Sexuality

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Human sexuality refers to the expression of sexual sensation and related intimacy between human beings, as well as the expression of identity through sex and as influenced by or based on sex.

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Quotes[edit]

The most damaging forms of intemperance are connected with eating, strong drink, and sexual activities. Overindulgence in any of these is fatal to success. ~ Napoleon Hill
Alphabetized by author
  • After the sexual revolution, starting in the late 1960s in modern industrialized societies, there was an increase in the frequency of sexual activities – as people began to use more effective forms of birth control. Sexual exploration continued to rise until around 1990 in many industrialized nations, after which it began to decline. Many people became more sexually cautious after 1990 when the mass media made it increasingly clear that a new disease – HIV/AIDS – was becoming epidemic and that it could be fatal. After 1990, people have gradually shifted to having fewer partners than before.
    • J.D. Baldwin, J.I. Baldwin, ” Sexual Behavior” in Encyclopedia of Human Behavior (Second Edition), (2012)
  • Although humans tend to view sex as mainly a fun recreational activity sometimes resulting in death, in nature it is a far more serious matter.
  • In many countries, the second half of the twentieth century was a period of sexual liberalization. The improved status of women was reflected in a greater recognition of their rights in sexual matters (with implications for partner choice, use of contraception and abortion, as well as sexual pleasure). One consequence of this change was to encourage research into contraception: the contraceptive pill became available from 1960, and sterilization for contraceptive purposes was the most widely used means of birth control in the world by the end of the 1970s. Research was also encouraged into the physiology of the orgasm, and particularly the female orgasm, in the 1950s and 1960s (E. Gräfenberg, A. M. Kegel, A. C. Kinsey, W. H. Masters and V. E. Johnson, etc.). Another important factor of change was the arrival at adolescence in the 1960s of the postwar baby boom generation; economic affluence was the context for their demands for greater sexual freedom. This aspiration was reflected in a fall in age of first intercourse, especially for young women, and, related to this, a decline in the norm of female virginity at first marriage (or formation of first stable union). This liberalization reached its peak in the developed countries at the end of the 1970s and was brought to an abrupt halt by the AIDS epidemic, awareness of which began to develop, first in the United States, from 1981.
    • A. Béjin, "Sexual Behavior: Sociological Perspective, 4 Post-1946: Empirical Research in the Age of Sexual Liberalization", International Encyclopedia of the Social & Behavioral Sciences, 2001
  • Between 1938 and 1954, Kinsey and his co-researchers interviewed more than 16,000 volunteers. While the personal information they collected was probably reliable, the sample constructed by Kinsey's team was not representative of the US adolescent and adult population. Kinsey et al. (1948, 1953) distinguished the following ‘sources of sexual outlet’: masturbation, nocturnal emissions (or sex dreams), premarital heterosexual petting, premarital coitus (or intercourse), marital coitus, extramarital coitus, intercourse with prostitutes, homosexual responses and contacts, animal contacts. They established that the sexual history of each individual represents a unique combination of these sources of outlet and showed that between individuals there could be wide variation in ‘total sexual outlet’ (the sum of the orgasms derived from the various sources of sexual outlet). They also identified a number of sociological patterns. For example, compared with less educated people, better educated men and women had first heterosexual intercourse later, but had greater acceptance and experience of masturbation, heterosexual petting, foreplay and orogenital sexual practices. Also, according to these researchers, people with a premarital petting experience were more likely to have a stable marriage. In these two volumes there were curious omissions, the most striking being the almost total neglect of the emotions, notably love. And the interpretations given by the authors were sometimes debatable, such as the presentation of premature ejaculation as almost ‘normal’ because it happened to be widespread in the United States, or in considering women's erotic imagination to be much less developed than men's on the grounds that it seemed less responsive to sexually explicit images.
    • A. Béjin, Sexual Behavior: Sociological Perspective, 4 Post-1946: Empirical Research in the Age of Sexual Liberalization", International Encyclopedia of the Social & Behavioral Sciences, 2001
  • The sex surveys of the 1990s cannot be summarized here, but a number of their shared characteristics can be identified. They are based either on interviews or questionnaires (either face-to-face, or self-administered, or by telephone), and have been facilitated by the unquestionably greater willingness in recent decades to talk about sex, as reflected in better participation and response rates and fewer abandons. The theories advanced to interpret the data collected are often, though not always, those which Laumann et al. (1994, pp. 5–24) refer to as ‘scripting theory,’ ‘choice theory’ and ‘social network theory.’ The first postulates that, because of their exposure to an acculturation process, individuals usually follow ‘sexual scripts’ which prescribe with whom, when, where, how, and why they should have sex. The second places the emphasis on the costs (in time, money, emotional and physical energy, personal reputation, etc.) of sexual behavior. The third seeks to understand why some types of sexual relations occur between people with similar social characteristics whereas others (more unconventional) involve socially more contrasted individuals.
    • A. Béjin, "Sexual Behavior: Sociological Perspective, 4 Post-1946: Empirical Research in the Age of Sexual Liberalization", International Encyclopedia of the Social & Behavioral Sciences, 2001
  • Developing a healthy sexuality is a key developmental milestone for all children and adolescents that depends on acquiring information and forming attitudes, beliefs, and values about consent, sexual orientation, gender identity, relationships, and intimacy. Healthy sexuality is influenced by ethnic, racial, cultural, personal, religious, and moral concerns. Healthy sexuality includes the capacity to promote and preserve significant interpersonal relationships; value one’s body and personal health; interact with both sexes in respectful and appropriate ways; and express affection, love, and intimacy in ways consistent with one’s own values, sexual preferences, and abilities. The various dimensions of healthy sexuality comprise the anatomy, physiology, and biochemistry of the sexual response system; identity, orientation, roles, and personality; and thoughts, feelings, and relationships. Ideally, children and adolescents receive accurate information on sexual health from multiple professional resources.
  • Pediatricians are in an excellent position to provide and support longitudinal sexuality education to all children, adolescents, and young adults with and without chronic health conditions and disabilities as part of preventive health care. Over the past decade, increasing numbers of adolescents contend with sexuality in the context of their own chronic physical or mental health condition and/or developmental disability. When sexuality is discussed routinely and openly during well-child visits for all children and adolescents in the pediatrician’s office, conversations are easier to initiate, more comfortable to continue, and more effective and informative for all participants. Pediatricians and other primary care clinicians can explore the expectations of parents for their child’s sexual development while providing general, factual information about sexuality and can monitor adolescent use of guidance and resources offered over time.
  • With insights into the typical stages of child and adolescent sexual development, parents can better understand their own child’s behaviors. For example, by recognizing that masturbation is typical toddler behavior, parents can better understand and discuss self-stimulatory behaviors of their teenager. The problem is often the inability to distinguish between behaviors that are publicly and privately appropriate as children grow older.
  • Alternative and divergent sexual practices such as masturbation and same-sex love are associated with periods of peace and prosperity. In unstable times with high infant mortality, the spilling of semen may be perceived as unnecessary, extravagant, or wasteful: although ejaculation is a rite of passage for young men of the Sambia tribe in New Guinea, it is brought about by fellatio so that the semen can be ingested rather than spilt.
  • The whole world is conscious of the growing preoccupation with the social impact of all men's thoughts, words and actions. Sexuality in all its aspects is obviously an area of the greatest human and social impact. The norms and values which govern this so vital human concern merit the attention and cooperation of all. Our world evolves at a frightening rate, creating at once a vivid sense of unity and a set of conflicting forces which could destroy us.
    This concern will be fruitful only if it leads all of us to recognize our true human worth in the possession of our inner powers by which we are distinctively ourselves with the full recognition of our complementary sexual differences on the physical, the psychological and the spiritual plane. Only in this manner will we achieve marriages that are truly unions of love in the service of life.
  • I see the birth of a new-boy system instead of the old-boy system. The new-boy system consists of athletic men who are self-confident and intelligent enough to be supportive of women, particularly those with their own self-confidence, sexual athleticism and intelligence. Men find these qualities in me a "turn on".
    • Suzy Chaffee quoted in Machisma: Women & Daring, by Grace Lichtenstein (1981)
  • Sexual dysfunctions are multifactorial and can be caused by a variety of psychological and biologic issues. As it concerns male sexual dysfunctions, most of the sexual medicine research regarding biologic factors has focused on hormonal, neurologic, and/or vascular issues. There has been a dearth of sexual medicine research on the biologic contribution of pelvic floor disorders to various male sexual dysfunctions. This is in sharp contrast to the large number of studies that have linked pelvic floor disorders in women to female sexual dysfunctions. In fact, pelvic floor therapy is one of several suggested sexual medicine strategies to successfully manage female sexual dysfunctions. Sexual dysfunctions are highly prevalent in men, increasing with age, and sexual function is regarded by many men as a vital and critical part of their overall health and wellness; moreover, male sexual dysfunctions have been linked to reduced quality of life and negative interpersonal relationships. Despite pelvic floor physical therapy representing a conservative, modifiable, noninvasive, non pharmacologic, and nonsurgical intervention in the treatment of male sexual dysfunction, the biologic relationship between pelvic floor function and male sexual function is seldom emphasized.
  • As Darwin puts it in The Descent of Man, 'Male snakes, though appearing so sluggish, are amorous.' Isn't that just like Darwin? It was one of his main ideas, you know, that the males of almost all animals have stronger passions than the females. Since then we've learned a thing or two. At any rate, the female snake is right there when spring arrives in the woods.
  • Typically, women in early modern England were expected to be pious and chaste, and erotic behaviour was deemed appropriate only within the space of heterosexual marriage. Despite this, there was both a cultural and medical understanding that women experienced sexual desire and pleasure.
    In medical texts it was suggested that in order for conception to occur, a woman had to experience an orgasm, preferably at the same time as the man. Advice given in the English translation of French surgeon Ambroise Paré’s medical treatise suggested that: “when the husband commeth into his wive’s chamber hee must entertaine her with all kinde of dalliance” and give her “wanton kisses with wanton words and speeches”. This would help the woman to orgasm and would better the chances of pregnancy.
    Medical texts also promoted the idea that unmarried women could suffer physical ailments because of a lack of sexual activity. It was widely believed that women had their own type of semen, or “female seed”, which contributed to procreation. A build up of this seed, due to lack of sexual release, could cause a range of disorders, like “madness from the womb”.
    . These medical ideas were also prominent within broader society, where virgins and widows were viewed as particularly lustful women. Representations of unmarried women’s sexual desires were often humorous, like the ballad “The Maids Complaint For Want of a Dil Doul [dildo]”, published around 1680.
  • Sexually transmitted diseases, ranging from the serious to the fatal, are a fact of life in high schools and neighborhoods across the country. Misinformation and scare tactics about common sexual practices like masturbation are rampant. Despite these facts, and despite parents' overwhelming desire for their children to receive detailed sex education at school as well as at home, our society remains unwilling to make sexuality part of a comprehensive health education program in the schools and anxious to the point of hysteria about young people and sex...Hysteria about sex has hindered attempts to address these pressing concerns, and the people hurt most are those who most need the information—our young people, the poor, and the uninformed. Ignorance is not bliss.
  • The invention of the pill was one of the most significant advancements in the fight for reproductive agency; it allowed us, as a society, to dramatically reconceptualize sexuality and gender relations. At the same time, our relationship to this groundbreaking medical technology has been shaped and constrained by our own conceptions of what's "natural" and what defines a woman. Similar reproductive and sexually liberating advancements that target men—Viagra, for instance—have not led to similar debates on what it means to be a man, or to have an "unnatural" hard-on. And while Viagra is covered by insurance, Dr. Naliboff says that most insurance companies do not cover extended cycle birth control to this day, even in cases where patients are on the pill for medical issues like primary ovarian insufficiency or endometriosis.
  • Despite longstanding stereotypes to the contrary, sexual interest remains alive among older adults. In data from the National Social Life, Health, and Aging Project (NSHAP), only one in four 75–85-year-old men report a complete lack of interest in sex, and only about half of 75–85-year-old women say the same (Lindau et al. 2007). In fact, these numbers are not significantly different than those for 57–64- and 65–74-year olds. Furthermore, many older adults aren’t merely interested in the idea, they’re still sexually active, though activity does decrease with age as physical ailments emerge and the death of spouses or partners increase (Lindau et al. 2007). Older adults’ satisfaction with their sexual relationships—the physical pleasure and emotional satisfaction they provide—remains relatively high: about one in three place a high value on sex (Laumann et al. 2006). Sexual activity retains benefits for older adults, including increased life satisfaction and marital quality (Yeh, Lorenz, Wickrama, Conger, & Elder, 2006), and research suggests that a satisfying sex life among married couples may in fact delay mortality (Seldin, Friedman, & Martin, 2002). Given the continued importance of sex for older adults and its positive implications for them—and considering how little we know about sex among seniors—it seems important to identify factors that shape their sexual activity and satisfaction.
  • Although Americans over 50 years old will soon make up the largest demographic in the United States, there has only been modest attention given to their sexual behavior patterns (Delamater and Moorman 2007). Drawing upon the NSHAP data, scholars have begun to investigate the sexual behaviors and functioning of older Americans ages 57 to 85, revealing that women are significantly less likely than men to report sexual activity at all ages, with 43 percent of women indicating low desire as their most prevalent sexual problem (Lindau et al. 2007). Gender disparities in having a spouse or romantic partner increase with age, as 78 percent of men and 40 percent of women ages 75 to 85 report having a spouse or partner. Those with poor health understandably reported less sexual activity than those in good or very good health. Although these demographic and health factors are important and informative and intuitive, they shed little light on more qualitative aspects of older adults’ relationships that may influence their sexual activity and satisfaction.
    Studies of sexual satisfaction focus more directly on such qualitative aspects of relationships (Kollock, Blumstein, & Schwartz, 1985). Sexual satisfaction is typically defined quite broadly as the degree to which an individual is satisfied with their sexual relationship; it encompasses both physical pleasure and emotional satisfaction derived from sex. Sexual satisfaction is positively associated with marital quality and duration (Edwards & Booth, 1994; Yeh et al., 2006). Delamater and his colleagues (2008), using data on sexuality among men and women in their mid-60s, note that satisfaction is closely linked with marital happiness and sexual frequency, and that the association is bidirectional (Delamater & Moorman, 2007). These findings are consistent with other research on sexuality among younger and middle-aged adults that also suggests the frequency of sex and satisfaction with it to be closely connected (Young, Dennis, Lugquis, & Young, 1998). Still, many factors that may explain older adults’ sex lives remain unexamined.
  • Late nineteenth-century America, characterized by intense mobility and change, produced anxious social orphans who were cut off from many traditional ties, left almost completely ungoverned and unprotected by the state, and set adrift in the complex new cities. Family and church could no longer provide stable bases for support and moral direction. Many people, in their search for individual and social blueprints, turned to less immediate advisors, purchasing in great quantities advice books and pamphlets written primarily by physicians and popular health and science writers. This essay deals with the ideological range and boundaries of that portion of "advice literature" which dealt with sexuality. Sexuality was one major symbol and focus of general social anxiety, and it was also a primary place where order, individual and social, might begin. Some advice writers, the purists or evangelicals, argued that order would be maintained only when sex was limited to procreation. Most advisors, the moderates, argued instead that sexuality for pleasure, and not merely for procreation, could be a force for both individual and social order if handled in a sensible manner. Thus, they argued for a self-controlled balance between restraint and expression, for self-repressed expression. Most advisors then developed a commonsensical sexual hygiene to detail a framework for moderate sexual expression. All argued that sex should serve the higher social end of enriching marriage. Most gave advice about frequency of intercourse and about the place of sexuality in the life cycle. Moderation, at best, permitted social and personal order and was seen as a kind of conservation of resources; sexuality was not a mode for the growth of human potential, but rather, it tended to heighten that anxiety it was intended to allay. Yet it was far better than no ordering principle at all.
  • Sexual frustration is the single most powerful force in the world. We are the only species where that frustration affects things like the amount of money given to the poor and the length of welfare lines. I hate that the fact that George Bush's wife is an ugly old piece of shit could cause suffering among millions and could cause wars. I don't think it's any coincidence that Kennedy was the last president who had a wife worth fucking and he was the last good president.
  • Appropriate patterns of reproductive, gender, and sexual conduct are all products of specific cultures and all can be viewed as examples of socially scripted conduct. Western societies now have a system of gender and sexual learning in which gender differential scripts are learned prior to sexual scripts, but take their origins in part from the previously learned gender scripts... There are two important points: The first is that both gender and sexuality are learned forms of social practice, and the second is that looking to "natural differences" between women and men for lessons about sexual conduct is an error.
    • John Gagnon, "The Eplicit and Implicit Use of the Scripting Perspective in Sex Research", 1990
  • It is precisely because I believe it is not possible to neatly separate the sexual from other sorts of relations that I find the movement to bar the sexual from pedagogy not only dangerous but supremely impractical.
  • However much people might be enlightened about their own sexuality, indeed about sexuality in general, there is always in them a modicum of some subconscious aversion to the knowledge that their own parents too are beings with the same kind of sexual needs and desires, which they actually put into practice, more or less regularly. Everyone knows that they weren’t brought by the stork, and yet, where it is the actual sex act that is at issue, as far as it concerns their own parents, most people would rather that they had been.
  • The dilemma of traditional sex research lay in the unconscious, but unquestioningly assumed division into opposing drives and hereditary factors. . . The division into heterosexuality and homosexuality, into heterosexuals and homosexuals, is also an artifact that rests on a grave mistake, namely, on the assumption that a fundamentally different model is necessary to explain heterosexual and homosexual behavior. The entire investigation of etiology was ideologically loaded beforehand because it separated a segment of the sexual continuum and attempted to make analyses with the help of fundamentally different concepts.
    • Rolf Gindorf, "Scientific ideologies in change: Fear of Homosexuality as an Intellectual Event", 1977
  • When authorities warn you of the sinfulness of sex, there is an important lesson to be learned. Do not have sex with the authorities.
    • Matt Groening, From "Basic Sex Facts For Today's Youngfolk" In Life In Hell
  • Maybe God isn't the sex police, Richard. Sometimes I think Christians get all hung up on the sex thing because it's easier to worry about sex than to ask yourself, am I a good person? […] It makes it easy to be cruel, because as long as you're not fucking around, nothing you do can be that bad. Is that really all you think of God?
  • There is hardly anyone whose sexual life, if it were broadcast, would not fill the world at large.
  • "There are major gaps in the literature, in particular with female sexuality," she says. "And unless a drug company can make money, there's very little funding." This lack of hard data allows misconceptions and quackery to take root. "It's so sad. We're so uncomfortable in this culture with dealing with our sexuality in a healthy way."
  • Results: Masturbation was common throughout the lifespan and more common than partnered sexual activities during adolescence and older age (70+). Although uncommon among 14- to 15-year olds, in the past year 18.3% of 16- to 17-year-old males and 22.4% of 16- to 17-year-old females performed oral sex with an other-sex partner. Also in the past year, more than half of women and men ages 18 to 49 engaged in oral sex. The proportion of adults who reported vaginal sex in the past year was highest among men ages 25-39 and for women ages 20-29, then progressively declined among older age groups. More than 20% of men ages 25-49 and women ages 20-39 reported anal sex in the past year. Same-sex sexual behaviors occurring in the past year were uncommonly reported.
    Conclusions: Men and women engage in a diverse range of solo and partnered sexual behaviors throughout the life course. The rates of contemporary sexual behavior provided in this report will be valuable to those who develop, implement, and evaluate programs that seek to improve societal knowledge related to the prevalence of sexual behaviors and to sexual health clinicians whose work to improve sexual health among the population often requires such rates of behavior.
  • Nobody knows what "causes" homosexuality any more than they know what "causes" heterosexuality. (Of course, there is far less interest in what causes the latter.) Overtly, the old psychoanalytic bugaboos are dead; there is no evidence, according to the Kinsey Institute, that male homosexuality is caused by dominant mothers and/or weak fathers, or that female homosexuality is caused by girls' having exclusively male role models. Furthermore, children who are raised by gay and lesbian couples are no more likely to be homosexual than children of heterosexual couples. Nor do people become adult homosexuals because they were seduced by older people or went to same-sex boarding schools...
    Though the causes of sexual orientation are unknown and the definitions fluid, the likelihood of converting a homosexual to a heterosexual orientation, or vice versa, is very slight. Some homosexual men and women voluntarily come for therapy to change from same-sex to opposite-sex partners, but it is not clear whether the limited "success" rate refers to a change in their feelings and the pattern of their desire, or just in their ability to consciously restrict their sexual contact to members of the opposite sex.
  • Social and cultural factors very broadly channel and limit sexual variation in human populations. Sexual laws, codes, and roles do restrict the range and intensity of sexual practices, as far as we can judge from the cross-cultural literature (Herdt and Stoller 1990). Kinsey lent his support to this view; Ford and Beach (1950) documented it in surveys; and Margaret Mead (1961) did so in her ethnographic studies. But biosocial, genetic, and hormonal predispositions also broadly limit and channel. Each culture's theory of the combination of these social and biological contraints we could call its theory of human sexual nature. Yet none of these broad principles, nor the local theory of human sexual nature, entirely explains or predicts a particular person's sexual desires or behaviors. A sexual behavior, that is, does not necessarily indicate an erotic orientation, preference, or desire. The homosexual is not the same as the homoerotic; whether in our society or one very exotic, I will claim, we can distinguish the homosexual from the homoerotic, as Oscar Wilde's case first hinted.
    • Gilbert Herdt, "Bisexuality and the Causes of Homosexuality: The Case of the Sambia"
  • No person may enjoy outstanding success without good health. Many of the causes of ill health are subject to mastery and control. These, in the main are: a. Overeating of foods not conducive to health. b. Wrong habits of thought... c. Wrong use of, and over indulgence in sex. d. Lack of proper physical exercise e. An inadequate supply of fresh air, due to improper breathing.... The most damaging forms of intemperance are connected with eating, strong drink, and sexual activities. Overindulgence in any of these is fatal to success...
  • Professors rarely speak of the place of eros or the erotic in our classrooms. Trained in the philosophical context of Western metaphysical dualism, many of us have accepted the notion that there is a split between the body and the mind. Believing this, individuals enter the classroom to teach as though only the mind is present, and not the body.
  • Of the 1,977 participants (including 876 White, 388 African American, 347 Latina, and 351 Asian women), 43% reported at least moderate sexual desire, and 60% were sexually active in the previous 3 months. Half of sexually active participants (n=969) described their overall sexual satisfaction as moderate to high. Among sexually inactive women, the most common reason for inactivity was lack of interest in sex (39%), followed by lack of a partner (36%), physical problem of partner (23%), and lack of interest by partner (11%); only 9% were inactive from personal physical problems. In multivariable analysis, African-American women were more likely than white women to report at least moderate desire (OR=1.65, 95%CI=1.25-2.17) but less likely to report weekly sexual activity (OR=0.68, 95%CI=0.48-0.96); sexually active Latina women were more likely than white women to report at least moderate sexual satisfaction (OR=1.75, 95%CI=1.20-2.55).
  • Little is known about sexual activity and functioning as women age, despite the aging of the population. Although female sexual function is widely believed to decline with age, many women report preserved sexual activity and satisfaction in older age (1-3). At this time, we do not understand why sexual function declines in some women but not others, and there is lack of consensus about what constitutes “normal” female sexual function across the lifespan (1, 4).
    A variety of factors have the potential to influence sexual function as women age, including hormonal and physiologic changes associated with menopause and chronologic aging (5-7), changes in physical or mental health (3, 8, 9), adverse effects of medications or other health interventions (10-12), and change in availability of a partner interested in and capable of sexual activity (13). Additionally, women's interest in and expectations about sexual activity may be critically influenced by their ethnic background as well as other socio-cultural factors (14, 15). To date, however, most clinical research on female sexual function has focused narrowly on biophysiologic contributors to women's sexual response, and very little research has explored sexual function in racially- and ethnically-diverse women.
  • One of the never‐ending debates in the developing field of sexual medicine is the extent to which genetics and experiences (i.e., “nature and nurture”) contribute to sexuality. The debate continues despite the fact that these two sides have different abilities to create a scientific environment to support their cause. Contemporary genetics has produced plenty of recent evidence, however, not always confirmed or sufficiently robust. On the other hand, the more traditional social theorists, frequently without direct evidence confirming their positions, criticize, sometimes with good arguments, the methods and results of the other side.
  • The existing literature on human sexuality provides evidence that many sexuality‐related behaviors previously considered to be the result of cultural influences (such as mating strategies, attractiveness and sex appeal, propensity to fidelity or infidelity, and sexual orientation) or dysfunctions (such as premature ejaculation or female sexual dysfunction) seem to have a genetic component.
    Current evidence from genetic epidemiologic studies underlines the existence of biological and congenital factors regulating male and female sexuality. However, these relatively recent findings ask for replication in methodologically more elaborated studies. Clearly, increased research efforts are needed to further improve understanding the genetics of human sexuality.
  • Substantial levels of unexpected sex, ambivalence about contraception and the association of fertility intentions with imperfect condom use all reflect the high degree of ambivalence toward sexuality that characterizes the United States. Women and men need more opportunities and forums for discussing issues such as whether and when sexual intercourse should occur in a relationship, methods of pregnancy prevention and decision-making about appropriate timing of childbearing. The increased emphasis in public school sexuality education programs and in other

