items assess the belief of whether or not it is "normal" for the person or the person's partner to feel attracted to people outside of the relationship, without this being a problem or reason that needs to be discussed, given that we only speak of physical attraction.

  14. 14.

    Fallacies about the responsibility of women:

    We also intend to verify the presence of the idea of considering the woman guilty of failure in terms of intercourse and sexual desire.

  15. 15.

    Prejudices about anal stimulation or anal masturbation:

    With these items, we want to analyze the beliefs and prejudices of men and women regarding anal stimulation, more specifically those associated with men. At the same time, we want to check the knowledge that the population has about the erogenous zones, specifically about the zone that we are dealing with in these statements.

Finally, the version of the scale used in this study corresponds to the latest version (Monterde-i-Bort et al., 2020) of the initial 53-item version developed by the first two authors (Monterde-i-Bort & Herrera, 2019), to which 6 items were added (one item parallel to one already existing in the first version, 2 on fear due to anatomical ignorance, and 3 on anal stimulation, not exclusively but especially referring to men). This second version has a total of 59 questions or items.

The questionnaire was designed to be distributed and answered online, accessed through a link, via email or smartphone (message or social network applications).

The response options are given, most of them are dichotomous, for or against, expressed in different ways, depending on the question: “Yes”/”No”, “I think so”/”I don’t think so”, or “ I agree”/”I disagree”. With some multiple-choice exceptions.

The questionnaire contains two types of questions, knowledge questions to practice sex and fallacies/myths related to sexual behavior.

Table 1 shows the numbered items, indicating the order in which they are presented in the online application. It can also be seen, and answered, by accessing this link: https://forms.gle/MLgSu1X7XnmEebbm8.

In addition to the answers given to each question (or item), total scores were also calculated by adding the answers that we have considered "correct". Which, in the case of questions about knowledge, the “correct” answers were simply the right answers, and in the case of the questions involving myths, fallacies, and "machismo" attitudes, the "correct" answers were decided by consensus among professionals. According to the western cultural model currently followed by professional psychology and/or sexology therapists in Spain.

Sample

A total of 1162 participants of different gender and age, all of them Spanish residents, participated in this research.

The sample collection period was during the years 2019, 2020 and 2021, divided into two studies (Monterde-i-Bort et al., 2020; Monterde-i-Bort & Herrera, 2019). Given that 6 new items were added in the second study, as explained in the previous section, when these items were analyzed, the sample size was reduced to that of the participants in the second study (N = 534).

Regarding gender, 808 identified as “female”, 350 identified as “male”, and only 4 identified as “non-binary”. This difference in participation between genders is consistent with that obtained in studies with online questionnaires. Women tend to participate much more than men.

Given the topic of study, we considered it relevant to ask about the individual’s sexual orientation (voluntary response): 957 participants declared themselves to be heterosexual, 26 gay/lesbian, 172 bisexual, and 7 "other".

Regarding the age of the participants, the range was from 14 years (two cases) to 64 years, with a mean of 24.62 (st. error = 0.263), median of 22, SD of 8.96, and mode of 21.

Design

The questionnaire was built in Google Forms and distributed over the Internet, by sending a link through social networks. It is therefore not an experimental study. Although it is randomized, it was not a probabilistic sampling because the complete census of the Spanish population was not used. To obtain the sample, an initial group of students from the Faculty of Psychology of the University of Valencia was chosen randomly from the census of the Faculty (so the initial sample was a probabilistic sample only for students from the Faculty of Psychology of Valencia). Each selected participant was asked to answer the questionnaire and forward it to people in their social network, by email or WhatsApp from their mobile phone (snowball sampling).

The Google database was prepared and adapted for use with SPSS, with which the statistical processing of the data was conducted.

In this study we present the results of the descriptive analyses, we compare between genders (women and men, self-identified as such, given that we did not obtain a sufficient sample of bisexuals), and we assess the relationship between the level of knowledge and age.

Results

Women Versus Men

In Table 1 we present the results of the survey. For each question (item), we present the percentage of participants that chose each of its answers. We differentiated between self-identified women and self-identified men.

Of the possible answers given to each question, we marked the answer that we considered adequate (correct), according to the specialist consensus based on the current Western cultural model, with “(1)” to be able to calculate total "knowledge" scores. However, this does not imply that these answers are necessarily correct in other populations or cultures. In any case, the reader will be able to compare the frequency of answers that each gender has given to each answer option and draw their own conclusions.

To neutralize the difference in participants by gender, this frequency is expressed in percentages, calculated within each gender. Thus, we can see that almost 76% of self-identified women and 79% of self-identified men in the studied sample agree that there are two types of female orgasm (clitoral and vaginal).

