Is orgasmic meditation a form of sex?: practitioners of orgasmic meditation view the practice as significantly more similar to meditation than to sex or fondling [version 1; peer review: awaiting peer review]

Background: Orgasmic Meditation (OM) is a structured, partnered meditative practice in which one person, who can be any gender, strokes the clitoris of their partner for 15 minutes. As such, it resembles a sexual activity. OM is taught as a practice that is distinct from sex, and we wondered whether people who engage in OM actually maintain that distinction themselves. Methods: We conducted an online convenience sample survey including qualitative open-ended text questions and quantitative Likert-style questions that was distributed to email listservs for practitioners of OM. In the study, 414 participants completed the 30item questionnaire including questions designed to differentiate the potentially related concepts of OM, seated meditation, fondling, and sex, as bases for comparison. Results: Participants reported that they strongly agreed that OM is not fondling or sex, giving an average Likert-type rating of 4.55 and 4.65, respectively. Participants disagreed most strongly with the statements “OM is Sex,” and “OM is Fondling,” with average ratings of 1.42 and 1.48, respectively (strongly disagree). There was also high disagreement with the statement “OM is not mediation,” with a rating of 1.53. Conclusion: The quantitative results of this mixed methods study show that OM practitioners view the practice as significantly more similar to meditation than to sex or fondling. These results were consistent, regardless of whether the question was asked in the positive or negative or whether OM was being compared to one behavior individually or to multiple behaviors at the same time. The Open Peer Review Approval Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article. Page 1 of 11 F1000Research 2022, 11:263 Last updated: 03 MAR 2022


Introduction
Orgasmic Meditation (OM) is a structured, partnered meditative practice involving manual stimulation of the clitoris. 1 In the 15-minute practice, one person strokes the clitoris of another "with no goal other than to feel the sensation." Even with orgasm in the name, practitioners do not expect or avoid physiological orgasm (for a description of physiological orgasm, see Ref. 2), but attempt to meet each stroke with full attention and approval. Similar to sitting meditation (see, for example, Ref. 3), when the attention wanders, OM practitionerswhether they are the person doing the stroking, or the one receiving the strokingaim to bring their attention back, in this case to the point of contact (between finger and clitoris) and the sensations in their body. The "stroker" is fully clothed and wears disposable gloves, while the "strokee" removes only as much clothing as is necessary. The practice has a strict protocol, referred to as "the container," which specifies steps, timing, and communication during the OM. OM has been shown to increase interpersonal closeness between the partners. 1 In addition, people who practice OM, regardless of age, sexuality, income, or how they learned to OM, report a number of benefits including relationships, friendships, health, professional life, and spiritual life. 4 People who practice OM also report that the practice can trigger mystical experiences. 5 People often ask how OM is different from sex. We acknowledge that this question is valid as both sex and OM involve genital touching. Although OM is taught as a practice that is distinct from sex, it is reasonable to ask whether people who engage in the practice actually maintain that distinction themselves.
The definition of what is and is not sex carries with it a variety of personal, scientific, societal, and legal implications and has been the subject of considerable study. Dictionary-based definitions of "sex" are typically vague and reflexive. For example, in the Oxford English Dictionary, "sex" is defined as "sexual activity, including specifically sexual intercourse." Looking up "sexual" leads to a similarly circular definition, for example: "of, relating to, or associated with sex or the sexes".
Research on the topic reveals considerable nuance in how sex is defined and by whom. As Horowitz and Spicer highlight, "Sexual definitions involve moral, cultural, and identity management dimensions." 6 Sexual Script Theory holds sexuality as socially constructed and choreographed psychologically by the scripts and meanings attached to various acts by participants. 7, 8 In short, there is no universally accepted definition of sex.
Most studies on sex have focused on respondents' definitions of what "counts" as sex. These studies have revealed a hierarchy in terms of agreement that any particular sexual activity is likely to be viewed as "sex." Penile-vaginal intercourse is most reliably labelled as "sex," followed by anal intercourse, oral-genital contact, manual-genital touching, touching the breasts/nipples, and kissing. 9 Overall, this hierarchy holds across groups, though some variations have been found between specific categories. For example, lesbians are more likely to consider manual-genital contact "sex" than other groups. 6 Similar to these studies that seek to determine if an activity "counts" as sex, we explored the question -"Is OM sex?" Specifically, do those who practice OM view the practice as sex? The answer to this question has personal, legal, policy, and programmatic implications for those who practice and teach OM and those in the sexuality and wellness sphere. For comparison, we also asked these participants how they perceive sitting meditation and fondling.
Strikingly, we found that OM practitioners did not consider OM to be similar to sex; instead, they viewed the practice as significantly more similar to meditation than to sex or fondling. These results were consistent, regardless of whether the question was asked in the positive or negative or whether OM was being compared to one behavior individually or to multiple behaviors at the same time. The distinction between OM and sex/fondling rapidly becomes more pronounced as practitioners complete more OMs.