public education efforts on abstinence as the only option for unmarried people suggests that fewer, rather than more, young women and men will be exposed to accurate information about sexuality issues in the coming years. In 1999, for example, 40% of sexuality education teachers in secondary public schools either taught that contraceptive methods and condoms are ineffective or did not cover them at all. Many adults continue to lack venues for learning about and discussing relationships, sexuality and contraception.

  • The very general occurrence of the homosexual in ancient Greece, and its wide occurrence today in some cultures in which such activity is not taboo suggests that the capacity of an individual to respond erotically to any sort of stimulus, whether it is provided by another person of the same or opposite sex, is basic in the species.
  • The history of medicine proves that in so far as man seeks to know himself and face his whole nature, he has become free from bewildered fear, despondent shame, or arrant hypocrisy. As long as sex is dealt with in the current confusion of ignorance and sophistication, denial and indulgence, suppression and stimulation, punishment and exploitation, secrecy and display, it will be associated with a duplicity and indecency that lead neither to intellectual honesty nor human dignity.
  • Males do not represent two discrete populations, heterosexual and homosexual. The world is not to be divided into sheeps and goats. Not all things are black nor all things white. It is a fundamental of taxonomy that nature rarely deals with discrete categories. Only the human mind invents categories and tries to force facts into separated pigeon-holes. The living world is a continuum in each and every one of its aspects. The sooner we learn this concerning human sexual behavior, the sooner we shall reach a sound understanding of the realities of sex.
  • Calculation will sho that the difference between one ejaculation in thirty years and mean frequencies of, say, 30 ejaculations per week throughout the whole of thirty years, is a matter of 45,000 times. This is the order of the variation which may occur between tow individuals who live in the same town and who are neighbors, meeting in the same place of business, an coming together in common social activities. These sexually extreme individuals may be of equal significance, or insignificance, in the societal organization. They may be considered as very similar sorts of persons by their lose friends who do not know their sexual histories. It has been notable throughout our field collections that a sample of as few as a hundred histories is likely to show a considerable portion of this full range of variation.
    These differences in frequency of sexual activity are of great social importance. The publicly pretended code of morals, our social organization, our marriage customs, our sex laws, and our educational and religious systems are based upon an assumption that individuals are much alike sexually, and that it is an equally simple matter for all of them to confine their behavior to the single pattern which the mores dictate. Even in such an obviously sexual situation as marriage, there is little consideration, under our present custom, of the possibility that the two persons who have mated may be far apart in their sexual inclinations, backgrounds, and capacities. Persons interested in sex education look for a program which will satisfy children-meaning all the children-at some particular educational level, overlooking the fact that one individual may be adapted to a particular, perhaps relatively inactive, sort of sexual adjustment, while the next would fine it practically impossible to confine himself to such a low level of activity. In institutional management, there has been almost complete unawareness of these possible differences between inmates. The problems of sexual adjustment for persons committed to penal, mental, or other institutions, the problems of sexual adjustment for men and women in the army, the navy, or other armed forces, are a thousand different problems for any thousand of the persons involved.
  • Women find it easier to talk about eroticism, sensuality and relationships than men. I think men tend to cover up their feelings by using locker room macho talk.
    • Cheryl Ladd, Cheryl Ladd satisfied with 'Crossings', Reading Eagle, February 23, 1986
  • Sex isn't disgusting unless you make it disgusting!
  • So, how did Americans imagine sex in the nineteenth century? How did they understand desire? The answers to these questions diverge significantly from the conventional story of nineteenth-century sexual repression, typically called “Victorian.” The reason for this discrepancy between the evidence and popular belief was that censorship distorted the historical record. Especially after 1873, when the Comstock Law banned the mailing of sexually explicit material, agents of the law confiscated and destroyed books, pamphlets, and periodicals they seemed obscene.
  • The expression that best conveys antebellum sexuality is conversation. Readers should try and imagine Americans in the era before the Civil War as engaged in a complex three- or four-way way conversation about sex. In the exchange, each side not merely disagreed; each imagined sexuality from a distinct cultural perspective.
  • Sex is not harmful to children. It is a vehicle to self-knowledge, love, healing, creativity, adventure, and intense feelings of aliveness. There are many ways even the smallest children can partake of it. Our moral obligation to the next generation is to make a world in which every child can partake safely, a world in which the needs and desires of every child—for accomplishment, connection, meaning, and pleasure—can be marvelously fulfilled.
  • Sexual play was a regular practice among the children from the earliest period. The adult attitude toward it, if not one of active encouragement, was at least that of mild amusement. [...] Regular intercourse began before puberty with patterns of group sexual play, two or three girls in the gang serving a number of boys in rapid succession with the other boys looking on. Occasionally there were individual affairs. Sexual techniques were learned through imitation of the adults. [...] Homosexuality was present in the form of mutual masturbation, but I have no data as to its frequency. [...] The gap between adults and children was such that it was impossible for an adult to win the child’s confidence. Relations between them were amiable but entirely dissociated.
    • Ralph Linton [Linton, Ralph. Marquesan Culture (July 1925), American Anthropologist Volume 27. Issue 3 (p. 474-478)]
  • It is the night-black Massachusetts legendry which packs the really macabre 'kick', Here is the material for a really profound study in group neuroticism; for certainly, no one can deny the existence of a profoundly morbid streak in the Puritan imagination....The very pre-ponderance of passionately pious men in the colony was virtually an assurance of unnatural crime; insomuch as psychology now proves the religious instinct to be a form of transmuted eroticism precisely parallel to the transmutations in other directions which respectively produce such things as sadism, hallucination, melancholia, and other mental morbidities. Bunch together a group of people deliberately chosen for strong religious feelings, and you have a practical guarantee of dark morbidities expressed in crime, perversion, and insanity. This was aggravated, of course, by the Puritan policy of rigorously suppressing all the natural outlets of excuberant feeling--music, laughter, colour, pageantry, and so on. To observe Christmas Day was once a prison offence....
  • According to their own testimonies, many people born in the Victorian age were both factually uninformed and emotionally frigid about sexual matters. Historically, it appeared that the licentious behaviour and attitudes of the Regency period had been replaced by a new order of puritan control and repression - personified by the censorious figure of Mrs Grundy - which was imposed by the newly dominant bourgeoisie, steadily permeated all classes, and lasted well into the 20th century. Then a hypocritical 'shadow side' to this public denial was glimpsed, in the 'secret world' of Victorian prostitution and pornography, and more openly in the 'naughty nineties'. These perspectives were contested by the French scholar Michel Foucault (reminding us that Victorian attitudes were not confined to Britain), who argued that sex was not censored but subject to obsessive discussion as a central discourse of power, bent on regulation rather than suppression. This helps explain why sexuality looms so large in art and medicine, for example, as well as in studies of the Victorian age.
    Lately, evidence has shown that Victorian sex was not polarised between female distaste ('Lie back and think of England', as one mother is famously said to have counselled her anxious, newly married daughter) and extra-marital male indulgence. Instead many couples seem to have enjoyed mutual pleasure in what is now seen as a normal, modern manner. The picture is occluded however by the variety of attitudes that exist at any given time, and by individuals' undoubted reticence, so that information on actual experience is often inferred from demographic and divorce court records. Certainly, the 1860s were briefly as 'permissive' as the same decade in the 20th century, while the 1890s saw an explosion of differing and conflicting positions. Throughout, however, the public discussion of sexual matters was characterised by absence of plain speaking, with consequent ignorance, embarrassment and fear.
    By mid-century the Victorian conjunction of moralism and scientific investigation produced ideas of orthodox human sexuality based on a combination of social and biological ideas. Popularly expressed, this amounted to 'Hogamus higamus, men are polygamous/Higamus hogamus, women are monogamous', with the added detail that 'the majority of women (happily for them) are not very much troubled by sexual feeling of any kind. What men are habitually, women are only exceptionally.'
  • In order to curb men's habitual urges, and in response to Malthusian predictions that population increase would inevitably outstrip food resources, early Victorian social moralists proposed and to some extent imposed a socio-medical discourse based on masculine self-control in support of the bourgeois ideal of domestic life. 'A patriarchal culture which prizes eternal self-vigilance as the key to manliness, moral worth and material success' then projected its sexual anxieties on to its subordinates:' women, children, the lower classes and other nations.' In line with the physiological idea of the body as a closed system of energy, male sexual 'expenditure' and especially 'excess' (spermatorrhea) were said to cause enfeeblement. Thus it was seriously held, for example, that sexual appetite was incompatible with mental distinction and that procreation impaired artistic genius. Men were vigorously counselled to conserve vital health by avoiding fornication, masturbation and nocturnal emissions (for which a variety of devices were invented) and by rationing sex within marriage. Even when other causes were present, sickness and debility were frequently ascribed to masturbation - the great erotic subject described as vigorously as it was denounced.
  • By the 1870s and 1880s, evolutionary ideas of male sexuality as a biological imperative, which added fuel to many male writings on gender, were countered by those who argued that 'civilisation' enabled humans to transcend animal instincts. This view acquired a public voice through the Social Purity campaign against the sexual 'double standard', and for male as well as female continence outside marriage. Though female Purity campaigners were often ridiculed as 'new puritans' who had failed to attract a spouse, the movement did succeed in raising public concern over brothels, indecent theatrical displays and images of naked women in art - the reason why Victorian female nudes are idealised and air-brushed.
  • I just think it's double standards the whole time. On the one hand people say, 'Oh, women have equal rights now, women can be as powerful as men and do the same jobs as men', but we're still not allowed to talk about sex, 'cos that's unladylike. It's like that old thing, if a man has slept with loads and loads of women, he's a stud. But if a woman has slept with loads of boys, she's a slag. Well, why? Why? What makes a man a stud 'cos he's pulled loads of women? And what makes me a slag 'cos I've slept with more than 10 men? It's ridiculous!
  • Married people too are called upon to progress unceasingly in their moral life with the support of a sincere and active desire to gain ever better knowledge of the values enshrined in and fostered by the law of God. They must also be supported by an upright and generous willingness to embody these values in their concrete decisions. They cannot, however, look on the law as merely an ideal to be achieved in the future: they must consider it as a command of Christ the Lord to overcome difficulties with constancy. And so what is known as 'the law of gradualness' or step-by-step advance cannot be identified with 'gradualness of the law', as if there were different degrees or forms of precept in God's law for different individuals and situations. In God's plan, all husbands and wives are called in marriage to holiness, and this lofty vocation is fulfilled to the extent that the human person is able to respond to God's command with serene confidence in God's grace and in his or her own will'. On the same lines, it is part of the Church's pedagogy that husbands and wives would first recognize clearly the teaching of Humanae Vitae as indicating the norm for the exercise of their sexuality, and that they should endeavour to establish the conditions necessary for observing that norm"
    • John Paul II, Apost. Exhort. Familiaris Consortio, November 22, 1981, n. 34).
  • Here we see reflected the curious conglomerate of humanity which makes up the world's picture audience. Most of its members are young people, many of them children under twelve years of age. The latter do not respond violently to sex appeal. And the adolescents respond unpleasantly to it, on the whole; they are just growing into sex life, and it sets up "growing pains." Frank, suggestive pictures embarrass some boys and girls between the years of twelve and eighteen. This is partly a by-product of Puritanism, at a time when profound psychic changes are taking place.
    Now enters still another factor to block the normal interest in sex appeal stories. The motion picture house is a family gathering place.
  • Psychic health depends on orgastic potency, i.e., upon the degree to which one can surrender to and experience the climax of excitation in the natural sexual act. It is founded upon the healthy character attitude of the individual's capacity for love. Psychic illnesses are the result of a disturbance of the natural capacity for love.
    • Wilhelm Reich, The Function of the Orgasm (1927), General Survey.
  • Only the liberation of the natural capacity for love in human beings can master their sadistic destructiveness.
    • Wilhelm Reich, The Function of the Orgasm (1927), Ch. V : The Development of the Character-Analytic Technique.
  • Sigmund Freud’s second great discovery was that even the small child develops a lively sexuality, which has nothing to do with procreation; that, in other words, sexuality and procreation, and sexual and genital, are not the same. The analytic dissection of psychic processes further proved that sexuality, or rather its energy, the libido, which is of the body, is the prime motor of psychic life. Hence, the biologic presuppositions and social conditions of life overlap in the mind.
    The third great discovery was that childhood sexuality, of which what is most crucial in the child-parent relationship (‘the Oedipus complex’) is a part, is usually repressed out of fear of punishment for sexual acts and thoughts (basically a ‘fear of castration’); the child’s sexual activity is blocked and extinguished from memory. Thus, while repression of childhood sexuality withdraws it from the influence of consciousness, it does not weaken its force. On the contrary, the repression intensifies it and enables it to manifest itself in various pathological disturbances of the mind. As there is hardly an exception to this rule among ‘civilized man’, Freud could say that he had all of humanity as his patient.
  • It was not until relatively late, with the establishment of an authoritarian patriarchy and the beginning of the division of the classes, that suppression of sexuality begins to make its appearance. It is at this stage that sexual interests in general begin to enter the service of a minority’s interest in material profit; in the patriarchal marriage and family this state of affairs assumes a solid organizational form. With the restriction and suppression of sexuality, the nature of human feeling changes; a sex-negating religion comes into being and gradually develops its own sex-political organization, the church with all its predecessors, the aim of which is nothing other than the eradication of man’s sexual desires and consequently of what little happiness there is on earth.
  • The moral inhibition of the child’s natural sexuality, the last stage of which is the severe impairment of the child’s genital sexuality, makes the child afraid, shy, fearful of authority, obedient, ‘good’, and ‘docile’ in the authoritarian sense of the words. It has a crippling effect on man’s rebellious forces because every vital life-impulse is now burdened with severe fear; and since sex is a forbidden subject, thought in general and man’s critical faculty also become inhibited. In short, morality’s aim is to produce acquiescent subjects who, despite distress and humiliation, are adjusted to the authoritarian order. Thus, the family is the authoritarian state in miniature, to which the child must learn to adapt himself as a preparation for the general social adjustment required of him later. Man’s authoritarian structure - this must be clearly established - is basically produced by the embedding of sexual inhibitions and fear in the living substance of sexual impulses.