Table 1 Percentages of response to each possible answer of each question: comparing genders
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The results shown in Table 1 reveal that in general the participants (Spanish sample) show a high level of knowledge about and attitudes towards sex, considering the current Western cultural model. According to the models applied in psychology and sexology clinics, the answers we considered "adequate" have been chosen by both genders with a very high frequency (99.1% to 73.1%,, with some exceptions mainly related to anatomy, where the level of knowledge drops dramatically), although women show somewhat higher percentages. In other words, the participants are quite knowledgeable about both the function of sex and how to enjoy it in a healthy way from a psychological point of view.

However, we also observe the weight of certain social and/or cultural prejudices. The sample not only mistakenly answers questions surrounding these topics, but also shows contradictions in other questions with similar meaning. We will come back to these later in the discussion section.

Sexual Knowledge and Age

In order to find out if the current level of knowledge is lower in older people or is independent of age, a total, global knowledge and proper attitudes score was calculated for each participant, depending on whether or not their answers were adequate, or compliant with the sexual model we followed. This total score was calculated by adding the "correct answers", that is, counting the number of matches with the answers that we considered appropriate.

Given that the last 6 questions were included in the second version of the questionnaire, and that not all the participants answered them, only the responses to items 1 to 53 were used to calculate this overall knowledge score.

To analyze the effect of age, we performed two types of analysis. Correlation (Pearson) and t-test (dividing the sample into two groups: up to 30 years of age, which we will call “young” for short, and over 30 years of age, which we will call “older”). The effect sizes were calculated for each measurement.

In Table 2, we present the correlations of the level of knowledge (correct answers) and age, and in Table 3 the results of the Student's t-test between the two age groups.

Table 2 Correlation sexual knowledge with age
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Table 3 T test between age groups in sexual knowledge (sum of hits)
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Both the correlation and the t-test results indicate that young people have a statistically significant higher level of knowledge about sex, however, the effect size, in both analyses has been small.

Measurement of the Knowledge for Sexual Practice and Interpretation of the Scores

The scores obtained by the sum of appropriate or correct answers can be used to measure an individual’s level of knowledge about the sexual practice. In this regard, the questionnaire that we used can serve as an evaluation instrument in contexts of clinical practice and for health professionals.

For this reason, we have included two tables with the Centile scores corresponding to the direct scores obtained in our study. One (Table 4), adding all the items of the latest version (59 items) and another (Table 5) adding up to item 53 (first version of the questionnaire, carried out with a larger sample). Centile scores are rounded to the nearest whole value.

Table 4 Centile scores for the number of correct answers up to item 53 (N = 1095)
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Table 5 Centile scores for the number of correct answers up to item 59 (N = 1095)
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Discussion

Despite finding very positive attitudes and very high knowledge in the sample, we still detect the weight of certain social and/or cultural prejudices, which we could call "historical”, and which may be conditioning sexual relationships, in some minority cases even leading to feelings of failure, abnormality, and the search for professional help (therapy).

This is the case, for example, of the distinction between vaginal and clitoral orgasmic women. This myth or false belief is still very much present in our culture (only rejected as false by 24% of self-identified women and 21% of self-identified men).

There is also the myth of premature ejaculation or the duration of intercourse (Intravaginal Ejaculatory Latency Time) as a cause for women not reaching orgasm during sexual intercourse (Canat et al, 2018; Semans, 1956; Xi et al., 2022), linked to the belief that the success of the female orgasm depends on the man knowing how to hold his own orgasm (to give the woman time). This fallacy is deeply rooted in our culture, with many publications dedicated to testing pharmacological treatments (Canat et al., 2017; Fu et al., 2018; Martin et al., 2017; Singh, 1963; Waldinger, 2014) or the use of specific condoms to delay orgasm in men (Wang & Yu, 2022). However, no solution invites women to self-stimulate during intercourse, or takes into account the damage that excessively prolonged intercourse will cause to the vagina. In our questionnaire, this fallacy is collected through several items, which address different aspects of this popular belief. Our results reveal the high and worrying percentage of answers which favor some of these items, contrary to what the scientific evidence provides on the "timing" of female vs. male orgasm (Darling et al., 1991; Newman, 1994):

21 (In general, women take longer than men to reach orgasm), with which 56% of self-identified women and 61% of self-identified men agree;

37 (Premature ejaculation is a problem in the couple's sexual relationship), with which 50% of self-identified women and 73% of self-identified men agree (note the large difference between genders); and

50 (The time elapsed between penetration and ejaculation is key for a sexual encounter to be satisfactory), a misconception that only 28% of self-identified women agree with, but 42% of self-identified men do (a percentage much higher than desirable in self-identified men).