Methods
We conducted an online convenience sample survey including qualitative open-ended text questions and quantitative Likert-style questions that was distributed to email listservs for practitioners of OM. The 30-item questionnaire was developed through expert consultation (see acknowledgments) and included questions designed to differentiate the potentially related concepts of OM, seated meditation, fondling, and sex, as bases for comparison. Questions were designed to explore the similarities and differences between these concepts both in Likert-style questions (results presented herein) and open-ended text (unpublished).

Ethical considerations
All study instruments and procedures were approved by the IntegReview Institutional Review Board. This protocol was determined to be exempt from requiring full IRB review according to code of federal regulations (CFR) 46.101(b) exempt category #2, as a survey that did not collect any identifying information. Language clarifying the voluntary nature was included in the survey. Since requiring collection of informed consent would provide identifying information, the IntegReview IRB granted a waiver of informed consent documentation.

Participants
A total of 414 people initiated the survey. However, the final sample consisted of 220 participants with analyzable data: 139 participants did not fill out any quantitative data; 19 participants indicated they had already filled out this survey; two participants indicated they were too young to fill out the survey; one participant indicated s/he had never practiced OM, one participant indicated s/he had never had sex; 16 participants indicated they had never practiced sitting meditation; 16 participants indicated they had no experience with fondling. Inclusion criteria included experience with each of these four behaviors, being 18 years of age or older, and an ability to read and respond in English. There were no exclusion criteria.

Study design and setting
Participants received an email regarding the introductions to the study, and a request to complete the questionnaires immediately. Data were gathered through an online survey administered through Qualtrics. Exempt determination was provided on February 20, 2019. Data were collected between February 22, 2019, and May 10, 2019. The study link was emailed to OM-trained practitioners.

Data measures
The survey gathered basic demographic information, including age, gender, sexual orientation, and relationships status; qualitative descriptions of OM, meditation, fondling, and sex (e.g., describe OM); qualitative comparisons of OM, meditation, fondling, and sex (e.g., describe how meditation is different from sex); and quantitative comparisons of OM, meditation, fondling, and sex (e.g., Likert-type scales responding to questions such as "OM is like meditation"; or "OM is more like sex than fondling"). This 30-item questionnaire (see Extended data, Appendix A 11 ) was developed through subject-matter expert consultation (a linguist, a human sexuality expert, and the study team).

Quantitative data analysis
Survey completers and non-completers were compared to examine potential differences in completion rates. Descriptive statistics, including means, standard deviations, and frequencies were used to describe the data below. Analyses were performed on R, version 4.0.5. Significant differences were determined by p < .05. We first analyzed the questions comparing OM to another behavior (i.e., OM is like meditation). We utilized one-way ANOVA to examine whether participants differed in their answers across the four behaviors (i.e., do the following answers differ: OM is like meditation, OM is like fondling, OM is like sex). We then utilized paired samples t-tests to make comparisons between pairs of behaviors (i.e., is there a difference between "OM is like meditation" and "OM is like sex?"). Given the large number of comparisons made, alpha was set to .01 to reduce type 1 error.