  • When sexuality is prevented from attaining natural gratification, owing to the process of sexual repression, what happens is that it seeks various kinds of substitute gratifications. Thus, for instance, natural aggression is distorted into brutal sadism, which constitutes an essential part of the mass-psychological basis of those imperialistic wars that are instigated by a few. To give another instance: From the point of view of mass psychology, the effect of militarism is based essentially on a libidinous mechanism. The sexual effect of a uniform, the erotically provocative effect of rhythmically executed goose-stepping, the exhibitionistic nature of militaristic procedures, have been more practically comprehended by a salesgirl or an average secretary than by our most erudite politicians. On the other hand it is political reaction that consciously exploits these sexual interests. It not only designs flashy uniforms for the men, it puts the recruiting into the hands of attractive women. In conclusion, let us but recall the recruiting posters of war-thirsty powers, which ran something as follows: ‘Travel to foreign countries — join the Royal Navy I’ and the foreign countries were portrayed by exotic women. And why are these posters effective? Because our youth has become sexually starved owing to sexual suppression.
  • At this point the obvious objection makes itself heard, namely, that the primitive who led a natural life in a matriarchal order also had mystical feelings. A very thorough proof is needed to show that there is a fundamental difference between the matriarchal man and the patriarchal man. Above all, this can be proven by the fact that religion’s attitude towards sexuality underwent a change in patriarchal society. Originally, it was a religion of sexuality; later it became an anti-sexual religion. The ‘mysticism’ of the primitives who were members of a sexually affirmative society is partially direct orgastic experience and partially animistic interpretation of natural processes.
  • Clinical experience shows incontestably that religious sentiments result from inhibited sexuality that the source of mystical excitation is to be sought in inhibited sexual excitation. The inescapable conclusion of all this is that a clear sexual consciousness and a natural regulation of sexual life must foredoom every form of mysticism; that, in other words, natural sexuality is the arch enemy of mystical religion. By carrying on an anti-sexual fight wherever it can, making it the core of its dogmas and putting it in the foreground of its mass propaganda, the church only attests to the correctness of this interpretation.
  • It was first shown in connection with the suppression of the natural sexuality of children and adolescents that there are funda­mental biologic functions of the human animal that have nothing to do with the economic distribution of the classes and that class boundaries overlap and cut across one another. The suppression of sexuality relates not only to all strata and classes of every patriarchal society; it is precisely in the ruling classes that this suppression is often most pronounced. Indeed, sex-economy was able to show that a large part of the sadism made use of by the ruling class to suppress and exploit other classes is to be ascribed chiefly to the sadism that stems from suppressed sexuality.
    • Wilhelm Reich, The Mass Psychology of Fascism, (1933), ch. 10; originally published in International Journal of Sex-Economy and Orgone-Research, 2 (1943).
  • In antiquity, the evidence suggests, sexual restraint was largely ignored; pagan religion normally did not attempt to regulate sexual activity. Free males could do almost anything sexually, even if they had to resort to slaves, with no moral or societal consequences to themselves.
  • Well, there’s always this human instinct about that, even from a very, very young age. I agreed that we are born with a sort of innate sexuality. But by like age 11, girls were talking about what they had and hadn’t done. I hadn’t even kissed a boy yet, so it always made me feel insecure, like I was never gonna be good or ready or know what to do — I didn’t even have boobs.
  • The mutual and exclusive self-donation of the marriage act consists in its being the gift and acceptance of something unique. Now this something unique is not only the seed (this indeed could be "biologism"), but the fullness of the sexuality of each spouse.
    It was in the context of its not being good for man to be alone that God made him sexual. He created man in a duality - male and female - with the potential to become a trinity. The differences between the sexes speak therefore of a divine plan of complementarity, of self-completion and self-fulfillment, also through self-perpetuation.
  • It has of course been traditional to explain the sexual urge in cosmic or demographic terms: just as we have a food appetite to maintain the life of the individual, so we have a sex appetite to maintain the life of the species. This explanation makes sense - as far as it goes. However, it clearly does not go far enough. The sex appetite - the strength of the sex appetite - surely corresponds not only to cosmic or collectivist needs, but also to personalist needs. If man and woman feel a deep longing for sexual union, it is also because they have - each one personally has - a deep longing for all that is involved in true sexuality: self-giving, self-complementarity, self-realization, self-perpetuation, in spousal union with another.
    The experience of such complete spousal sexuality is filled with many-faceted pleasure, in which the simple physical satisfaction of a mere sense instinct is accompanied and enriched by the personalist satisfaction of the much deeper and stronger longings involved in sex, and not marred and soured by their frustration.
  • Were kisses all the joys in bed, one woman would another wed.
  • The earliest behaviors that precede sexual behaviors and that are common in children between the ages of 2 and 5 years are hugging and kissing, self-stimulation, and exhibitionism. Genital interest and related behaviors tend to become more covert among older children and adolescents, given that sexuality continues to be viewed as a taboo topic. However, studies show that genital interest, coital play, and even mutual handling of genitals between boys increase during the ages of 7–13 years. For example, masturbation in boys rises from about 10% at 7 years to over 80% at 13 years. Self-reported spontaneous nocturnal emissions are related to sexual fantasies and ideation, and they are a significant predictor of both noncoital sexual behavior and sexual intercourse. Sexual fantasies and ideation include thinking about sex, estimating the likelihood of whether one will have intercourse within the next year, and how much one would like to have sex within the next year. Noncoital behaviors include holding hands, hugging and kissing for a long time, touching girls’ breasts, girls touching penis, and touching girls’ sex organs. The onset of sexual behavior has also been related to changes in secondary sex characteristics such as the deepening of voice, facial hair, and genital development.
    • H.P. Shroff, L.A. Ricciardelli, “Physical Appearance Changes in Childhood and Adolescence – Boys” in Encyclopedia of Body Image and Human Appearance, (2012)
  • Increase in the release of sex hormones is associated with children’s awareness of their sexuality. Specifically, increases in testosterone levels have been shown to be a causal factor in the timing of sexual initiation and the frequency of sexual activity during adolescence. Boys with higher levels of testosterone report more sexual experiences requiring a partner and are more likely to initiate coitus. In addition, early maturers also report downloading and viewing pornography more often than later maturers. The impact that this may have on early maturing boys has yet to be determined. It may be a way to explore sexuality or it may lead to problematic sexual experiences. While early maturation has been shown to be associated with increased sexual behavior, later maturing boys display delayed sexual behavior. Given that these boys are out of step with their peers, they may become more anxious about their physical development and experience more body image concerns. Both these factors may hinder boys’ interest in sexual behaviors and intimate relationships.
    • H.P. Shroff, L.A. Ricciardelli, “Physical Appearance Changes in Childhood and Adolescence – Boys” in Encyclopedia of Body Image and Human Appearance, 2012
  • In the past, medical attitudes to female sexuality were grotesque, reflecting the anxiety and hypocrisy of the times. In the medieval world, the population feared hunger, the devil, and women, being particularly outraged and threatened by normal female sexuality. The 19th century attitude was no better as academics confirmed the lower intellectual status of women, particularly if they ventured into education. The medical contribution to this prejudice was shocking, with gynaecologists and psychiatrists leading the way designing operations for the cure of the apparently serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-1867, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. There is virtually no novel or opera in the last half of the 19th century where the heroine with "a past" survives to the end. The wheel has turned full circle and in the last 50 years new research into the sociology, psychology and physiology of sexuality has provided a greater understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder (HSDD). This is now regarded as a disorder worthy of treatment.
  • The 19th century medical attitude to normal female sexuality was cruel, with gynecologists and psychiatrists leading the way in designing operations for the cure of the serious contemporary disorders of masturbation and nymphomania. The gynecologist Isaac Baker Brown (1811-1873) and the distinguished endocrinologist Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-7, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. Or perhaps it led and encouraged public opinion. There is virtually no novel or opera in the last half of the 19th century where the heroine with 'a past' survives to the end. H. G. Wells's Ann Veronica and Richard Strauss's Der Rosenkavalier, both of which appeared in 1909, broke the mould and are important milestones. In the last 50 years new research into the sociology, psychology and physiology of sexuality has provided an understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder. This is now regarded as a disorder worthy of treatment, either by various forms of counseling or by the use of hormones, particularly estrogens and testosterone.
  • After the hypocrisy and tyranny directed at female sexuality in the 19th Century the change of attitude occurred slowly. Literature became more permissive with authors like D. H. Laurence, Henry Miller and Anais Nin being influential. Theatre and cinema remain conservative. In the real world Marie Stopes’ Married Love was greatly influential, listed by Bragg as one of “the 12 books that changed the world”, stressed the emotional importance of sexual intercourse within marriage. She did not discuss contraception, masturbation or sex outside of marriage in the earlier editions. Kinsey and colleagues in 1953 broke the scientific silence by publishing details of the sexual behaviour in the human female. Seymour Fisher devoted a whole book to the female orgasm and Shere Hite in her extensive use of questionnaires from women described six basic types of masturbation in women. Masters and Johnson's work on the physiology was a landmark in understanding normal sexual response. Greenblatt pioneered the use of testosterone for loss of libido and subsequently the female androgen deficiency syndrome (FADS) has been recognised. There are now good control studies indicating the value of testosterone implants, tablets and patches by Davis and her colleagues to improve the problems of hypoactive sexual desire disorder (HSDD).
  • [S]exuality and marriage are like this fire and this hearth. Fire is powerful and because of this it can be dangerous. However, as long as it is contained within the proper limits of the fireplace, it brings warmth and light. However, if that fire somehow got outside of its proper limits, the house would begin to catch fire and that which illumined and warmed the house would become a source for its destruction. In the same way, sexuality, when it is practiced within the proper limits of marriage, which God instituted from the beginning, is a source of great charity and fruitfulness, even to the degree that it is an image of Christ's unfailing love for His bride the Church. All married men and women must be careful, however, that the fire of their sexuality, which has great potential for good, is not exercised outside of the rules and context of marriage that God has set up.
  • Molly Notkin often confides on the phone to Joelle van Dyne about the one tormented love of Nokin's life thus far, an erotically circumscribed G.W. Pabst scholar at New York University tortured by the neurotic compulsion that there are only a finite number of erections possible in the world at any one time and that his tumescence means e.g. the detumescence of some perhaps more deserving or tortured Third World sorghum farmer. . .
  • There are two kinds of sex, classical and baroque. Classical sex is romantic, profound, serious, emotional, moral, mysterious, spontaneous, abandoned, focused on a particular person, and stereotypically feminine. Baroque sex is pop, playful, funny, experimental, conscious, deliberate, amoral, anonymous, focused on sensation for sensation's sake, and stereotypically masculine. The classical mentality taken to an extreme is sentimental and finally puritanical; the baroque mentality taken to an extreme is pornographic and finally obscene. Ideally, a sexual relation ought to create a satisfying tension between the two modes (a baroque idea, particularly if the tension is ironic) or else blend them so well that the distinction disappears (a classical aspiration).
    • Ellen Willis, "Classical and Baroque Sex in Everyday Life" (1979), Beginning To See the Light: Pieces of a Decade (1981)
  • These apparently opposed perspectives meet on the common ground of sexual conservatism. The monogamists uphold the traditional wife's "official" values: emotional commitment is inseparable from a legal/moral obligation to permanence and fidelity; men are always trying to escape these duties; it's in our interest to make them shape up. The separatists tap into the underside of traditional femininity – the bitter, self-righteous fury that propels the indictment of men as lustful beasts ravaging their chaste victims. These are the two faces of feminine ideology in a patriarchal culture: they induce women to accept a spurious moral superiority as a substitute for sexual pleasure, and curbs on men's sexual freedom as a substitute for real power.
    • Ellen Willis, "Lust Horizons: Is the Woman's Movement Pro-Sex?" (1981), No More Nice Girls: Countercultural Essays (1992)
  • In addition to his bio-physical heresies, Dr. Reich vastly offended many people by his sociological theory, which holds that fascism is just an exaggerated form of the basic structure of sex-negative societies and has existed under other names in every civilization based on sexual repression. In this theory, the character and muscular armor of the average citizen — a submissive and frightened attitude anchored in body reflexes — causes the average person to want a strong authority figure above them. Tyranny, in this model, is not created by tyrants alone but by neurotic masses who want tyrants.
    • Robert Anton Wilson, in Everything Is Under Control : Conspiracies, Cults, and Cover-Ups (1998), p. 361; some of Wilson's account of the suppression of Reich's ideas and work are technically exaggerative: though many of Reich's books mentioning his concepts of orgone energy and the "orgone accumulators" of his laboratory were destroyed the destruction of his equipment and books was not actually total.
  • There is a paucity of neurobiological research on human sexual activity, even though this knowledge could potentially have widespread applications in the treatment of sexual disorders, and contribute to further elucidating the complex systems involved in pain, pleasure, and reward. In particular, studies of the human orgasm are sparse, most likely due to the considerable methodological difficulties this work presents, along with cultural constraints. As a result, presently there are only two laboratories that conduct systematic studies of the regional brain activity leading up to and including orgasm in the female human--the Komisaruk group at Rutgers University, using functional magnetic resonance imaging,(Komisaruk, Whipple et al, 2004; Komisaruk & Whipple, 2005; Komisaruk, Wiseet al, 2010, 2011; Wise et al., 2012) --and the Holstege and Georgiadis group, in the Netherlands, using positron emission tomography, (Georgiadis et al., 2006; 2009; Huynhet al., 2013).
    • Wise, Nan (author); Komisaruk, Barry R (chair); Delgado, Mauricio (co-chair); Tricomi, Elizabeth (internal member); Hanson, Catherine (internal member); Whipple, Beverly (outside member); Rutgers University; Graduate School - Newark; “Genital stimulation, imagery, and orgasm in women”, p.43

“Handbook of Medieval Sexuality” (1996)[edit]

Vern L. Bullough and James A. Brundage, eds., “Handbook of Medieval Sexuality”, Garland, (1996)

