Abstinence-Only-Until-Marriage (AOUM) education centres primarily on the strict prohibition of sexual activity until marriage, sometimes reinforced through practices such as virginity pledges. (9)

Despite this emphasis, AOUM does not significantly reduce premarital sexual activity. Approximately 65%–70% of evangelical and Protestant young adults engage in premarital sexual activity. (9, 21)

At a population level, AOUM policies correlate with higher rates of unintended pregnancy, with individuals exposed to these approaches being less likely to use condoms or birth control. (9)

When it comes to sexually transmissible infections, there is no significant difference in lifetime STI diagnosis between individuals exposed to purity culture messaging and those who are not. While Christians may delay engagement in sexual activity, they may do so without adequate protection, placing themselves at risk for STIs. (9)

Men are depicted as hypersexual, with an insatiable visual appetite, and their experience of lust can be presented as an inevitable struggle for men.

Women, in contrast, are depicted as “sexual gatekeepers”, responsible for keeping men’s lust and behaviour in check by ensuring that they are not “stumbling blocks” to men. (20)

These gendered expectations can continue into marriage. Women may be instructed to remain constantly available for their husband’s sexual demands, with sexual availability presented as a way of preventing husbands from viewing pornography or engaging in infidelity. (16)

Evangelical Purity Movement scripts can also negatively affect men. These messages can discourage emotional vulnerability, reinforce pressure to fulfil a rigid breadwinner role, and teach men that their lust is an uncontrollable force that they cannot regulate. (20)

Premarital sexual activity is routinely framed through objectification and contamination metaphors such as “chewed gum”, “used tape”, “stained water”, or a flower with its “petals stripped off”. (7)

These metaphors can communicate that premarital sexual activity causes permanent spiritual damage or reduces an individual’s personal worth. (7)

Persistent sexual guilt can continue into marriage. Fear-based education can induce sexual anxiety and shame, and individuals may find it difficult to transition from messages requiring the suppression of sexuality before marriage to expectations that sexuality can simply be turned “on” after marriage. (9)

Female sexual pain, including vaginismus, has also been associated with fear-based and restrictive religious upbringings and particular purity-culture tropes, including “soul ties” and “obligation sex”. Research has identified higher odds of developing severe sexual pain in comparison with non-religious populations. (13, 15)

Within marriage, sex can be framed as a marital duty, particularly through messages instructing women to remain constantly available for their husband’s sexual demands. Women may again be positioned as responsible for male sexual behaviour, with sexual availability presented as a means of preventing pornography use or infidelity. (16)

Obligation sex is associated with relational distress and the experience of greater sexual pain. (12) It is important to recognise that obligation sex may reflect consensual compliance, however, it does not reflect active consent which is a critical component of Authentic Agreement and sexual wellbeing.

Rape-myth acceptance is also highly correlated with endorsement of purity-culture beliefs, including difficulty correctly identifying marital or acquaintance rape. (18)

Fear-based and restrictive religious sexual upbringings have been associated with female sexual pain, including vaginismus, particularly in connection with purity-culture messages such as “soul ties” and “obligation sex”. (13, 15)

Shame and embarrassment around sexuality can also contribute to communication paralysis, making it difficult for individuals and couples to communicate openly about their sexual relationship. (10)

The orgasm gap has been found to be wider within Christian communities, with research identifying factors including limited female anatomy education, sexual shame and rigid gendered scripts around sexual activity. (22)

Christian men and women also self-report higher levels of pornography or sex “addiction”. Research suggests that intense religious shame and conflict between sexual behaviours and religious values can contribute to these self-perceptions, rather than necessarily reflecting the presence of a clinical sexual disorder. (17, 21)

Same-sex attraction may be ignored, erased, or explicitly taught as sinful, a spiritual failure, or demonic within purity-culture messaging. (20, 23)

These messages can contribute to the ostracisation of same-sex attracted Christian individuals. Research discussed here also identifies a higher risk of suicidality among same-sex attracted individuals in religious contexts compared with non-religious same-sex attracted individuals. (20, 23)