Quantitative results
All Likert-type ratings ranged from 1-5 with 1 being strongly disagree and 5 being strongly agree. We first examined questions comparing OM to each behavior individually (e.g., OM is not sex, OM is fondling, OM feels like meditation). Overall participants had the strongest agreement (average 4.69 rating) for the statement "OM is a form of Meditation." Participants strongly agreed that OM is not fondling or sex, giving an average Likert-type rating of 4.55 and 4.65, respectively. Of note, for all of these individual comparisons -OM is, OM is not, OM is a form ofthere was no significant difference between fondling and sex. Only the question "OM feels like" had significant differences between the two, with participants agreeing more with the statement "OM feels like sex" than "OM feels like fondling." Participants disagreed most strongly with the statements "OM is Sex," and "OM is Fondling," with average ratings of 1.42 and 1.48, respectively (strongly disagree). There was also high disagreement with the statement "OM is not mediation," with a rating of 1.53. Based on these individual comparisons, we see that participants believe OM is significantly more similar to meditation than to sex or fondling. See Table 1 for full comparisons and significance.
In total, 18 participants either disagreed or strongly disagreed with the statement "OM is not sex" or agreed or strongly agreed with the statement "OM is sex." We explored their demographics to see if there were any significant differences between them and the rest of the study cohort and found that they were less experienced than the overall responders.
In the questions comparing multiple behaviors at a time (e.g., OM is more similar to mediation than sex), over 80% of participants felt that OM was more similar to meditation than sex, and that OM was more similar to meditation than fondling. Only 15% of participants thought that OM was more similar to sex than to meditation.
The data were even more pronounced for fondling, where 80.9% of participants thought fondling was more like sex than meditation and only 6.4% thought it was more like meditation than sex. See Table 2

Sub-analyses by demographic Gender and sexual orientation
Based on our data, women tended to be more certain that OM was meditation and not sex than men. Bisexual participants were also more convinced than heterosexual participants in their views that OM was meditation and not sex. Bisexual women had the most extreme views on OM being meditation and not sex. We had small n for queer and other sexual orientation so cannot draw conclusions about these subgroups.

Age
The vast majority of the comparisons were non-significant. However, respondents did differ (p < .01) by age in their response to OM is a form of sex, with 30-44-year-olds disagreeing more strongly than other age groups.

Relationship
Like age, most of these comparisons were non-significant, although partnered respondents agreed more strongly than single participants that OM is not fondling.

Level of OM experience
Participants with fewer OMs found OM to be less dissimilar from sex and fondling than participants with more OM experience. While the majority of participants found OM to be more similar to meditation than to sex, these results were more pronounced with more experience. The effect of OM experience was most marked within the first 50 OMs, and virtually disappeared after that. See Table 3 and Figure 2 for results stratified by OM experience.

Discussion
This is the first study of its kind on the topic of Orgasmic Meditation and how practitioners perceive this practice. There is little research on Orgasmic Meditation in general, and this study helps place it in the larger context of meditation and sexuality, two fields with much ongoing research. The quantitative results of this mixed method study show that OM   practitioners view the practice as significantly more similar to meditation than to sex or fondling. These results were consistent, regardless of whether the question was asked in the positive or negative (e.g., disagreeing with the question OM is sex, agreeing with the question OM is not sex)and whether OM was being compared to one behavior individually or to multiple behaviors at the same time.
The results of this study also show that the distinction between OM and sex/fondling rapidly becomes more pronounced as practitioners complete more OMs. This suggests that the novelty of genital touching in meditation may diminish over time, as practitioners get used to the more alternative point of focus. If OM is viewed differently by different groups of