  • One of the more popular examples of such relations to sex in history, although not from a medievalist, occurred in Edith Hamilton’s bestselling and wonderfully idealized study of ancient Hellas, in which she never once mentioned the homoerotic practices of Greeks in the classical era. She perhaps ignored such practices because few classicists of her generation admitted any awareness of them. When it finally dawned on one of Miss Hamilton’s older contemporaries, John Jay Chapman, that the ancient Greeks whom he so admired had commonly engaged in sexual practices which he disapproved, he concluded that the “Attic mind” must have been psychologically abnormal. “But why had I not found this out before?” he asked. And he answered: “Because the books and essays on Plato that I had been reading were either accommodated to the Greek psychology or else they accommodated to modern Miss Nancyism-and, by the way, the two agree very sociably.”
    To challenge the moralistic generalizations of a Ranke or the innocence of an Edith Hamilton required a willingness to examine sexuality in some detail. In the United States during the 1930s and 1940s Freudian psychoanalysts were emphasizing the importance of repressed sexuality, and a few medievalists began to incorporate psychoanalytical perceptions into the work. The real revolution in public discourse about sexuality began in earnest with the publication of the two Kinsey reports on human sexual behavior in the late 1940s and the early 1950s. It took some time, however, before American academics in any discipline felt secure enough to undertake serious research into human sexuality. Early steps in this direction were cautious. Members of the Annales school of historians in France discreetly began to produce occasional studies of the history of marriage, family, and even of sexual behavior during the 1950s. One of the editors of this volume (VLB) published a study of prostitution in 1964, as well as several articles on the history of sexuality, but none of these appeared in medieval or even historical journals.
    • pp. xiii-xiv
  • Foucault argued that the history of sexuality in the modern world had been marked by a continuous increase in the “mechanisms” and “technologies” of power. Beginning in the eighteenth century, as Foucault saw things, the locus of power shifted from the confessional to the research laboratory and the clinic and this made it possible for sexuality to become the subject of serious scientific investigation. He emphasized four mechanisms that employed the “knowledge of power” of sex: (1) “the hysterization of women’s bodies”; (2) “pedogogization of children’s sex”; (3) “the socialization of procreative behavior” and (4) “the psychiatrization of perverse pleasure.” These mechanisms were directed at four common types of sexual experience: those encountered by hysterical women, masturbating children, couples who used contraceptives to curtail births, and sexually deviant adults.
    • pp.xiv
  • Foucault’s categorizing and theorizing seemed to confer intellectual legitimacy on the study of sexuality and that encouraged scholars from the humanities and history to venture openly into the field, if only to challenge some of Foucault’s assumptions. One difficulty with Foucault’s approach to the study of sexuality lay in the fact that he began his analysis of the history of sexual behavior with the eighteenth century. Medievalists in particular questioned how valid his assumptions about the earlier past might be. Eventually Foucault himself accepted the wisdom of some of the reservations expressed about his earlier volume, and in the second and third volumes of his ‘’History of Sexuality’’ he began to explore perceptions of sexuality in classical antiquity. Foucault died, however, before he would carry the enterprise forward into the Middle Ages.
    • p.xv

"Catechism of the Catholic Church" (March 4, 2009)[edit]

"Catechism of the Catholic Church" 2nd Edition, Vatican. Archived from [https://www.vatican.va/archive/catechism/p3s2c2a6.htm#III the original on March 4, 2009. Retrieved 2009-03-20.

  • Sexuality affects all aspects of the human person in the unity of his body and soul. It especially concerns affectivity, the capacity to love and to procreate, and in a more general way the aptitude for forming bonds of communion with others.
    • Paragraph 2332
  • Everyone, man and woman, should acknowledge and accept his sexual identity. Physical, moral, and spiritual difference and complementarity are oriented toward the goods of marriage and the flourishing of family life. The harmony of the couple and of society depends in part on the way in which the complementarity, needs, and mutual support between the sexes are lived out.
    • Paragraph 2332
  • Sexuality, by means of which man and woman give themselves to one another through the acts which are proper and exclusive to spouses, is not something simply biological, but concerns the innermost being of the human person as such. It is realized in a truly human way only if it is an integral part of the love by which a man and woman commit themselves totally to one another until death."142
    Tobias got out of bed and said to Sarah, "Sister, get up, and let us pray and implore our Lord that he grant us mercy and safety." So she got up, and they began to pray and implore that they might be kept safe. Tobias began by saying, "Blessed are you, O God of our fathers. . . . You made Adam, and for him you made his wife Eve as a helper and support. From the two of them the race of mankind has sprung. You said, 'It is not good that the man should be alone; let us make a helper for him like himself.' I now am taking this kinswoman of mine, not because of lust, but with sincerity. Grant that she and I may find mercy and that we may grow old together." And they both said, "Amen, Amen." Then they went to sleep for the night.143
    • Paragraph 2361
  • The acts in marriage by which the intimate and chaste union of the spouses takes place are noble and honorable; the truly human performance of these acts fosters the self-giving they signify and enriches the spouses in joy and gratitude."144 Sexuality is a source of joy and pleasure:
    The Creator himself . . . established that in the [generative] function, spouses should experience pleasure and enjoyment of body and spirit. Therefore, the spouses do nothing evil in seeking this pleasure and enjoyment. They accept what the Creator has intended for them. At the same time, spouses should know how to keep themselves within the limits of just moderation.
    • Paragraph 2362

“Gender Differences in Receptivity to Sexual Offers”[edit]

Russell D. Clark III, Elaine Hatfield; “Gender Differences in Receptivity to Sexual Offers”

  • According to cultural stereotypes, men are more eager for sex than are women; it is women who set limits on such activity (see McCormick, 1979; Hatfield 1982; and Peplau, 1983). Theorists from a variety of perspectives haves agreed with this observation. What they disagree about is why such gender differences exist. Researchers have collected an abundance of interview and correlational data which provide some support for this contention. No experimental support for this hypothesis exists, however. In this research, we report an experimental test of this proposition.
    • pp.39-40.
  • Traditionally, biological determinists such as Sigmund Freud argued that biology is destined and that interest in sexual activities is determined primarily by genes, anatomy, and hormones. Early sociobiologists assumed that men and women are genetically programmed to be differentially interested in sexual experience/restraint (see Hagen, 1979, Kenrick, 1987, Symons, 1979, or Wilson 1975). Symons (1979) stated that “the comparison of males and females is perhaps the most powerful available means of ordering the diversity of data on human sexuality” (p.4). His sociobiological argument proceeded as follows: according to evolutionary biology, animals inherit those characteristics which insure that they will transmit as many of their genes to the next generation as possible. It is to both men’s and women’s advantage to produce as many surviving children as possible. But men and women differ in one critical respect-in order to produce a child, men need only to invest a trivial amount of energy; a single man can conceivably father an almost unlimited number of children. Conversely, a woman can give birth to an raise only a limited number of children; it is to her advantage to insure that those few children she does conceive survive. Symons observed: “The enormous sex differences in minimum parental investment and in reproductive opportunities and constraints explain why ‘’Homo Sapiens’’, a species with only moderate sex difference s in structure, exhibit profound sex differences in psyche” (p.27).
    • p.40
  • Among the differences Symons cited are: (1) men desire a variety of sex partners; women do not; (2) for men, “sexual attractiveness” equals “youth.” For women, “sexual attractiveness” equals “political and economic power”; (3) men have every reason to actively pursue women (they are genetically programmed to impregnate as many women as possible. Women have every reason to be “coy.”) It takes time to decide if a man is a good genetic risk-is likely to be nurturant, protective and productive. In all societies, women copulate a service to men, not vice versa.
    • pp.40-41
  • Recently, socio-biologists and social psychologists have discovered that the process is a bit more complicated than was initially though. Kurt Freund and his colleagues (1983 and 1986) observe that courtship normally consists of four phases: (a) initial appraisel and location of a potential partner, (b) pretactile interaction (for example, smiling at someone, laughing, flirting, talking), (c) tactile interaction (touching, embracing), and (d) bringing about genital union. A number of authors have found that women have a far more active role in the first three stages of courtship than the early sociobiologists though. They do far more than serve as “gatekeeper” who stop action (see Gauiler, tavis & Allgeier, 1986; Moore, 1985; and Perper, 1985). For example, Moore (1985) found that in a singles bar, it is women who initiate interaction. They signal their interest in a variety of ways-by smiling, laughing, tossing their heads, or hiking up their skirts. Sometimes they “parade” (they walk across the room with an exaggerated swing of their hips, stomach held in, head held high, back arched, so their breasts are pushed out). They then “approach”-they go up to men and position themselves within two feet of them. The next move is up to the men. If the men are interested, the two begin to talk. Eventually, however, it is the men who must “formally” initiate sexual relations, especially the first time sexual intercourse occurs. After that, although men generally initiate sexual relations, women are freer to share intiation.
    • p.41
  • On the other end of the spectrum are those who argue that sexual behavior is learned (see Bernard, 1973; Byrne & Byrne, 1977; Firestone, 1970; Foucault, 1978; Griffit & Hatfield, 1984; Rubin, 1973; Tavris & Offir, 1977; Safilos-Rothschild, 1977; or Hatfield & Walster, 1978). According tho this model, men and women simply learn the “scripts” that are appropriate for initiating sexual encounters and responding to sexual offers. They simply learn to be as sexually adventuresome or cautious as their culture expects them to be. Cultural rewards and punishments shape behavior. Thus, if men are more adventuresome than women, it is simply because the culture encourages them to be so.
    • pp.41-42
  • In the late 1970s, when this study was planned, a number of feminist and Marxist scholars were speculating that the socio-political context might shape societal rewards and punishments. Sociopolitical pressures might have at least some impact on who is supposed to be sexual/who is forbidden to be, who is punished/who is not for violating sexual rules, and even what kinds of foreplay and sexual positions are considered to be “normal.” Since this is a male-dominate society, they continued, perhaps existing sexual norms tend to mee the needs of men. Perhaps it is men who are encouraged to express themselves sexually, women who are punished for doing so. It is the style of intercourse men prefer (e.g., the “missionary” position) that is considered normal; the activities that women prefer (e.g. “cuddling,” cunnilingus) that are neglected. No wonder then that men find sex in its common forms more appealing than do women (see Firestone, 1970 and Allgeir & McCormick, 1983). In the 1980s, of course, the power of “sociopolitical pressures” pales before the threat of AIDS, which makes sexual behavior equally risky for both men and women. One might predict, then, that from the late 1980s into the 1990s, men and women will become far more conservative about engaging in sexual activity. Thus, gender differences in receptivity to sexual offers may soon disappear.)
    • p.42
  • Traditionally, erotica has been written for men. The assumption has been that women are not interested in such things. Kinsey (1948 and 1953) found that the women in his sample were considerably less likely than men to have ever been exposed to erotica, and even when both sexes were familiar with such literature, men reported being more aroused by it than did women. For example, 47% of the men reported having been aroused by erotic stories. Only 14% of the women reported similar levels of arousal. Izard and Caplan (1974), too, found that more men than women reported interest in and arousal in response to erotic passages.
    • pp.42-43
  • Recently, however, researchers have begun to ask both men and women about their feelings ‘’’and’’’ to get objective measures of their psychological arousal in response to erotica. (To do this they generally use two instruments: a penile strain-gauge and a photo-plethysmograph.) In such studies, researchers generally find that although men and women often ‘’report’’ differential interest in erotica, the objective evidence suggests that both are equally aroused. For example, Veitch and Griffit (1980) found no gender differences in response to literary erotica. In fact, some data suggest that explicit portrayals of sexual activity may evoke equal or greater erotic responsiveness in women than in men. Jakobovits (1965) found that women consistently rated “hard core” erotic stories as more interesting and sexually stimulating than did men. Heiman (1977) found that both men and women judged audiotapes of exclusively “romantic: encounters less arousing than audiotapes describing either romantic ‘’and’’ erotic or exclusively erotic sexual encounters. Women actually rated the explicit erotic audiotapes as more arousing than did men. Heiman found no sex differences on the physiological measures of sexual arousal.
    • p.43
  • Several studies have documented that men may well be more responsive to erotic films than are women, as well (see, for example, Abelson, 1970; Berger, Gagon, & Simon, 1970; Byrne & Lambeth, 1970; Griffitt, 1975; Heiman, 1977; Izard & Caplan, 1974; Jakobovits, 1965; Kiney et al., 1953; Mosher, 1973; Schmidt & Segush, 1970; Steele & Walker, 1974). Typical of these finding are those of Abelson et al. (1970) who found that only 7% of women but 20% of men reported that they become aroused when viewing explicit pictures and stag films.
    • pp.43-44
  • Traditionally, theorists have assumed that sex is far more important for men than for women.
    Kinsey and his colleagues (1948 and 1953) tried to assess the sexual activity f men compared with women throughout their lives. They asked men and women how often they had an orgasm during a typical week – regardless of whether they achieved it by way fo sex dreams, petting, masturbating, sexual intercourse, homosexual encounters, or contacts with animals.
    They found that: (1) indeed, men did seem to engage in more sexual activity than women; and (2) men and women had strikingly different histories. At 18, it was usually the men who pushed to have sex. Most men were as sexually expressive at 15 as they would ever be. In fact, according to Masers and Johnson (1966 and 1970) 25% of men are impotent by age sixty-five and 50% are important by age seventy-five. Women’s experience was markedly different. Most women are slow to begin sexual activity. At 15, most women are quite inactive. Sometime between the ages of 16 and 20, they begin to be more sexually active. Their sexual interest seems to remain high until their late 40s. In commenting on women’s sexual histories, Kinsey (1953) observed:
    One of the tragedies which appears in a number of marriages originates in the fact that the male may be most desirous of sexual contact in his early years, while the responses of the females are still underdeveloped and while she is still struggling to free herself from the acquired inhibitions which prevent her from participating freely in the marital activity. But over the years most females become less inhibited and develop an interest in sexual relations, which they may maintain until they are in their fifties or seven sixties. But by then the responses of the average male may have dropped so considerably that his interest in coitus, and especially in coitus which a wife who had previously objected to the frequencies of his requests, may have sharply declined. (pp. 353-354)
    • p.44
  • In Kinsey’s day, a double standard existed. Men were allowed, if not encouraged, to get sex whenever and wherever they could. Women were supposed to save themselves for marriage (see Baker, 1974; Ehrmann, 1959; Kaats & Davis, 1970; Reiss, 1967; Schofield, 1965; or Sorenson, 1973) . In light of the double standard, it was not surprising that Ehrmann (1959) found that both men and women college students reported that it was the man who was more likely to initiate sexual advances.
    More recent evidence suggests that traditional standards, although changing, are no dead. For example, the most recent data indicate that it is almost always men who initiate a sexual relationship. While research indicates that contemporary college students reject a sexual double standard (Hopkins, 1977; Komarovsky, 1976; Peplau, Rubin, & Hill, 1976), this new single standard does not seem to have changed the cultural stereotype of male as sexual initiator and female as limit setter (McCormick, 1979). In a recent study, Peplau et al. (1977) found that , among unmarried students, the woman serves as the “gatekeeper” she has the power to veto sexual activity. Once the couple begins to have sexual relations, however, the man has more to say about the type and frequency of sexual activity.
    • pp.45-46
  • Following Kinsey, researchers (Ehrmann, 1959; Schofield, 1965; Reiss, 1967; Sorenson, 1972; and DeLameter & MacCorquodale, 1979) interviewed samples of young people about their sexual behavior: Had they ever necked? At what age did they begin? Have they French kissed? Fondled their lover’s breasts or genitals? had their own genitals fondled? Had intercourse? Engaged in oral-genital sex? When we compare the data from these studies, we find that, indeed, a sexual revolution ‘’is’’ occurring. In the early study, men were, in general, far more experienced than were women. By the 1980s, these differences have virtually disappeared. As DeLameter and MacCorquodale (1980) observe:
    …there are virtually no differences in the incidence of each of the behaviors. Unlike most earlier studies which generally reported lower frequencies of more intimate activities among females, we find that women are as likely as men to have ever engaged in these behaviors. The only exception occurs with coitus, which women… are less likely to have experienced. (‘’Among students’’, 75% of the men and 60% of women had had intercourse. ‘’Among non0students’’, 79% of men and 72% of women had had intercourse.)
    DeLameter and MacCorquodale continue:
    Thus, the gender differences in lifetime behavior which were consistently found in studies conducted in the 1950’s and 1960’s have narrowed considerably. This is also an important finding; it suggests that those models which have emphasized gender as an explanatory variable are no longer valid. (p.58)
    • p.46
  • In most areas of social psychology, the experimental paradigm has been ‘’the’’ paradigm. It is only recently that a “crisis in social psychology” occurred, and social psychologists have begun to urge one another to supplement laboratory findings with naturalistic observations of people engaged in complex social interactions. Only in the area of human sexuality has the social—psychological tradition been reversed. Until recently, studies of love and sex were taboo (see Berscheid & Hatfield [Walster], 1978). Until recently, scientists have had to rely almost exclusively on interviews and naturalistic studies for their information. Only recently have researchers begun to conduct laboratory experiments (see Byrne & Byrne, 1977).
    This laboratory research had paid off. It has had a dramatic impact on our thinking about human sexuality. For example, in 1953, Kinsey et. Al. (1953) took it for granted that males and females were very different in their potential to respond to erotic literature, tapes, and films. “So different…that they might be considered different species.” By 1978, the experimental research,, although far from conclusive, had convinced most investigators that men and women were very similar if not identical in their ability to become aroused by erotica (see Hyde, 1979; Byrne & Byrne, 1977).
    • p.47
  • To date, there have been few, if any, ‘’experimental’’ studies of men and women caught up in the sexual initiation/rejection process. In real life, the intimacy process is obviously a complex ballet. Officially, the man is supposed to initiate sexual encounters. But how overt can he be? Can he be fairly blunt? Or must he be indirect to be effective (see McCormick, 1979)? Surely, before most men extend a proposition to a woman, they look for some kind of evidence of interest on her part. If, in real life interactions, the man awaits until the woman is receptive before issuing an invitation, who is inviting whom? How blunt can the woman be in accepting an invitation? Are most men upset by too much enthusiasm? Would such norm violations lead them to say “No”? Would most men be delighted? Such are the questions that can only be answered by careful experimentation.
    • p.47
  • Again and again, researchers have found that while men and women ‘’expect’’ the sexes to respond in very different way, when real men and real women find themselves caught up in naturalistic settings they respond in much the same way (see Maccoby & Jacklin, 1974; Griffitt & Hatfield, 1984). It may be that ‘’both’’ men and women turn out to be more receptive to sexual invitations than one might expect. (Data such as DeLameter & MacCorquodale’s 1979, might suggest such an outcome.)
    Or, both men and women might be far less receptive than one might expect. Traditionally, men are expected to jump at sexual offers. Women are supposed to turn them down. But some investigators have suggested that both men and women might be afraid of casual sex. For example, Hatfield (Walster) et al (1973), in a study of men’s reactions to “easy to get women,” found that men are very uneasy about dating an “easy” woman. They saw such encounters as very risky. Such a woman might be easy to get, but hard to get rid of. She might get serious. Perhaps she would be so over sexed or over-affectionate or “hard-up” in public that she would embarrass you. Your buddies might snicker when they saw you together. After all, they would know perfectly well why you were dating her. And, you might get a disease. (The recent epidemics of herpes and AIDS make these concerns especially salient now and into the future. See Baum, 1987.) These were all reservations that men voiced.
    • p.48
  • It may be, as sociobiologists suggest, women are eager for love and commitment. Men are eager for sexual activity. Such theorizing is consistent with the data. Both men and women were willing to date a total stranger. (When one goes out on a date, one has the opportunity to assess the probability that a loving relationship could occur). Women were unwilling to go to a man’s apartment or to have sexual relations. Men, on the other hand, were surprisingly willing to go to a strange woman’s apartment or to bed. (In fact, they were less-willing to accept an invitation to date than to have sexual relations!)
    • p.51