The response to these items would confirm the weight that these fallacies still have. However, other items that address the same idea, but which include the personal experience of the respondents above social prejudices, offer contradictory results. See the responses given to items 12, 23, 26, 33, 42, 43, 49 and 50 in Table 1 in which the respondents, and especially the women, mostly reject that their orgasm depends on these circumstances (more in line, although not completely, with the results of the work of Bischof-Campbell et al., (2019).

Additionally, we also want to highlight that a discreet percentage, but in our opinion relevant, of those surveyed sees men not waiting for women to have her orgasm as a form of selfishness, disregard for women, or even “machismo” (items 43 and 54).

Another of the typical fallacies in Spanish culture is the belief that the man is responsible for the woman’s orgasm. As an example, we can look at item 11 (The woman should have orgasms and the man must be able to give them to her), which 33% of self-identified women and 46% of self-identified men agreed with, a percentage which is too high in our opinion. Another example is item 29 ("There are no frigid women only incompetent men"), an idea with which 31% of self-identified women and 20% of self-identified men agreed, which we also considered too high. The weight of this fallacy is also verified by item 47 (The man has to know where to stimulate a woman. If she does not reach orgasm with intercourse, it is because she has not been stimulated enough previously), an idea with which surprisingly, 50% of self-identified women and 61% of self-identified men agreed. However, it contrasts with the answer given to item 18, which asks directly if the man has to take the initiative (The man is the one who has to take the initiative of the sexual encounter. He must know where, when, and how), which has been virtually rejected by all self-identified women and men surveyed (99% and 97% respectively). One can interpret these results as there being a shift towards sharing the responsibility for satisfactory sexual relationships. In other words, we can say that women are currently expected to assume a much more active role in sexual encounters (Sakaluk et al., 2014).

Another aspect to highlight is related to those fallacies and false expectations that are directly linked to feelings of failure and guilt, or that lead individuals to think of abnormality or psychological "disorders", and to consider consulting with a specialist. The most representative fallacy of this would be that of simultaneous orgasm (items 15 and 30), recognized to be the goal of sexual intercourse in many manuals of the 1950s (Brody & Weiss, 2011; Darling et al., 1991; McCary & McCary, 1982). It is worth noting that 32% of self-identified women and 49% of self-identified men set themselves the goal (for an "ideal intercourse") of reaching orgasm at the same time (item 15). Not achieving this goal leads some (both self-identified women and especially self-identified men -49%-) to feel bad after the sexual encounter (a feeling that some authors connect with self-esteem: Cooper et al., 2014; Séguin et al., 2015). In addition, women not reaching orgasm through vaginal penetration is considered by some to be a problem (item 30), as it involves moving away from "true" sex (Potts, 2000). It is even considered to be a disorder (item 25) by 31% of self-identified women and 46% of self-identified men. Furthermore, even though it is low, an important percentage of respondents (item 38) consider it to be a good enough reason for women to seek the help of a specialist (10% of self-identified women and 15% of self-identified men). Given the consequences of this belief, we can observe proof of the damage that these fallacies and myths are doing to our current society in the field of sexual health (Golbası et al., 2016).

However, when asked about their opinion regarding whether women reach orgasm during intercourse only through penetration (item 6), or if this is the most common way for women to reach orgasm (item 14), the great majority say no. They are even opposed to considering that this should be the way for women to reach orgasm (item 27), rejected by more than 90% of those surveyed. These opinions are more in line with scientific evidence (Salisbury & Fisher, 2014; Shirazi et al., 2018). The answers given to items 32 and 52 would complement the information on the weight of this fallacy and/or myth.

Another of the aspects addressed with our survey has been the interest in the risks of practicing sex (items 22, 41, and 44). In view of the results, we can conclude that the respondents have shown a positive attitude towards being informed, and almost all of them understand the risks, know about sexually transmitted diseases, how to prevent them and recognize the need to stay informed. Rejecting the false idea that “sex is safe if you practice it with people you know” fallacy that was a health problem in the late 1990s (Appleby et al., 1999; Boulton et al., 1995; MacPhail & Campbell, 2001; Meyer-Weitz et al., 1998; McLean et al., 1994; Offir et al., 1993) and which seems to be outdated.

Regarding the fallacy of the relationship between having given birth and the ease of having orgasms (item 40), our sample has shown responses consistent with the absence of said relationship, evidenced by Witting et al. (2008), who found no correlation between the number of children and the woman's sexual satisfaction.