Results by OM Experience
OM is more like meditation than sex OM is more like sex than meditation Linear (OM is more like meditation than sex) Linear (OM is more like sex than meditation) A B Figure 2. Respondents reporting that "OM is more like meditation than sex" increases by experience level. (A): Response to the question "OM is more like meditation than sex" is segregated by experience level (1 strongly disagree, 5 strongly agree). (B): Response to both "OM is more like meditation than sex" and "OM is more like sex than meditation" are displayed together, segregated by experience level (1 strongly disagree, 5 strongly agree). Dotted lines show a linear model for the results.
practitioners, there may be programmatic and policy implications in the management of OM instruction. For example, if new OM practitioners are more likely to conflate OM and sex, there is a heightened likelihood of unintended outcomes related to sexual stigma, trauma, or perceived sexual harassment at that stage. Such sexuality-related side-effects should be addressed in the instruction and in communications with participants, and additional supports may be necessary to help new practitioners navigate these complexities until they are clear on the practice and how to internalize their experiences.
In addition, of the gender and sexual orientation combinations with large enough sample sizes to study, bisexual women viewed the practice as most different from sex/fondling. This was surprising because of the scientific research showing that lesbians were more likely to classify manual-genital contact as sex. The finding suggests that the context highly impacts how an act of a sexual nature is perceived. The same physical behavior that in the bedroom may be considered sex, is considered meditation in the container of a practice setting. The fact that this subgroup was more adamant that the practice is not sex highlights how much the intention behind the act makes a difference. In other words, the practice is not differentiated from sex because of the actual physical action, but because of the intention behind it.

Future research
Given the fact that OM involves genital stroking, it is interesting to ask why the response to the survey is so clear. One possibility is that there are certain aspects of the practice itself that clearly divides it from sex and fondling. For example, the stroker in OM is fully clothed and wears gloves. There is no eye gazing or kissing. Practitioners generally do the practice away from their beds, usually on the floor with meditation and other cushions that do not resemble bed pillows.
Practitioners are also taught that if the practice stirs desires for sex, that they are to complete the practice and put away the practice supplies before deciding whether to have sex. If practitioners follow this guidance, then OM will effectively be separated from sex or from activities that might lead to sex.
It is also important to note that OM is not the only practice that confounds the traditional conceptualizations of sex and meditation. Tantra, for example, seeks to use sexual energy to reach a meditative state. 10 It would be interesting to know how practitioners of tantra would respond to a similar survey.

Study limitations
This study has several limitations. As with any convenience sample survey, the respondents may not accurately represent the entire community of OM practitioners. Furthermore, the study was promoted by OneTaste, and so practitioners who are happy with OneTaste as a company might have been more likely to respond. OneTaste explicitly teaches that OM is not sex, so it is possible that respondents are reporting what they've learned, rather than what they believe. No race, class, or geographic location data was collected, and thus we cannot account for differences across these demographic factors.

Conclusions
The results of this study have implications for the practice and how it is approached and regulated. As previous studies have shown, sociocultural and historical context play a large role in what constitutes sex. In the wake of current public controversy over sex and consent, a practice whose practitioners report benefits in relationships, friendships, health, professional life, and spiritual life, 4 has teachings around sexuality and consent, and yet is rated as clearly distinct from sex, has clear benefits and a role in the broader conversation of health, wellness, and positive sexuality.

Data availability
Underlying data Open Science Framework: Practitioners of orgasmic meditation view the practice as significantly more similar to meditation than to sex or fondling. https://doi.org/10.17605/OSF.IO/6J2WQ 11 This project contains the following underlying data:: • OM v Sex Survey_February 3, 2022_11.36.xlsx (OM vs. SEX de-identified: Data from study)

Extended data
Open Science Framework: Practitioners of orgasmic meditation view the practice as significantly more similar to meditation than to sex or fondling. https://doi.org/10.17605/OSF.IO/6J2WQ 11 This project contains the following extended data: • Email for recruiting participants OM vs Sex 012919.pdf (text used to recruit for first part of study) • OM_v_Sex_Survey.pdf (OM vs. Sex Survey for participants: Survey used for study) Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication).
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