“The long sexual revolution: English women, sex and contraception 1800-1975” (2004)[edit]

Cook, Hera, “The long sexual revolution: English women, sex and contraception 1800-1975”, Oxford University Press, (2004)

  • [T]he pill did produce a situation in which these pre-existing social conditions led to a new twist on male sexual exploitation of young single women in the 1960s. Throughout the nineteenth and twentieth centuries, the family, the Church, and later schools had attempted to supervise and control unmarried women’s sexual behavior. In this social setting women might have had to struggle against persuasive male arguments and persistent groping but they had the entire weight of society, backed up by the ultimate sanction of pregnancy, supporting them if they did not wish to have intercourse. In the 1960s the arrival of the pill meant that for the first time women could have confidence that they would not get pregnant. There is a new sense of excitement and possibilities present in many accounts by heterosexual women who were young and single at this time. In choosing to reject the control of their sexual behaviour they saw themselves as rejecting control over their lives as a whole However, abandoning the traditional moral position left many confused, with no substantial arguments against casual or dishonest male sexual exploitation. By the early 1970s, men assumed fashionable young women were on the pill and statistics show that well over half actually were.
    • p.3
  • Historians of sexuality, especially heterosexuality, have tended to disregard people in whose lives sexual expression was unimportant in favour of people who had extensive sexual knowledge and experience. In a society in which speaking, or writing, about physical sexual experience was strongly discouraged, those who have left records of their sexual expression were unusual by definition. From 1900 to the 1940s, sexually knowledgeable and experienced people usually belonged to relatively small sectors of the community such as artists, bohemians, some wealthy businessmen, sexual radicals, sailors, and the non-respectable section of the working class. Male boarding school pupils frequently had adolescent same-sex contacts but on many this appears to have had little impact. The number of unmarried women who were sexually active with men other than their intended spouse was increasing from 1900 but the only substantial group of such women continued to be those who worked as prostitutes. Their numbers diminished as legislation and intensification of policing introduced pimps into the equation and made prostitution a less acceptable lifestyle for women before the Second World War. Occasional comments reveal the existence of women and men who were otherwise conventional but who had sexual experience and pleasure greater than that suggested as usual by most sources. This category included active but married homosexuals. Taken as a whole all these different groups probably amounted to no more than around 15 per cent of the population at this time. With the exception of the wealthy businessmen, they tended to be marginal or powerless, and they lived within a sexual culture that silenced them. None of the sources suggest that extensive sexual experience was usual or acceptable to conventional, respectable people before the 1950s. The community as a whole supported and maintained sexual norms. Individuals who openly transgressed sexual boundaries, such as girls who had been sexually assaulted, unmarried mothers, or homosexuals who encountered the police, were usually treated harshly by their families and communities. It was this community support that enabled authorities to uphold rigid sexual mores.
    • Sexuality and Sex Manuals, pp.178-179
  • Although, for the majority of the population, physical sexual activity involved both men and women, they inhabited almost separate sexual cultures, a male culture and a female culture. Very different, and contradictory, pictures of sexual mores appear depending on which is examined. Gendered sexual cultures were part of a society in which gender segregation was usual in most schooling and in most occupations and remained a common experience up to the 1960s. Discussion of sexuality and of the sexual body in mixed-gender groups including respectable women or in the public sphere was extremely limited under the mid-1960s. Female gossip is characterized as contributing to maintaining rigid sexual mores, but Robert Roberts described how older men also disapproved of the increase in explicit male sexual boastfulness after the First World War.
    • Gendered Sexual Cultures, p.179
  • In the 1920s and 1930s, British sexual culture was shaped by an almost abstract perception of sexuality as a negative force that had to be restricted and controlled in whatever form it occurred. The genitals were not primarily a source of pleasure but a part of the body to avoid and think about as little as possible. The major shift that occurred in the sex manuals of the 1930s was a move away from acceptance of this feeling of shame and fear to promotion of a more positive conception of the body and sexuality. While the manuals do challenge male control of sexual activity in new ways during the 1930s, the challenge is largely indirect, and it comes about from the desire of both men and women that women should experience sexual pleasure. The redefinition of masturbation which took place during the inter-war decades had more impact than any direct challenge to gender relations on sexual practice in the 1930s. Attitudes to masturbation concerned not only the relation of the individual to their own body but their approach to the body of a sexual partner. The limits that these inhibitions about the body placed on physical sexual practice were severe.
    • The Spontaneous Feeling of Shame: Masturbation and Freud 1930-1940, p.207

“Men versus women on sexual brain function: prominent differences during tactile genital stimulation, but not during orgasm” (Oct 9, 2009)[edit]

Janniko R Georgiadis, A A T Simone Reinders, Anne M J Paans, Remco Renken, Rudie Kortekaas; “Men versus women on sexual brain function: prominent differences during tactile genital stimulation, but not during orgasm”, Hum Brain Mapp. 2009 Oct;30(10):3089-101.

  • Biological differences in male and female sexuality are obvious in the behavioral domain, but the central mechanisms that might explain these behavioral gender differences remain unclear. In this study, we merged two earlier positron emission tomography data sets to enable systematic comparison of the brain responses in heterosexual men and women during sexual tactile genital (penile and clitoral) stimulation and during orgasm. Gender commonalities were most evident during orgasm, a phase which demonstrated activations in the anterior lobe of the cerebellar vermis and deep cerebellar nuclei, and deactivations in the left ventromedial and orbitofrontal cortex in both men and women. During tactile genital stimulation, deactivations in the right amygdala and left fusiform gyrus were found for both genders. Marked gender differences were seen during this phase: left fronto-parietal areas (motor cortices, somatosensory area 2 and posterior parietal cortex) were activated more in women, whereas in men, the right claustrum and ventral occipitotemporal cortex showed larger activation. The only prominent gender difference during orgasm was male-biased activation of the periaqueductal gray matter. From these results, we conclude that during the sexual act, differential brain responses across genders are principally related to the stimulatory (plateau) phase and not to the orgasmic phase itself. These results add to a better understanding of the neural underpinnings of human sexuality, which might benefit treatment of psychosexual disorders.
  • Gender differences in sexuality and sexual behavior are often subject to humor and ridicule. Nevertheless, differences in the way the male and female brain produce a sexual response may be clinically relevant, because there is a large group of gender‐specific sexual disorders without a clear somatic cause (psycho‐ or neurogenic sexual disorders). As these sexual disorders are associated with high occurrences of health and relationship problems [Laumann et al.,1999; Lloyd,2005], gaining knowledge about the functional neurobiology underlying human sexual behavior is important. This process is delayed by the lack of neurobiological studies that are actually carried out in human subjects, especially pertaining to more progressed stages of the sexual response, like genital stimulation and orgasm. In previous studies, we have identified regions in the human brain associated with tactile genital stimulation and orgasm in men [Georgiadis and Holstege,2005; Holstege et al.,2003; Georgiadis et al.,2007] and women [Georgiadis et al.,2006]. An outstanding question is how the brain reponses in both gender groups compare during these crucial sexual phases.
    From similar animal studies conducted in male [Baum and Everitt,1992; Coolen et al.,1996; Kollack‐Walker and Newman,1997; Marson et al.,1993] and female [Coolen et al.,1996; Marson,1995; Marson and Murphy,2006], rodents a picture emerges of a shared neuronal substrate for the processing of genital information and the control of genital responses comprising regions in the thalamus, the amygdala, the midbrain, and the hypothalamus. Bridging the gap between animal studies and human sexual activity is not straightforward. For example, animal models exist for the neuronal substrate underlying penile erection and ejaculation, but not for the subjective experience of sexual arousal and orgasm. Other concerns with the relevant animal studies are that the vast majority of them focuses on male sexual behavior, and that the cerebral cortex is usually not investigated despite insights gained from neurological patients about its importance for the integrity of human sexual behavior [Aloni and Katz,1999; Sandel et al.,1996].
    Gender differences in human brain function have been demonstrated for emotional tasks: a meta‐analysis of 65 neuroimaging studies revealed that compared to men, women more frequently activate midline limbic structures, including the subcallosal anterior cingulate, the thalamus, the midbrain, and the cerebellum. Men, on the other hand, showed more hemispheric lateralization and more activation in occipital and left inferior frontal cortices [Wager et al.,2003]. For visually evoked sexual arousal, men had more activation in amygdala [Hamann et al.,2004] and hypothalamus [Hamann et al.,2004; Karama et al.,2002].
  • Gender differences in the human sexual response were taken into account when the male and female experiments were designed. For instance, women typically reach orgasm most easily through clitoral stimulation, and not via penetration [Hite,1976; Lloyd,2005]. In addition, women are far more likely to stay aroused after orgasm than men [Mah and Binik,2001].
  • The main objective of this study was to explore gender commonalities and differences. Due to the lack of studies on this topic, we accepted and report those brain areas that survive a statistical threshold of P < 0.001, uncorrected for multiple comparisons [Friston et al.,1991]. To investigate rCBF changes occurring in men and women for stimulation or orgasm respectively, we performed conjunction analyses using statistical parametric maps of the minimal t statistic, P < 0.001 uncorrected, over “male” and “female” t contrasts (conjunction null hypothesis, see: Friston et al.,2005; Nichols et al.,2005]. These effects are called “gender commonalities.” The mutual subtraction of the appropriate male versus female t contrasts rendered differential contrasts for sexual genital stimulation and orgasm, which are called “gender differences.” Parameter estimates were calculated to gain knowledge about how brain regions in men and women responded during the different phases of the experiment. We used MarsBar (http://marsbar.sourceforge.net/), a region of interest tool that can be implemented in SPM5. Two separate extended models were designed to test for possible confounding effects of differences across genders in scan order and orgasm repetition. The influence of these effects was tested by two independent analyses of covariance (scan order: 1–8; orgasm repetition order: 1, 2, 3) using an F test (P < 0.05, corrected). Brain regions were identified using three stereotactic atlasses: Schmahmann et al. [1999] for foci in the cerebellum, Mai et al. [1997] for foci in the subcortical gray matter, and the WFU‐pickatlas tool [Maldjian et al.,2003,2004] with incorporated Talairach Daemon [Lancaster et al.,2000] for gyral‐ and Brodmann‐labeling of foci in the telencephalic cortical coverings.
  • This study aimed to investigate gender differences and commonalities with respect to cerebral blood flow changes during two phases of human sexual behavior, namely orgasm and the preceding phase of tactile genital stimulation. The main result of this study was that gender differences were most prominent during tactile genital stimulation, while gender similarities were observed during orgasm.
    It is highly unlikely that differences measured during sexual tactile genital stimulation were caused by sexual dimorphism of cerebral structures. First of all, our spatial brain normalization entailed iterative non‐linear warping which effectively obliterates inter‐individual structural variance. Second, although structural gender differences exist in amygdala, hippocampus and prefrontal cortex [Allen et al.,2003; Cahill,2006; Luders et al.,2006], none of these areas were identified in our study as being functionally different between genders. In contrast, we found shared rCBF changes in both the amygdala and prefrontal cortex. Interestingly, we observed in our study that part of the occipital lobe was activated more in men than in women, a finding which has been demonstrated previously for emotional tasks [Wager et al.,2003].
  • The conjunction analysis confirmed results of our prior publications demonstrating little overlap between penile and clitoral stimulation with regard to activated brain regions. Only two regions showed a tendency towards activation in both gender groups, the left primary (SI) and secondary (SII) somatosensory cortex. However, the conjunction analysis did not corroborate animal studies which suggest a shared neuronal substrate for the processing of male and female genital afferent information during sexual activity at the level of the brainstem and the diencephalon [Baum and Everitt,1992; Coolen et al.,1996; Kollack‐Walker and Newman,1997; Marson,1995; Marson and Murphy,2006; Marson et al.,1993]. This is intriguing because penis and clitoris derive from the same embryonic tissue and share a common peripheral somatic innervation via the pudendal nerve. Taking this into account, one might assume that common pathways in humans must exist at the subcortical level for the sensory information from the genitalia to reach the cerebral cortex. However, the present study depicts discrepancies which may be based on physiological differences between rodents and humans. Conflicting results may also be due to the experimental set‐up or the restrictions of the scanning technique used.
    Consistent with our previous publications we show activity decreases in the medial temporal lobe in both men and women, most notably in the right amygdala and left fusiform gyrus. Our results are also in line with the well‐established inverse relationship, demonstrated both by clinical [Aloni and Katz,1999; Baird et al.,2002] and neuroimaging [Bocher et al.,2001; Dimpfel et al.,2003; Moulier et al.,2006; Redouté et al.,2000; Tiihonen et al.,1994] studies, between activity in the temporal lobe and the degree of sexual arousal. The present results strengthen this concept, and, most importantly, show specific sites within the temporal lobe in men and women, the right amygdala and left fusiform gyrus, that might restrain sexual arousal during a non‐sexual resting state.
  • During tactile genital stimulation we observed higher activation of the right posterior claustrum in men than in women. The claustrum has extensive and mostly reciprocal connections with the neocortex [for review, see Crick and Koch,2005], and functionally, has been linked to cross‐modal matching [Hadjikhani and Roland,1998; Horster et al.,1989] and multisensory integration [Naghavi et al.,2007]. Studies using visual sexual stimulation (VSS) have shown a positive correlation between claustrum activity levels and the degree of penile turgidity [Arnow et al.,2002; Redouté et al.,2000,2005]. Arnow and colleagues proposed that claustrum involvement reflects cross‐modal transfer of visual input to imagined tactile (penile) stimulation [Arnow et al.,2002]. Following this line of thinking, claustrum activation during sexual tactile genital stimulation with eyes closed could point to cross‐modal transfer of genital sensory information to a visually imagined situation. Support comes from anatomical studies, showing that the posterior portion of the claustrum is connected to visual cortical areas, at least in cat [Narkiewicz,1964; Olson and Graybiel,1980] and monkey [Pearson et al.,1982]. Although no data were collected from our subjects that could confirm stronger visual imagery in men during tactile genital stimulation than in women, the idea remains attractive: (i) next to the claustrum, men also had stronger activation in the right ventral occipitotemporal region, a visual area that is activated during visual imagery [Ishai et al.,2000; Roland and Gulyas,1995]. This is also consistent with the meta analysis by Wager et al. which speculated about the a higher sensitivity and attention to visual stimuli in men in emotional paradigms [Wager et al.,2003]. (ii) behavioral observations have shown that men have a greater interest in visual sexual stimuli than women [Laumann et al.,1994].
  • The question arises as to why tactile sexual genital stimulation elicits such marked differences in frontoparietal activity between men and women. One explanation could be that the stimulation was not identical for both genders due to the different physical properties of penis and clitoris. For instance, in women often the entire vaginal vestibulum was stimulated, and not only the clitoris. It is quite possible that in a region like SA2, where somatotopy is still highly preserved [Young et al.,2004], such physical differences could lead to divergent activation across genders. Another explanation is provided by mirror neuron theory, which holds that certain neurons activate both during the execution of an action and the perception of the same action performed by another person. This may be a potential neural basis for individuals to understand each other's actions [Rizzolatti and Craighero,2004]. Main elements of this system, the premotor cortex, the inferior parietal lobule, and the posterior parietal cortex, showed female‐biased activation in the present study. Individuals with a high capacity to sense the perspective of others, a trait that is more often associated with women than men [Baron‐Cohen et al.,2005], display stronger activation in “mirror areas” [Gazzola et al.,2006]. One might therefore assume that our female subjects had a stronger “motor embodiment” of their partner's action (i.e. performing genital stimulation). Left‐lateralized primary motor and premotor activation was consistent with right‐handed stimulation of the clitoris performed by the partner. Although premotor activation in response to the sight of a hand action has been reported to be more ventral than the location we presently show (e.g. Buccino et al.,2001], dorsal premotor activation similar to ours was found in response to heard, but unseen hand actions [Gazzola et al.,2006]. Recall that our subjects were unable to see their partner perform the stimulation. Within the inferior parietal lobule the activated clusters were located posteriorly, corresponding to simulation of hand/arm or possibly even leg/foot or pelvis actions [Buccino et al.,2001]. We want to stress that this explanation remains speculative in the absence of data on perspective taking.
  • The anterior lobe of the cerebellum was also activated across genders. For detailed discussion of cerebellar involvement in orgasm we refer to previous work [Georgiadis et al.,2006,2007]. A novel orgasm‐related effect was the activation of the pontine extension of the cerebellar cluster. In this part of the brainstem cerebellum‐projecting nuclei are located, but it is also the site for cardiovascular and respiratory control centers, as well as for centers controlling sympathetic tone. This corresponds well with the peak state of cardiovascular arousal [Exton et al.,1999; Krüger et al.,1998] and the high level of norepinephrine in the cerebrospinal fluid [Krüger et al.,2006] that are found during orgasm. Consistent with this finding is a study on the neuronal correlates of mental and physical exercise in humans, which showed that the pons and anterior lobe of the cerebellar vermis were positively correlated with cardiovascular arousal [Critchley et al.,2000].
    One way to interpret the fact that gender commonalities dominate the picture for orgasm is that the orgasmic experience is largely similar for both gender groups. Support for this notion is provided by sexological research showing that written orgasmic experiences of men and women could not be differentiated by gynaecologists, medical students, and psychologists [Vance and Wagner,1976].
  • Orgasm‐related gender differences in brain activity were sparse, but interesting: in particular, men had stronger activation than women in the periaqueductal gray matter (PAG). The PAG has a prominent role in the control of reproductive behavior, at least in experimental animals [Sakuma and Pfaff,1979a,b]. Our data for the first time indicate that the PAG may also be involved in human sexual activity. Besides its role in reproductive reflexes, the PAG is also known to be involved in vocalization, cardiovascular and respiratory arousal, and pain suppression [for review see Holstege et al.,1996]. Our finding also corresponds with the observation in male human opiate addicts that the PAG was activated after intravenous administration of heroin [Sell et al.,1999], which could point to orgasm‐related, male‐biased endogeneous opiate release in the PAG. Although the differential involvement of the PAG in male and female sexual orgasm cannot be explained at this point, it is potentially interesting and certainly merits further research.
  • Most studies concerning the neurobiology of human sexuality have used visual sexual stimulation (VSS) to elicit a state of sexual desire and arousal in subjects. Gender differences in brain responses to VSS were investigated in only two studies, which basically showed that men activated the hypothalamus and amygdala more than women [Hamann et al.,2004; Karama et al.,2002]. As we have demonstrated here, these effects were not present during later stages of the sexual response. It is important to understand, however, that VSS paradigms differ fundamentally from the paradigm we used, both with respect to the sexual phase under investigation (sexual desire vs. sexual “consumption”) and the type of sexual stimulation used (visual vs. tactile).
    In rodents activation of the amygdala is important for identifying sexual salience in distal olfactory and visual signals [Newman,1999; Parfitt and Newman,1998], after which sexual desire can be established. This is consistent with amygdala activation demonstrated with VSS paradigms [Beauregard et al.,2001; Ferretti et al.,2005; Gizewski et al.,2006]. However, the present data clearly demonstrate that amygdala activity decreases once the sexual act commences. Supporting our finding are studies showing that similar attenuated amygdala activity is characteristic of euphoric mental states such as cocaine rush [Breiter et al.,1997] and romantic love [Bartels and Zeki,2004]. This change in amygdala activity may be crucial for prolonged sexual arousal during the sexual act.
    In order to understand the absence of a gender effect in the hypothalamus it is important to consider recent work by Ferretti et al. [2005], who demonstrated that the hypothalamus was activated during the onset of penile erection, but not when sustaining it. In other words, once penile erection has been established it can be sustained without further marked activation of the hypothalamus, provided that there is erotic stimulation.
  • Gender differences in brain activity were particularly marked during tactile genital stimulation. Specifically, in men the right claustrum and ventral occipitotemporal cortex were activated more strongly, and in women left fronto‐parietal areas. Gender commonalities were sparse during this phase. For the orgasm phase a different picture emerged: The gender commonalities dominated the picture, most notably in the orbitofrontal cortex, whereas the only prominent gender difference was observed in the midbrain PAG. Translating these neuroimaging results to actual sexual behavior, this could mean that men and women have different ways to reach orgasm while undergoing tactile stimulation, but that their orgasmic experience is largely similar. These results could potentially benefit treatment strategies for psychosexual problems.

“Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing” (10 March 2010)[edit]

Stacy Tessler Lindau, Natalia Gavrilova; “Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing”, BMJ 2010; 340:c810: (10 March 2010)

  • Human sexuality is increasingly recognised by doctors and policymakers as an important aspect of health and quality of life throughout the life course. Sexual activity has been associated with health benefits and longevity. Recent data from the US national social life, health and aging project (NSHAP) indicate that more than half of people aged 57-85 and about a third of those aged 75-85 are sexually active and that physical health is significantly correlated with sexual activity and many aspects of sexual function, independent of age.
    Since 2000, a focus on sexuality in older adults has been heavily driven by the availability of drugs to treat male erectile dysfunction. Effective treatment of this condition is likely to extend the duration of sexually active life for men and their partners as they age. Problems with sexual functioning are prevalent among older adults in the United States and other countries. About half of all sexually active men and women aged 57-85 in the United States report at least one bothersome sexual problem; one third report at least two. Yet doctors rarely address sexual concerns in older adults, particularly in women.
  • Using two datasets, the study affirmed a positive association between later life health and both sexual partnership and any sexual activity. In addition, a consistently strong association was found between good health and other domains of sexuality not previously linked to health in later life, including the frequency of sexual activity (weekly or more often) in men, a good quality sex life, and a higher interest in sex. Sexual activity, a good quality sex life, and interest in sex were higher for men than for women and this gender gap widened with age. Sexually active life expectancy was longer for men, but men lost more years of sexually active life as a result of poor health than women.
  • Overall, the study found that men live a significantly greater proportion of their adult life as sexually active (due at least in part to more years of partnership than women) yet lose significantly more years of sexually active life as a result of poor health than do women. This resonates with findings from a previous analysis using the NSHAP dataset, showing that men’s physical health problems were most commonly cited by both sexes as the reason for sexual inactivity in later life. The stronger association between sexually active life expectancy and health found in men may be explained in part by the effects of common chronic illnesses (for example, diabetes, cardiovascular disease, prostate cancer) and their treatments on erectile function. Loss of erectile function diminishes or prohibits penetrative intercourse and is often accompanied by a decline in or cessation of a man’s sexual activity and sexual satisfaction.
    In contrast, the effects of illness or drug use on sexual function in women are poorly understood. Sexual problems, including low desire, vaginal dryness, difficulties with orgasm, and pain with intercourse are prevalent among sexually active older women, are associated with decreased sexual satisfaction, but typically do not render a woman physically incapable of sexual intercourse. Women’s sexual interest or motivation may be more resilient to illness or sexual problems than men’s, may be more contextually dependent on the partner or situational factors, or, as seen in younger populations, older women may have less agency over their sexual activity than men.
  • Sexual partnership, frequency of sexual activity, a good quality sex life, and interest in sex are positively associated with health among middle aged and older adults in the United States. Interest in sex among middle aged and older men in the United States has increased since 2000. Overall, the study found that men have a longer sexually active life expectancy and that most sexually active men report a good quality sex life. In contrast, only about half of sexually active women reported a good quality sex life. This disparity, and its implication for health, requires further exploration.

“The Psychology of Human Sexuality”[edit]

Don Lucas, Jennifer Fox; “The Psychology of Human Sexuality”

  • Sexuality is one of the fundamental drives behind everyone’s feelings, thoughts, and behaviors. It defines the means of biological reproduction, describes psychological and

sociological representations of self, and orients a person’s attraction to others. Further, it shapes the brain and body to be pleasure-seeking. Yet, as important as sexuality is to being human, it is often viewed as a taboo topic for personal or scientific inquiry.

    • p.1
  • Sex makes the world go around: It makes babies bond, children giggle, adolescents flirt, and adults have babies. It is addressed in the holy books of the world’s great religions, and it infiltrates every part of society. It influences the way we dress, joke, and talk. In many ways, sex defines who we are. It is so important, the eminent neuropsychologist Karl Pribram (1958) described sex as one of four basic human drive states. Drive states motivate us to accomplish goals. They are linked to our survival. According to Pribram, feeding, fighting, fleeing, and sex are the four drives behind every thought, feeling, and behavior. Since these drives are so closely associated with our psychological and physical health, you might assume people would study, understand, and discuss them openly. Your assumption would be generally correct for three of the four drives (Malacane & Beckmeyer, 2016). Can you guess which drive is the least understood and openly discussed?
    • p.2
  • The history of human sexuality is as long as human history itself—200,000+ years and counting (Antón & Swisher, 2004).For almost as long as we have been having sex, we have been creating art, writing, and talking about it. Some of the earliest recovered artifacts from ancient cultures are thought to be fertility totems. The Hindu Kama Sutra(400 BCE to 200CE)—an ancient text discussing love, desire, and pleasure—includes a how-to manual for having sexual intercourse. Rules, advice, and stories about sex are also contained in the Muslim Qur’an, Jewish Torah, and Christian Bible.
    By contrast, people have been scientifically investigating sex for only about 125 years. The first scientific investigations of sex employed the case study method of research. Using this method, the English physician Henry Havelock Ellis (1859-1939) examined diverse topics within sexuality, including arousal and masturbation. From 1897 to 1923, his findings were published in a seven-volume set of books titled Studies in the Psychology of Sex. Among his most noteworthy findings is that transgender people are distinct from homosexual people. Ellis’s studies led him to be an advocate of equal rights for women and comprehensive human sexuality education in public schools.
    • pp.3-4
  • Because cultures change over time, so too do ideas about gender. For example, European and American cultures today associate pink with femininity and blue with masculinity. However, less than a century ago, these same cultures were swaddling baby boys in pink, because of its masculine associations with “blood and war,” and dressing little girls in blue, because of its feminine associations with the Virgin Mary (Kimmel, 1996).
    • p.6
  • While some argue that sexual attraction is primarily driven by reproduction (e.g.,Geary, 1998), empirical studies point to pleasure as the primary force behind our sex drive. For example, in a survey of college students who were asked, “Why do people have sex?” respondents gave more than 230 unique responses, most of which were related to pleasure rather than reproduction (Meston & Buss, 2007). Here’s a thought-experiment to further demonstrate how reproduction has relatively little to do with driving sexual attraction: Add the number of times you’ve had and hope to have sex during your lifetime. With this number in mind, consider how many times the goal was (or will be) for reproduction versus how many it was (or will be) for pleasure. Which number is greater?
    • p.6
  • Although a person’s intimate behavior may have sexual fluidity—changing due to circumstances (Diamond, 2009)—sexual orientations are relatively stable over one’s lifespan, and are genetically rooted (Frankowski, 2004). One method of measuring these genetic roots is the sexual orientation concordance rate(SOCR). An SOCR is the probability that a pair of individuals has the same sexual orientation. SOCRs are calculated and compared between people who share the same genetics (monozygotic twins, 99%); some of the same genetics (dizygotic twins, 50%); siblings (50%); and non-related people, randomly selected from the population. Researchers find SOCRs are highest for monozygotic twins; and SOCRs for dizygotic twins, siblings, and randomly-selected pairs do not significantly differ from one another (Bailey et al. 2016;Kendler et al., 2000). Because sexual orientation is a hotly debated issue, an appreciation of the genetic aspects of attraction can be an important piece of this dialogue.
    • p.6
  • “Only the human mind invents categories and tries to force facts into separated pigeon-holes. The living world is a continuum in each and every one of its aspects. The sooner we learn this concerning human sexual behavior, the sooner we shall reach a sound understanding of the realities of sex.” (Kinsey, Pomeroy, & Martin, 1948, pp. 638–639)
    • p.7
  • The international scientific and medical communities (e.g., World Health Organization, World Medical Association, World Psychiatric Association, Association for Psychological Science) view variations of sex, gender, and sexual orientation as normal. Furthermore, variations of sex, gender, and sexual orientation occur naturally throughout the animal kingdom. More than 500 animal species have homosexual or bisexual orientations (Lehrer, 2006). More than 65,000 animal species are intersex—born with either an absence or some combination of male and female reproductive organs, sex hormones, or sex chromosomes (Jarne & Auld, 2006). In humans, intersex individuals make up about two percent—more than 150 million people—of the world’s population (Blackless et al., 2000). There are dozens of intersex conditions, such as Androgen Insensitivity Syndrome and Turner’s Syndrome (Lee et al., 2006). The term “syndrome” can be misleading; although intersex individuals may have physical limitations (e.g., about a third of Turner’s individuals have heart defects; Matura et al., 2007), they otherwise lead relatively normal intellectual, personal, and social lives. In any case, intersex individuals demonstrate the diverse variations of biological sex.
    • p.7
  • Although incidence rates of transgender individuals differ significantly between cultures, transgender females (TGFs)—whose birth sex was male—are by far the most frequent type of transgender individuals in any culture. Of the 18 countries studied by Meier and Labuski (2013), 16 of them had higher rates of TGFs than transgender males (TGMs)—whose birth sex was female—and the 18 country TGF to TGM ratio was 3 to 1. TGFs have diverse levels of androgyny—having both feminine and masculine characteristics. For example, five percent of the Samoan population are TGFs referred to asfa'afafine, who range in androgyny from mostly masculine to mostly feminine(Tan, 2016); in Pakistan, India, Nepal, and Bangladesh, TGFs are referred to ashijras, recognized by their governments as a third gender, and range in androgyny from only having a few masculine characteristics to being entirely feminine (Pasquesoone, 2014); and as many as six percent of biological males living in Oaxaca, Mexico are TGFs referred to as muxes, who range in androgyny from mostly masculine to mostly feminine (Stephen, 2002).
    • p.8
  • Sexual orientation is as diverse as gender identity. Instead of thinking of sexual orientation as being two categories—homosexual and heterosexual—Kinsey argued that it’s a continuum (Kinsey, Pomeroy, & Martin, 1948). He measured orientation on a continuum, using a 7-point Like rt scale called the Heterosexual-Homosexual Rating Scale, in which 0 is exclusively heterosexual, 3 is bisexual,and 6 is exclusively homosexual. Later researchers using this method have found18% to 39% of Europeans and Americans identifying as somewhere between heterosexual and homosexual (Lucas et al., 2017; YouGov.com, 2015). These percentages drop dramatically (0.5% to 1.9%) when researchers force individuals to respond using only two categories (Copen, Chandra, & Febo-Vazquez, 2016; Gates, 2011).
    • pp.9-10
  • Just as we may wonder what characterizes particular gender or sexual orientations as “normal,” we might have similar questions about sexual behaviors. What is considered sexually normal depends on culture. Some cultures are sexually-restrictive—such as one extreme example off the coast of Ireland, studied in the mid-20th century, known as the island of Inis Beag. The inhabitants of Inis Beagde tested nudity and viewed sex as a necessary evil for the sole purpose of reproduction. They wore clothes when they bathed and even while having sex. Further, sex education was nonexistent, as was breast feeding (Messenger, 1989). By contrast, Mangaians, of the South Pacific island of A’ua’u, are an example of a highly sexually-permissive culture. Young Mangaian boys are encouraged to masturbate. By age 13, they’re instructed by older males on how to sexually perform and maximize orgasms for themselves and their partners. When the boys are a bit older, this formal instruction is replaced with hands-on coaching by older females. Young girls are also expected to explore their sexuality and develop a breadth of sexual knowledge before marriage (Marshall & Suggs, 1971). These cultures make clear that what are considered sexually normal behaviors depends on time and place.
    • p.10
  • Sexual behaviors are linked to, but distinct from, fantasies. Leitenberg and Henning (1995) define sexual fantasies as “any mental imagery that is sexually arousing.” One of the more common fantasies is the replacement fantasy—fantasizing about someone other than one’s current partner (Hicks & Leitenberg, 2001). In addition, more than 50% of people have forced-sex fantasies (Critelli & Bivona, 2008). However, this does not mean most of us want to be cheating on our partners or be involved in sexual assault. Sexual fantasies are not equal to sexual behaviors.
    • p.10
  • Clearly, people engage in a multitude of behaviors whose variety is limited only by our own imaginations. Further, our standards for what’s normal differs substantially from culture to culture. However, there is one aspect of sexual behavior that is universally acceptable—indeed, fundamental and necessary. At the heart of what qualifies as sexually “normal” is the concept of consent. Sexual consent refers to the voluntary, conscious, and empathic participation in a sexual act, which can be withdrawn at any time (Jozkowski & Peterson, 2013). Sexual consent is the baseline for what are considered normal—acceptable and healthy—behaviors; whereas, nonconsensual sex—i.e., forced, pressured or unconscious participation—is unacceptable and unhealthy. When engaging in sexual behaviors with a partner, a clear and explicit understanding of your boundaries, as well as your partner’s boundaries, is essential. We recommend safer-sex practices, such as condoms, honesty, and communication, whenever you engage in a sexual act. Discussing likes, dislikes, and limits prior to sexual exploration reduces the likelihood of miscommunication and misjudging nonverbal cues. In the heat of the moment, things are not always what they seem. For example, Kristen Jozkowski and her colleagues (2014) found that females tend to use verbal strategies of consent, whereas males tend to rely on nonverbal indications of consent. Awareness of this basic mismatch between heterosexual couples’ exchanges of consent may proactively reduce miscommunication and unwanted sexual advances.
    The universal principles of pleasure, sexual behaviors, and consent are intertwined. Consent is the foundation on which sexual activity needs to be built. Understanding and practicing empathic consent requires sexual literacy and an ability to effectively communicate desires and limits, as well as to respect others’ parameters.
    • pp.13-14

“American Sexual Behavior: Trends, Socio-Demographic Differences, and Risk Behavior” (Updated March, 2006)[edit]