Other very traditional fallacies and myths, such as that a healthy sexuality is one that conforms to the norms (item 45), the relationship between the size of the penis and the amount of pleasure provided to women (item 46), that the main function of sexual intercourse is to procreate (item 4), or that intercourse should be avoided during pregnancy (item 7) (Bartellas et al., 2000; Murtagh, 2010; Pauleta et al., 2010; Thanh et al., 2021), have been rejected by almost all of the respondents.

Another result, which we consider important to highlight, is the one related to female masturbation (items 2, 8, 17, 31, 35, 39). The results clearly indicate that the fact that the woman masturbates, even during intercourse, even when having a stable partner, and even when having regular sexual intercourse with a stable partner, is fully accepted in our sample, and given that our results are supported by those of Kaplan (1974) and Shirazi et al. (2018), we could say that women helping themselves by masturbating during intercourse (what has been called "assisted intercourse" or "concurrent clitoral stimulation during intercourse") is already accepted as normal by our society.

This leads us to state that women having to help themselves during intercourse to reach orgasm is not considered a symptom of failure in the sexual relationship. Neither is the use of sex toys, alone or with a partner (item 48), which is also seen as normal in this sample, coinciding with other studies based on population surveys (e.g., Döring & Poeschl, 2020). Once again, beliefs about the negative connotation that have been given to sex toys for a long time (Quilliam, 2007) are disappearing, so people are beginning to assume that they are a complement to the sexual relationship, and not a symptom of failure.

As we said in the Method section, the second version of the questionnaire included three questions about masturbation or anal stimulation, especially in men, during heterosexual intercourse (items 55, 57, and 59), in response to the concerns of some psychology students, and the fact that it is a subject of increasing interest (Agnew, 2000). Our aim was to understand both the acceptance of this practice and whether it is still subject to prejudice (to what extent anal stimulation is considered inappropriate in men, if it is a sign that a man who considers himself heterosexual is not quite heterosexual, or if it cannot produce pleasure in men). The results indicate that these prejudices are rejected by more than 82% of the respondents who self-identify as men (and by more than 94% of the women who self-identify as such), so we can conclude that at present it would be considered as a normal sexual practice among heterosexual couples, and that any stigma associated with its practice has disappeared.

To conclude, if at the beginning we highlight that the participants have shown, in general, a high level of knowledge related to the practice and enjoyment of sex (with the exceptions related to the ongoing weight of some myths and cultural fallacies that we have pointed out), we cannot say the same about anatomical-physiological knowledge. In this group of items (items 1, 5, 9, 10, 13, 20, 24, 34, 36, 46, 51, 56, 58, 59), although the vast majority of responses have been within the desired range, from the point of view of professional psychotherapists, there are some in which the level of ignorance has been revealed to be very high.

This is the case of the items:

1 (There are two types of orgasms for women: clitoral and vaginal), with which 76% of self-identified women and 79% of self-identified men have erroneously agreed;

9 (A woman's clitoris is a tiny organ located on the outside of the vagina), with which 62% of self-identified women and 69% of self-identified men erroneously agreed;

13 (Take a good look at this image –a photo of a vulva is presented with areas divided by lines-. In which area do you think the exit of the urethra is located (where pee comes out)?), which surprisingly only 36% of self-identified women and 38% of self-identified men answered correctly (also intriguing that slightly more men than women answered correctly, although still with a very low percentage); and.

24 (Which of these areas of the penis –a photo with four images of different parts of the penis is presented—do you think have the greatest sensitivity for the man to reach orgasm?), only answered correctly by 19% of self-identified women and 24% of men (the low level of accuracy among men -self-identified as such- is striking). Therefore, we consider that this knowledge is still a pending issue.

In the rest of the items in this group, the level of knowledge has been from very to quite high, as can be seen in Table 1.

As a final comment, due to its importance for professional psychological practice, we highlight that almost a total majority considered it acceptable to feel attracted to people other than their partner or that other people may be attracted to their partner (items 3 and 53) with a percentage of answers in favour (“desirable” from the psychological point of view) around 90%. This indicates the scarce role that jealousy is playing in the relationship, an issue that in addition to other major problems causes dissatisfaction within the relationship (Dandurand & Lafontaine, 2014).

Limitations of This Study and Future Goals

As usual in online surveys, our sample is also unbalanced with respect to gender, with a greater presence of women, which is important to take into account since some studies suggest that women are less conservative in their prejudices (e.g.: Kinlaw et al., 2015; Lingiardi et al., 2016). These studies also point in the same direction with age, a variable in which our sample is also more loaded with young people. However, the greater presence of young people (median age 22 and mean 24.6) does not worry us so much since it is among the youth where we are most concerned about the presence of these prejudices, fallacies, and "machismo".

