And if you're a gay woman, then you're supposed to have oral sex, because that's what gay women do. And so those become, like markers, for when virginity is lost." The concept of "technical virginity" or sexual abstinence through oral sex is popular among teenagers. For example, oral sex is common among adolescent girls who fellate their boyfriends not only to preserve their virginity, but also to create and maintain intimacy or to avoid pregnancy. In a 1999 study published in "JAMA" (the "Journal of the American Medical Association"), the definition of "sex" was examined based on a 1991 random sample of 599 college students from 29 US states; it found that 60% said oral-genital contact (like fellatio, cunnilingus) did not constitute having sex. Stephanie Sanders of the Kinsey Institute, co-author of the study, stated, "That's the 'technical virginity' thing that's going on." She and other researchers titled their findings "Would You Say You 'Had Sex' If ...?" By contrast, in a study released in 2008 by the Guttmacher Institute, author of the findings Laura Lindberg stated that there "is a widespread belief that teens engage in nonvaginal forms of sex, especially oral sex, as a way to be sexually active while still claiming that technically, they are virgins", but that her study drew the conclusion that "research shows that this supposed substitution of oral sex for vaginal sex is largely a myth". A 2003 study published in the "Canadian Journal of Human Sexuality" focusing on definitions of "having sex" and noting studies concerning university students from the United States, the United Kingdom, and Australia reported that "[w]hile the vast majority of respondents (more than 97%) in these three studies included penile-vaginal intercourse in their definition of sex, fewer (between 70% and 90%) respondents considered penile-anal intercourse to constitute having sex" and that "oral-genital behaviours were defined as sex by between 32% and 58% of respondents". A different study by the Kinsey Institute sampled 484 people, ranging in ages 18–96. "Nearly 95 percent of people in the study agreed that penile-vaginal intercourse meant 'had sex.' But the numbers changed as the questions got more specific." 11 percent of respondents based "had sex" on whether the man had achieved an orgasm, concluding that absence of an orgasm does not constitute "having had" sex. "About 80 percent of respondents said penile-anal intercourse meant 'had sex.'