Tom W. Smith, “American Sexual Behavior: Trends, Socio-Demographic Differences, and Risk Behavior” National Opinion Research Center University of Chicago GSS Topical Report No. 25 (Updated March, 2006)

  • Sexual behavior is not only of basic biological importance, but of central social importance. Not only does it perpetuate the human species, but it is the central behavior around which families are formed and defined, a vital aspect of the psychological well-being of individuals, and a component of a variety of social problems. Among current concerns tied in part to sexual behavior are the familial problems of marital harmony and divorce; criminal problems of rape, incest, child molestation, and prostitution; reproductive problems of infertility, sterility, unwanted and mistimed pregnancies, and abortion; and health problems related to sexually transmitted diseases (STDs).
    • p.1
  • Premarital sexual intercourse become increasingly common over the last century (Table 1A, see also Hopkins, 1998 and Whitbeck, Simons, and Goldberg, 1996; Joyner and Laumann, 2001). This increase was not merely the result of the so-called sexual revolution of the 1960s. The change was underway for decades prior to the 1960s and has continued since then. Rates among men were moderately high even from the beginning (61% of men born before 1910 report having had sexual intercourse before marriage) and climbed steadily. Women had low rates of premarital intercourse to begin with (only 12% of those born before 1910 had pre-marital sexual intercourse), but their rates grew more rapidly than those of men and the gap between men and women has narrowed over time. By the 1980s (roughly the 1965-1970 birth cohort) women had almost as much sexual experience as men prior to marriage (in 1988 of those 15-19 60% of men and 51.5% of women had engaged in premarital sex). This increase in premarital sexual experience is confirmed by community studies (Wyatt, Peter, and Guthrie, 1988 and Trocki, 1992) and longitudinal panels (Udry, Bauman, and Morris, 1975).
    • p.3
  • Then in the early 1990s the century-long increase in the level of premarital and adolescent sexual activity reached a peak and then declined for the first time in decades (Table 1A and Abma et al., 2004; Abma and Sonenstein, 2000; Averett, Rees, and Argys, 2002; Bachrach, 1998; Besharov and Gardiner, 1997; DuBois and Silverthorn, 2005; Stossel, 1997; Peipert, et al., 1997; Singh and Darroch, 1999). The decrease appears to be somewhat greater for males than females, but both genders show a leveling-off and then some reversal.
    • p.3
  • With the increase in levels of premarital sexual intercourse came a fall in the age of first intercourse (Table 1B). In 1970 5% of women age 15 and 32% age 17 were sexually experienced, by 1988 this had grown to 26% at age 15 and 51% at age 17 (see also Kahn, Kalsbeek, and Hofferth, 1988; and Hofferth, Kahn, and Baldwin, 1987). This trend may also have leveled-off and possibly reversed since then, but the evidence is inconclusive (Table 1B).
    When the increase in levels of premarital sexual intercourse is coupled with the rising age at first marriage, this means that men and women are spending longer and longer periods of their sexual life outside of marriage (Ehrhardt and Wasserheit, 1992; Bachrach and Horn, 1987; Laumann, Gagnon, Michael, and Michaels, 1994). Between 1960 and 2000 the median age at first marriage rose from 22.8 to 26.8 for men and from 20.3 to 25.1 for women. For women the median age of first premarital intercourse in 1960 was about 19.0 (Turner, Miller, and Moses, 1989 and Bachrach and Horn, 1987), meaning on average only a short period of premarital sexual activity. In 1990 the median age at first sex was 16.9 for women (Divs. of Epidemiology and Prevention; Adolescent and School Health; and Reproductive Health, 1992), meaning an average exposure of 8.2 years. For men the period of premarital sexual activity now averages 10.7 years (26.8 - 16.1).
    • p.4
  • With people spending longer periods engaged in premarital sexual activity the number of lifetime sexual partners has also grown for both men and women (Table 1C). Between the pre-1910 birth cohort and the 1940-49 birth cohort the portion of men with two or more premarital sexual partners rose from 49% to 73%, while for women the gain was from 3% to 26%. This trend continued until recent years. For example, among sexually-experienced women ages 15-19 living in metropolitan areas, 38% had had 2 or more sexual partners in 1971 while by 1988 this had increased to 61%. More recently there is evidence of a reversal of this trend. On the Youth Risk Behavior Surveys (YRBS) the % of male high school students with 4+ sexual partners declined from 1989 to 2001-03, but the trend among females is less clear.4 For males and perhaps for females the decline may have leveled-off by 2003.
    • p.5
  • The rise in premarital and adolescent sexual activity, coupled with delays in marriage, has led to more people living together. Since 1970 the rate of living together outside of marriage has increased more than 6 fold, from 1.1% to 7.4% of couples in 1999 (Table 2 and Bramlett and Mosher, 2002; Manning and Smock, 2005). Similarly, the proportion of households involving a cohabiting couple climbed from 0.8% in 1960/1970 to 5.2% in 2000. Also, the portion of single mothers who were cohabitating grew from 2% in 1970 to 12% in 1995 (London, 1998). However, there is some indication that the long rise in cohabitations may have leveled of in recent years.
    • p.5
  • With the link between sexual activity and marriage breaking down, the connection between marriage and procreation has also lessened. In the 1960s (and presumably before) when premarital sexual intercourse resulted in conception, the women's pregnancy usually in turn led to a marriage before the child was born (Table 4 and Driscoll, et al., 1999; South, 1999). Since then, the propensity of unmarried parents to marry before the birth of their child has steadily fallen. By the 1990s less than 25% of women who conceived children before marriage got married before their child's birth.
    As a result of the higher level of premarital sexual activity and the decline in marriages after a conception but prior to birth, there has been a large increase in out-of-marriage births (Ermisch, 2005; Miller and Heaton, 1991 and Table 5). In 1960 only 5% of all births were to unmarried women. This climbed to 14% by 1975 and 33% by 1994. After 1993 th rate of increase slowed appreciably with the % of all births to unmarried mothers only rising from 32.6% in 1994 to 34.0% in 2002.
    • p.6
  • In brief, over the last century premarital sexual activity become more widespread, sexual initiation started at younger ages, the period of premarital sexual activity lengthened, and the number of premarital sexual partners increased. This expansion in premarital sexual activity in turn led to major increases in cohabitation and unmarried child bearing.
    But during the 1990s a small, but historic, reversal of some of these trends occurred. The level of premarital and adolescent sexual activity leveled-off and in some aspects retreated and the proportion of births outside of marriage reached a plateau. These changes are partial rather than across the board (e.g. levels of cohabitation continue to rise) and even those behaviors that have leveled-off or reversed are at near record high rates. But even limited changes to a massive, century-long trend are highly notable and potentially important from a public-health perspective.
    • p.7
  • Compared to the amount of information available on premarital and adolescent sexual behavior, until recently there has been little scientifically reliable data on the sexual behavior of adults or of the population in general (Aral, 1994; di Mauro, 1995; and Seidman and Rieder, 1994). Moreover, the dearth of representative and credible studies has created a vacuum that has been filled by unrepresentative and incredible misinformation from popular magazines, sex gurus, and others.
    • p.8
  • Few debates have been so contentious as the controversy over the sexual orientation of Americans (Billy, et al., 1993; Stokes and McKiran, 1993; Michaels, 1997; Mosher, Chandra, and Jones, 2005; and Swann, 1993). The gay and lesbian communities have long adopted 10% as the portion of the population that is homosexual. However, a series of recent national studies (Table 8A) indicate that only about 2-3% of sexually-active men and 1-2% of sexually- active women are currently engaging in same-gender sex (see also Anderson and Stall, 2002; Black et al, 2000; Butler, 1998; Horowitz, Weis, and Laflin, 2001; and Sell and Becker, 2001). These national American estimates are consistent with figures from local communities in the United States (Blair, 1999; Trocki, 1992; McQuillan, Ezzati-Rice, Siller, Visscher, and Hurley, 1994; Guterbock, 1993; and Rogers and Turner, 1991), indirect measurements (Aguilar and Hardy, 1991), and statistics from other countries such as Great Britain, France, Norway, and Denmark (AIDS Investigators, 1992; Johnson, Wadsworth, Wellings, Bradshaw, and Field, 1992; Biggar and Melbye, 1992; Melbye and Biggar, 1992; Sundet, et al., 1988; Sandfort, 1998; and Diamond, 1993)(Table 8B).
    • pp.9-10
  • There is little reliable evidence on whether sexual orientation has changed before the late 1980s. In terms of attitudes levels of approval of homosexuality slightly declined from 1973 to 1991, but then rose notably in 1992-2000 (Laumann, Gagnon, Michael, and Michaels, 1994; Smith, 1994; and Davis, Smith, and Marsden, 2005). Since then, the last year and five-year rate for women has increased somewhat and the last year, but not the five-year rate for men (Table 9).9
    Studies of male and female homosexuality both in the United States and Europe regularly find a higher proportion of males are gay than the share of females who are lesbian (Tables 8A & 8B and Spira, Bajos, Ducot, 1994; Hubert, Bajos, and Sandfort, 1998; Wells and Sell, 1990; AIDS, 1992; Johnson, Wadsworth, Wellings and Field, 1994; Sandfort, 1998).
    Sexual orientation does not vary much across socio-demographic groups (Table 9). The most distinctive pattern for both gays and lesbians is that they are less likely to have married. About 60% of those with a same gender partner during the last 12 months have never been married compared to the 16% of female heterosexuals and 21% of male heterosexuals who have never been married.
    • p.11
  • There is some evidence that the frequency of intercourse rose from the 1960s to the 1970s (Trussell and Westoff, 1980) and may have declined in the 1980s. Among teenage males 17-19 living in metropolitan areas the rate fell from 59.8 times per year in 1979 to 39.0 in 1988 (Sonenstein, Pleck, and Ku, 1990), but then among all males ages 17.5-19, it rose from 30 to 49 times per year between 1988 and 1991 (Ku, Sonenstein, and Pleck, 1993). Among unmarried women ages 20-29 the rate showed a more modest decline from 59.8 in 1983 to 56.0 in 1988-93 (Tanfer and Cubbins, 1992 and GSS, 1994). However, no meaningful change has been occurring among all adults since 1988. On average adults engage in sex about 62 times per year, a little over once a week (Table 10A; James, 1998).
    • p.12
  • The overall adult average is relatively uninformative however since the frequency of sexual intercourse varies notably across socio-demographic groups (Table 10B). The factor making the biggest difference is age. Among those 18-29 frequency averages about 84 times per year. This then falls off steadily to 63.5 times per year for those in their 40s to 10 times per year for those 70 and older. Among the married the decline is even more striking, dropping from 109 times per annum for those under 30 to 17 times per annum for those 70 and older. This pattern prevails both for husbands and wives. This age-related pattern is nearly identical to one shown in the 1988 National Survey of Families and Households (Hughes and Gove, 1992) and is consistent with a large number of other studies (Call, Sprecher, and Schwartz, 1996; Feldman, Goldstein, McKinlay, Hatzichristou, and Krane, 1992; Hawton, Gath, and Day, 1994; Jasso, 1985; Jasso, 1986; Kahn and Udry, 1986; Laumann, Gagnon, Michael, and Michaels, 1994; Leigh, Temple, and Trocki, 1993; Rao and VandenHeuvel, 1995; Tanfer and Cubbins, 1992; Udry, 1980; Udry, Deven, and Coleman, 1982; National Council on the Aging, 1998; and Udry and Morris, 1978).
    • pp.12-13
  • Marital status also influences sexual activity (Table 10B; Wade and DeLamater, 2002). Frequency is greatest among the currently married (with those remarried slightly exceeding those in their first marriage probably because of the honeymoon effect). The never married and divorced have lower rates, probably because of less continuous and convenient availability of a partner. The widowed have by far the lowest rates, a function of their age as well as their marital status. The edge of the married over the non-married becomes even more apparent when age is taken into consideration. Activity is 28-400+% greater among the married compared to the non-married at various ages. Among the married intercourse is more frequent among those who have happier marriages (Smith, 1991a; Waite and Joyner, 1996).
    Husbands and wives closely agree on the frequency of intercourse in the aggregate and in most paired comparisons of partners (Bachrach, Evans, Ellison, and Stolley, 1992 and Smith, 1992a and 1992b). However, unmarried men and women differ considerably with men reporting more activity than women do (Bachrach, et al., 1992). This is true even if the surplus of widowed females is accounted for.
    • p.13
  • A multivariate analysis indicates that more sexual intercourse is separately and independently related to a) being young, b) having been married less than 3 years, and b) rating ones marriage as happier. It is unrelated to gender with controls for these other factors (GSS, 2005).
    Frequency of sexual activity also decrease as church attendance increases. While this is somewhat related to the fact that church attendance increases with age, there is still a decline controlling for age.
    There are little differences by race, community type, education, or income and these are mostly related to age and/or marital status. Likewise, frequency does not vary whether one or both partners are employed (Hyde, DeLamater, and Durik, 2001).
    • pp.13-14
  • Sexual inactivity ppears to have modestly declined since the early 1980s (Table 11; Mosher, Chandra, and Jones, 2005). Both among women of childbearing age and among all adults the proportion not engaging in sex over extended periods (3-12 months) has decreased in the late 1980s and early 1990s. Since 1996 sexual inactivity has increased.
    • p.14
  • Among adults there is a u-shaped curve with sexual inactivity most frequent among the youngest and oldest adults. Sexual inactivity among the elderly is fairly common and is a function of general aging, poor health, and unavailability of a partner. As we saw in the section on frequency of sexual intercourse, sexual activity decreases markedly with age even when a partner remains available. This is a function of both a reduction in the rate of sexual intercourse among those remaining sexually active and also an increase in the proportion sexually inactive. Among those over 70 61% are not currently sexually active. Among those over 70 61% are not currently sexually active. Among this age group sexual abstinence reaches 33% among the married and among the non-married it hits 90.6% (Table 11).
    Sexual inactivity is much less common among younger adults. Among the currently married only 1.3-2.5% of those 18-49 are sexually inactive. Almost all of this group either have poorer than average health and.or rate their marriage as unhappy (Smith, 1992; see also Donnelly, 1993 and Edward and Booth, 1976). While 6% of married couples of all ages are sexually inactive over the last year (GSS, 2005), fully 16% of married couples have not engaged in sexual intercourse in the last four weeks (Donnell, 1993, see also Dolcini, et al., 1993). Sexual abstinence is much higher among the non-married ranging between 15% and 28% for those under 50.
    Most other socio-demographic differences are small and merely reflect underlying differences in age and/or marital status, but sexual inactivity is lower in households with higher incomes.
    While there has been long-term and massive increases in all aspects of premarital and adolescent sexual activity, there is little evidence that similar changes in regards to adult or overall sexual behavior have occurred. Moreover, adult sexual behavior appears to be more restrained and traditional than it has commonly been portrayed.
    • p.14
  • While the overall number of sexual partners among all adults has not diminished in recent years (Table 14), some change has been occurring among teenagers and young adults (Table 1C). Among young males the number of partners was probably rising for most of the century until the early 1990s. However, the evidence is somewhat mixed for the 1980s. The mean number of lifetime partners among sexually active males 17-19 in metropolitan areas fell from 7.3 to 6.0 between 1979 and 1988, while among sexually active males ages 17.5-19 the mean number of sexual partners in the last 12 months rose from 2.0 in 1988 to 2.8 in 1991 (Ku, Sonenstein, and Pleck, 1993). During the 1990s there appears to have been a decline in number of partners. The % of male high school students with a lifetime total of 4 or more partners declined from 31% in 1989 to 14% in 2001 (Table 1C). For young females there is less clear evidence that the long-term increase in number of partners reversed in 1990s. The YRBS data indicate year-to-year fluctuation rather than any definite trend. The GSS shows a decline from the late 1980s/early 1990s to the mid-1990s in the number of sexual partners among those 18-24, but no further drop and even possibly a partial rebound in the late 1990s and 2000s.
    • pp.19-20
  • Among adults, having multiple sexual partners during the last year and during the last five years is most strongly associated with being young, unmarried, and male. It is also higher among Blacks, residents of large central cities, those with low incomes and less education, and infrequent church attenders. The adult lifetime figures show a similar pattern except that there is no relationship between income or race and number of sexual partners and the less educated have fewer partners than the better educated.19 The reversal of the education relationship results from less educated, earlier cohorts having fewer partners than more recent and better-educated cohorts have had.
    • p.20
  • Multiple partners are thus found in two main social niches, among young, unmarried adults and adolescents who have not yet "settled down" and among disadvantaged segments of society in general and among inner-city minorities in particular who also tend to lead less stable and conventionally-ordered lives (Ford and Norris, 1995 and Wagstaff, et al., 1995).
    • p.21
  • Risk increases not only with one's number of sexual partners, but also with the casualness and transitoriness of relationships. When it comes to STDs one "sleeps not only with a partner, but with all of that partner's partners." Closer relationships are associated with (but do not guarantee) mutual monogamy, while casual relationships come without any likelihood of exclusivity.
    • p.21
  • More casual relationships (pick-ups, prostitutes, and acquaintances) are most prevalent among the young, unmarried, and males. They are also more common among Blacks, residents of large central cities, those with lower incomes, and those attending church less frequently. Similarly having ones last sexual encounter with someone that one did not have an "on-going relationship" with is more common among men, Blacks, the young, never married, city residents, those with lower incomes, the less educated, and infrequent church attenders (Table 15). "One-night stands" are equally common for Black and White males, but less frequent for Black females than for White females (Tanfer, 1994). In general, those socio-demographic groups with a high number of partners also tend to have less familiar partners.
    • p.21
  • In brief, the available studies are extremely limited in number and most are unrepresentative of the United States as a whole (one study of course is not even from the United States). In particular, extrapolations from these few local studies to national estimates could well be wrong, especially if prostitution is heavily concentrated in urban centers. This possibility is supported by the fact that on the 1988-2004 GSSs 0.3% of men living in rural areas reported having sex with a prostitute during the last year, while 2.0% of those living in the 12 largest central cities reported having sex with a prostitute during the last 12 months (Table 17). In addition, the lifetime figures show a similar pattern.
    • p.23
  • Since early in the 20th century the bonds between marriage and sexual activity have been unraveling. More men and women have engaged in premarital sexual intercourse, they have become sexually active at earlier ages, and they have accumulated more sexual partners. While premarital and adolescent sexual activity has grown for both men and women, the largest changes has been in the sexual behavior of women. The expansion of sexual behavior has in turn led to a rise in cohabitation and a surge in non-married births, and contributed to the growth of various public-health and social- welfare problems (Besharov and Gardiner, 1993).
    Rather than being an isolated phenomenon these changes in sexual behavior, living together, and child bearing have been part of broader social changes towards an individualistic rather than a family-center society (Glenn, 1987; Popenoe, 1993; and Smith, 1999) and towards modern rather than traditional roles for women (Firebaugh, 1990 and Simon and Landis, 1989). Moreover, there are suggestive signs that parallel shifts have occurred in other post-industrial societies. As such, the changes in American premarital and adolescent sexual behavior may result from the development of advanced economies, welfare states, and liberal governments in general rather than from any special situation peculiar to America.
    Of late however this long-term trend has moderated and in a few limited, but key, aspects reversed. First, the increase in premarital and adolescent sexual activity has ended and to some degree has waned. Second, the rise in the portion of nonmarital births has slowed and is perhaps leveling-off (albeit at near record levels). Third, condom use more than doubled during the last 20 years and apparently continues to grow. While there have not been decreases in all forms of risky sexual behavior in all segments of the population, these departures from the long-term trend are notable and may reflect an underlying, nascent shift in social values.
    • pp.26-27
  • While marriage is no longer the portal into sexual activity for most Americans, it remains an important regulator of sexual behavior and thus a barrier to AIDS and other STDs. Since most married people most of the time engage in sex only with their marriage partner, marriage limits one's total number of sexual partners and reduces the spread of HIV and other STDs. However, marriage may be less of a barrier than it used to be. The decline in reported rates of ever having had extra-marital relations among those 50 and over does suggest that monogamy may have declined across recent generations. But, on the other hand, there has been no decrease in disapproval of extra-marital relations (Smith, 1990; 1994 and Davis, Smith, and Marsden, 2003), extra-marital relations have not increased since 1988, and "affairs" are much less common than presentations in either pop and pseudo-scientific studies or the entertainment media suggest.
    Of course, marriages themselves are also not as enduring as they used to be. The two-and-a-half fold growth of the divorce rate from the 1960s to the early 1980s and its continuation at near historically high levels to the present means that over half of all recent marriages will end in divorce (Smith, 1999). For most divorced people this means accumulating new sexual partners and especially for those under 50 this often means having multiple sexual partners (Stack, 1992).
    • p.27
  • There are also large differences between Whites and Blacks in their sexual behaviors (Bowser, 1992; Brewster, 1994; Sterk-Elifson, 1992; Kilmarx, et al., 1997; Peterson, Catania, Dolcini, and Faigeles, 1993; Brunswick, et al., 1993; Reitman, et al., 1996; and Quadagno, et al., 1998; Smith, 1999; but see Wyatt, 1989). Blacks become sexually active at an earlier age, accumulate more sexual partners over their lifetime, have more casual partners, are less likely to marry, have less stable and shorter-term marriages, and have many more children born outside of marriage. Black sexual and child-bearing behavior puts African-Americans at greater risk of contracting AIDS and other STDs (and Blacks do have higher HIV and STD infection rates) and contributes to such problems as single-parent families and childhood poverty.
    Sexual behavior also varies by community type. Residents of large central cities have more sexual partners, more casual partners (including prostitutes), and more extra-marital relations than those living in rural areas. In addition, probably due to selective migration, gays concentrate in large cities. Overall since risk behaviors (both sexual and injection drug use) are more common in large cities and the HIV virus is more prevalent in these localities, the chances of becoming infected is especially high in large metropolitan areas (Catania, et al., 1992).
    Finally, religion exercises a traditional restraint on sexual behavior (Thornton and Camburn, 1989; Seidman, Mosher, and Aral, 1992; Stack and Gundlach, 1992; Tanfer and Schoorl, 1992; Goldscheider and Mosher, 1991; Hogan, Sun, and Cornwell, 1998; and Brewster, Cooksey, Guilkey, and Rindfuss, 1998). Those who attend church regularly are less likely to a) become sexually active, b) have multiple and casual partners, and c) among the married, have sexual partners other than their spouse. Church attendance, like rural residence, imposes traditional restraint on sexual behavior.
    • p.28