This suggests to us the need to replicate this study with new samples (and we invite other researchers to use this questionnaire in their respective countries or with new samples).

On the other hand, our study on the presence of myths, fallacies and "machismo" in sexual relations has been limited to the heterosexual model of couple, in response to the incidence that these prejudices have on the perception of failure in the sexual relationship between traditional couples, and on the decision to seek help from the specialist.

In this direction, a future line would be to adapt this questionnaire to models of non-heterosexual relationships, for other sexual and gender identities.

The results have also increased our interest in including a scale of social desirability. We reserve it for future work.

We also have to say that, although we have collected the most important myths and fallacies (for their effect on the failure of sexual intercourse and on the search for help), we have left some others not included in this study, some known, such as the myth of the negative effect of having sex before performing a competitive sports activity (Moncada-Jimenez & Chacón-Araya, 2006) and others that we still do not know, fruit of the cultural advancement of our societies.

We have not considered it appropriate to carry out statistical significance tests comparing the response percentages given by men and women to each item (Monterde-i-Bort et al., 2006, 2010). We reserve this comparison for when we have factorized the questionnaire and analyzed its psychometric characteristics.

Another limitation refers to the generalization of the results. Please take into account the demographic data of the sample used in this study, which are described in the Method section.

But despite these limitations, we believe that the results of this study are quite generalizable and useful, and that both they and the questionnaire that we have developed to obtain the data will be well received by researchers specialized in this topic.

Finally, if this study is well received, we also have a pending task to carry out a psychometric study of the questionnaire (K4SA) that we have developed for this study. To convert it into a clinical evaluation instrument.

Conclusions

The main objective of this work was to assess the knowledge of the population regarding sexual relationships, and to what extent sexual myths and fallacies condition both this practice and the expectations that partners establish for their sexual intercourse.

Our findings allow us to conclude that the Spanish population has, in general, good knowledge to lead a healthy and satisfactory sexual life, being the dimensions with the best score (greater than 90% of correct answers): "use of toys", "attraction to others”, “fallacy of children”, “anal stimulation”, and “female masturbation”. While the ones with the worst scores are those of "anatomical-physiological knowledge", "failure as a symptom of machismo", "duration of intercourse", and "male initiative", all of them with a much lower average score of "correct answers" (answers that we consider adequate or desirable).

We have also verified that there are important differences between men and women both in terms of the level of knowledge (number of adequate answers) and in the presence of the myths and fallacies. More specifically, it is women who have a higher level of knowledge, while presenting fewer prejudices. This confirms the studies that were reviewed (DeMiguel-Álvarez, 2021; Elberdin, 1999).

We can also conclude that, although we have found statistically significant relationships between the level of knowledge and age, in favor of the younger population (with a greater number of appropriate responses), this relationship has not been sufficiently proven (their effect sizes have been modest).

Regarding the items in which there are more differences between genders, we found that men score worse (more incorrectly, for us) than women on items 11, 15, 16, 25, 32, 33, 37, 43, 47, 52 and 56 (see Table 1).

As a final conclusion, we observe that it is women and young participants who have the most correct information and the ones who are least carried away by the prejudices imposed by society. In addition, through the different formulation of questions, we verified that many participants have the necessary theoretical knowledge to enjoy a healthy sexual life but that they are won over by prejudice. When they are asked in a more applied way, closer to their personal experience, that is, when their personal experience is confronted with some of the very socioculturally coined prejudices, they present contradictory answers. Therefore, it is important to intervene in this area for a better understanding of couple sexual relationships, as well as to better understand the functioning of our sexual organs and, above all, so that the knowledge that people have is internalized, to definitively eliminate these myths and fallacies, and their serious effects on sexual satisfaction.

In this sense, we defend the role of psychologists in this field, not only as sex therapists but as prevention agents who have the tools to provide sex education to younger people that is real and goes beyond the use of condoms and sexually transmitted diseases. In this way and at the same time, a step would be taken towards the normalization of sex, allowing the youngest to express themselves without prejudice or fear.

Clinical and Policy Implications

This study, and the questionnaire developed, will allow evaluating the level of presence of these fallacies and negative attitudes, both in different societies, groups, and in individuals. Information that will be of great help to professional therapists who treat sexual dysfunctions and problems in couple/marital life. Especially those problems that have their origin in the feeling of failure of their sexual relations due to the presence of these false and unrealistic expectations in their minds. With this study (which we encourage and expect to repeat in other countries), we also hope to contribute to a healthier and more accepted sexual life.