In or Out? Experts recommend giving outercourse a try

With unintended pregnancy and HIV infections a perpetual risk, some say outercourse — general making out, caresses, oral sex or some combination — is a way many people of all ages revel in their sexuality.

Now a buzzword in the sexual science world, outercourse is based on the idea that sex does not equal penetration — and even if you want to include intercourse in the banquet that is your sex life, you should feel free to fill up on the soup and appetizers.

"Use all five of your senses," said Dr. Beverly Whipple, professor at Rutgers University in New Jersey and former president of the American Association of Sex Counselors and Therapists. "Outercourse includes erotically feeding your partner, like licking whipped cream off their body, using different types of touch, reading erotica or watching movies together or using different types of touch, like with a feather."

Staying on Third Base

Outercourse was born in the 1980s, emerging from the politically loaded stew of adolescent sexuality and sex education. For people exposed to the concept while growing up, outercourse has become a staple of their sex lives.

"Before I lost my virginity, I read all these books so that I'd be prepared for the whole experience," said Theresa, an actress from Alabama.

Teens today may have never heard of the term itself, but they sure know the concept, says Patricia Hersch, author of A Tribe Apart: A Journey Into the Heart of American Adolescence.

"Kids see sex as a toolbox or a grab-bag of various things to do or not do," she said. "A lot of younger kids and maybe older ones too will say 'Eew, oral sex is gross,' but you know what? They get over it. They don't want to get pregnant and they don't want AIDS."

Remember the Eisenhower-era metaphor of the baseball diamond? Get to first base (kissing); second base (petting above the waist); or third base (petting below the waist) — but when it comes to making it to home plate, leave your runners stranded for now.

"The whole first base/second base concept could be called prudery and righteous self-restraint," Hersch said, "but we should find modern interpretations." Kids need to get the straight dirt on sex, she argues, which includes ways to pleasure your partner that don't include intercourse. "Touching a person you care about is wonderful and exciting, and one of the best things about being an adolescent."

The Price of Holding Back

Outercourse has not received universal support. Advocates of abstinence-based sex education argue that sending mixed messages about experimenting with sexual feelings is doomed to failure.

"The more sexually arousing the activity, the more likely it will eventually lead to sexual intercourse," Dr. Stephen Genuis of the University of Alberta wrote in the journal Clinical Pediatrics. Especially with regards to kids, encouraging experimentation with sexual pleasure can be like playing with fire.

"If we're touched genitally, it's difficult not to continue increasing the pleasure," said Arizona sex therapist Dr. Gene Gary Gruver. "I'm pretty liberal about sex, but for teens [outercourse] might not be the best strategy."

And just because bodily fluids aren't exchanged — that's assuming oral sex happens with condoms and dental dams — don't think it's 100 percent safe.

The chance of pregnancy is wiped out without intercourse as long as semen doesn't enter the vagina, but the risk of some STDs remains. Unprotected oral sex poses a smaller but still significant risk of passing on HIV, and skin-to-skin contact can spread genital herpes and the human papilloma virus, which causes genital warts — all of which are incurable.

Couples Therapy

Outercourse needn't be solely a teen thing. Gruver and other sex therapists use it as a tool with couples, with non-penetration activities as the primary tool.

When a partner has trouble becoming aroused, for example, outercourse provides baby steps to a healthier sex life. It begins with non-genital touch exercises, getting used to caressing each other and enjoying pure skin on skin.

When patients are ready to move on, Gruver has patients try more advanced outercourse main courses like genital caresses, with the touchee guiding the toucher's hand. From there it's on to unguided genital touches and oral sex.

"Most sex therapies include non-penetration activities for the first five weeks," he said. "It desensitizes the old sex negatives ... kind of like starting fresh."

Putting intercourse on the back burner, whether for the newly sexual or longtime partners, gives a fresh perspective and slows down sex in a very fun way, Hersch said. She adds: "You may want to have an orgasm, but you don't have to have intercourse. There is so much about sex that is wonderful and fun and pleasurable. There's no need to rush."