“Sexual Physiology: A Scientific and Popular Exposition of the Fundamental” (1885)[edit]

Russell Thacher Trall, “Sexual Physiology: A Scientific and Popular Exposition of the Fundamental”, (1885)

  • The question has been discussed whether a married life or a state of “single blessedness,” is most conducive to longevity. It is argued on the one side that, as man imparts more or less of his unreplenishable fund of vitality at each sexual embrace, a life of entire abstinence would be most conducive to a long life and a “green old age.” I do not regard the question as very important. For all practical purposes the best life if the longest. The object of living in this earthly tenement-and all the object that I can discover-is to develop our own inherent an God-given powers, and assist others to do so. This development implies the use of bodily organs as the instruments of the mind or soul; and it consists in ascertaining the existence of beings and objects external to ourselves, and our relations to them. From the cradle to the grave this process should go on. Even in the decline of life, when the bodily structures are consolidating, and the vital spark expiring, many persons possess the ability to think, and feel, and reason; they continue to develop almost until the last breath. Others become demented in middle life; while many in youth acquire such morbid conditions that further development in this life is impossible. Who, in the exercise of his reason, would desire to live, even if he had the power to make provision therefor, for one moment beyond the period of usefulness? Who “could” desire to remain in this earthly tenement for an hour after the capacity to do good or receive good was lost? It is then that Death-the Angel of Mercy, rather than the “King of Terrors”-translated him to another sphere, “to the abodes of more than mortal freedom,” where the development of the powers of the soul commenced on the earth, can go on for ever and ever.
    • “Law of Intercourse”, pp.240-241
  • PLEASURE OF SEXUAL INTERCOURSE.-Whatever may be the object of sexual intercourse-whether intended as a love embrace merely, or as a generative act-it is very clear that it should be as pleasurable as possible to both parties. Indeed, when it is otherwise to either party unless generation be intended, it is mere lust. Nor can the offspring be as perfect as it should be unless the act is both desired and enjoyed by both parties. This rule or law, for it is a law of Nature, at once suggests the conditions which are necessary to insure this result. There must be mental harmony and congeniality between the parties. Each must be able to respond to the “whole” nature of the other-bodily, morally and intellectually, to that extent that there shall be no sense of discord, no feeling of repugnance; but, on the other hand, an utter abnegation of selfhood.
    • “Law of Intercourse”, p.245
  • [T]he ways of wisdom are ways of pleasantness, and all her paths are peace.
    • ”Law of Intercourse”, p.246
  • Sexual intercourse should never, under any circumstances, be indulged when either party is in a condition of great material excitement or depression, nor when in a condition of great bodily fatigue, nor soon after a full meal, nor when the mind is intensely preoccupied ; but always when the whole system is in its best condition, and most free from all disturbing influences.
    • “Law of Intercourse”, p.246
  • TIME FOR SEXUAL INTERCOURSE.-The usual habits of sexual intercourse are the worst that the nature of the case admits of, either for the good of the parties themselves or for the benefit of the offspring The time chosen is usually when darkness reigns over the earth, as though the act was one to be ashamed of (which is true in too many cases), and the part of the night the evening, when, generally, both parties are in their worst bodily and mental conditions. A hard day’s work, an indigestible supper, and sexual intercourse, afford the rationale of a multitude of diseases and infirmities on the part of parents, and of deformities, eccentricities and monstrosities innumerable on the part of offspring.
    If children are to be begotten, or if that result is either desirable or possible, the sexual embrace should be had in the light of day. It is only then that the magnetic forces and the nervous system are in their highest condition of functional activity, and the body, refreshed by sleep, in its most vigorous condition. But it should not be the hurried act of the early morning, like a hasty meal before a day’s work. It is better that it should never be indulged, either in the morning or late in the evening, but that the time be selected and appropriated for the purpose. As no function in life is more important, and as the consequences of a single act may be the happiness or misery of a future being, it is worth a little time and preparation.
    • “Law of Intercourse”, pp.247-248
  • Every child that is born into the world has the birthright inheritance of a sound organization. It has, too, as one of the human family, an inherent right to sustenance and education. If despoiled of the former by the ignorance or perversity of its parents, it will surely be revenged ; and if robbed of the latter by the errors or imperfections of society, society will assuredly suffer. This is one of the unpardonable sins. There is no forgiveness-certainly not in this life. A vicious, malformed, diseased or perverted child can not exist in the family without “rendering evil for evil,” any more than a vagrant or imbecile person can exist in society without, to some extent, contaminating the whole social atmosphere. This may seem a hard doctrine in its bearings on individuals; but it is true in Nature, and beneficient in its application to the whole human race.
    • ”Hereditary Transmission”, p.249
  • ”If we should give the races of rats access to all our stores of food, destroying our traps and whistling of the cats, and open to every rodent a career of unlimited bread and cheese for himself and his progeny, how long would it be before the rats would be in force to eat us?
    “The human animal has not powers of reproduction to vie with the rats ; and yet if mankind were relieved of their chronic apprehension of poverty in an office and a salary awaited every child that was reared-especially if early marriages became usage, as they inevitably would under such a society-the number of candidates would speedily exhaust all the places, and the great surplus army of men to be detailed to till the ground would soon raise such a surplus of good that it would not pay to harvest it.
    “See what checks restrain the prodigality of human reproduction. Few sensible men dare place themselves under obligations to support a family until there is a reasonable prospect of some just and honorable provision for its maintenance. If the consideration does not influence the passions of young men, it does influence the cooler judgment of young women; and it is sure to be considered by parents and friends, whose influence is always potent. So that, as our business grows more complicated, and the chances of fortune more precarious, marriage gets postponed to the wise years when more and find how much easier and wiser it is to forego it altogether. But, with all these checks, the contribution to population in nearly all civilized States seems to be in excess of the demands of nature in excess of the means to provide for them by nearly one hundred per cent.; for what are these diseases of infancy that destroy half the human race before they are ten years old but Nature’s interference with redundant births? What if we should find out how to isolate or destroy whooping-cough, measles, and scarlatina? What safeguard have we against new disorders that would take their place?
    • pp.286-287

“Sexual behaviour in context: a global perspective”[edit]

Kaye Wellings, Martine Collumbien, Emma Slaymaker, Susheela Singh, Zoé Hodges, Dhaval Patel, Nathalie Bajos; “Sexual behaviour in context: a global perspective”, World Health ORganization

  • Sexuality is one of the fundamental drives behind everyone’s feelings, thoughts, and behaviors. It defines the means of biological reproduction, describes psychological and sociological representations of self, and orients a person’s attraction to others. Further, it shapes the brain and body to be pleasure-seeking. Yet, as important as sexuality is to being human, it is often viewed as a taboo topic for personal or scientific inquiry.
    • p.1
  • Research aimed at investigating sexual behaviour and assessing interventions to improve sexual health has increased in recent decades. The resulting data, despite regional differences in quantity and quality, provide a historically unique opportunity to describe patterns of sexual behaviour and their implications for attempts to protect sexual health at the beginning of the 21st century. In this paper we present original analyses of sexual behaviour data from 59 countries for which they were available. The data show substantial diversity in sexual behaviour by region and sex. No universal trend towards earlier sexual intercourse has occurred, but the shift towards later marriage in most countries has led to an increase in premarital sex, the prevalence of which is generally higher in developed countries than in developing countries, and is higher in men than in women. Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the past year is more common in men than in women, and reported rates are higher in industrialised than in non-industrialised countries. Condom use has increased in prevalence almost everywhere, but rates remain low in many developing countries.
    • p.1
  • The huge regional variation indicates mainly social and economic determinants of sexual behaviour, which have implications for intervention. Although individual behaviour change is central to improving sexual health, efforts are also needed to address the broader determinants of sexual behaviour, particularly those that relate to the social context. The evidence from behavioural interventions is that no general approach to sexual-health promotion will work everywhere and no single-component intervention will work anywhere. Comprehensive behavioural interventions are needed that take account of the social context in mounting individual-level programmes, attempt to modify social norms to support uptake and maintenance of behaviour change, and tackle the structural factors that contribute to risky sexual behaviour.
    • p.1
  • The ability of individuals or couples to pursue a fulfilling and safe sex life is central to achievement of sexual health. Creation of supportive environments in which safe sexual behaviour can take place is vital if the Millennium Development Goals (MDGs) for sexual equality, maternal health, and HIV/AIDS are to be achieved.1Conventionally, public health has focused on adverse outcomes of sexual behaviour. As important determinants of fertility patterns and transmission of sexually transmitted infections, sexual behaviours contribute substantially to the burden of disease. The past decade has seen growing attention in the international policy arena to sexual rights, and new standards are being formulated for the creation and maintenance of a sexually healthy society, invoking values of dignity, respect, and choice.5 Information about sexual behaviour is essential to the design and assessment of interventions to improve sexual health. Importantly, too, empirical evidence is needed to correct myths in public perception of behaviours. Yet despite being scrutinised everywhere, sexual behaviour poses challenges for scientific enquiry. The same paradox is seen in relation to intervention; sexual activity is strongly regulated in virtually every society, but its modification to improve sexual health has proved difficult.
    • p.1
  • The need to predict and prevent transmission of HIV has provided a valuable impetus to both sexual behaviour and intervention studies in the past two decades. Data are sparser in some regions than others, in particular those with low HIV prevalence or strong prohibitions surrounding sex, or both. African countries, for example, have received hugely disproportionate attention from researchers compared with Asian countries, and so the evidence base is partial. Even so, a reasonable global impression can be gained from the large number of developing countries with comparable data (those for which a Demographic and Health Survey (DHS) has been undertaken), and from other countries with comparable national surveys. Data are accumulating too, from assessments of the effect of interventions to improve sexual health.
    The resulting evidence provides a historically unique opportunity to take stock of sexual behaviour and efforts to protect sexual health at the beginning of the 21st century. Sexual behaviour changes in response to both secular and non-secular social forces. Recent decades have seen large socioeconomic changes in poverty, education, and employment. Demographic changes have taken place, in the age structure of populations, in the timing of marriage, and in the scale of mobility and migration between and within countries, including seasonal labour, rural-to-urban movement, and social disruption due to war and political instabilities. Attitudes to sexual behaviour have altered in many countries. Worldwide communications, including the internet,have had a bearing on social norms, transporting sexual images from more liberal to more conservative societies, especially those in which advances in information technology have been rapid.
    • pp.1-2
  • Information about sexual behaviour is essential to inform preventive strategies and to correct myths in public perceptions of sexual behaviour. Increased research in this area in the past two decades provides a historically unique opportunity to take stock of sexual behaviour, and efforts to safeguard it, at the beginning of the 21st century. Gaps in knowledge remain, especially in Asia and the middle east, where obstacles to sexual-behaviour research remain.
    • p.2
  • Most people are married and married people have the most sex. Sexual activity in young single people tends to be sporadic, but is greater in industrialised countries than in developing countries.
    • p.2
  • Marriage does not reliably safeguard sexual-health status. Married women find negotiation of safer sex and use of condoms for family planning more difficult than do single women. Very early sexual experience within marriage can be coercive and traumatic.
    • p.2
  • Factors that determine variations and trends in sexual behaviour are environmental and include shifts in poverty, education, and employment; demographic trends such as the changing age structure of populations and the trend towards later marriage; increased migration between and within countries; globalisation of mass media; advances in contraception and access to family-planning services; and public-health HIV and sexually transmitted disease prevention strategies.
    • p.2
  • Almost everywhere, sexual activity begins for most men and women in the later teenage years (ages 15–19 years), but regional and sex variations between men and women are substantial (table 2). For women, median age at first intercourse is low in regions in which early marriage is the norm (for example, in south Asia, central, west, and east Africa), and high in Latin America and in some countries of the middle east and southeast Asia. For men, age at first intercourse is, in general, not linked to age at marriage. In most African and Asian countries, men start to have sex later than do women. Gender differences are most pronounced in the less industrialised countries.
    None of these data suggest a universal trend towards sex at a young age. The trends are complex and vary greatly with male or female sex. The proportion of women who report early intercourse (before age 15 years) decreased significantly or remained stable between the late 1970s and the late 1990s in four of five countries for which comparisons can be made (figure 1). For men, the proportion either remained stable or increased during that period. The increase was significant in several Latin American and African countries. In societies in which first intercourse still occurs mainly within marriage, the trend towards later marriage has been accompanied by a trend towards later sex in young women,37 and is particularly a feature of countries in Africa and south Asia (figure 2). In some industrialised countries, sexual activity before age 15 years has become more common in recent decades (though the prevalence is lower than in other regions and the increase is not generally significant).
    • p.4
  • The trend towards later marriage in many countries has also led to an increase in the prevalence of premarital sexual intercourse. Again, large regional and sex differences in prevalence exist (figure 3). As shown in figure 4, on average, the time between first sexual intercourse and living with a partner is longer for men than for women (typically 3–6 years compared with 0–2 years, respectively) apart from in industrialised countries, in which the time is about the same for both (about 5 years). Trends in the average time spent between first sexual experience and settling with a marital or cohabiting partner result from changes in both the proportion who have first sexual intercourse before marriage, and the changing interval between these two events. Although the number of countries in which first sexual intercourse and marriage coincide is diminishing a clear increase in the intervening period is taking place in only very few countries, again, notably in the more industrialised (figure 2).
    • p.4
  • Most people are married and married people have the most sex (figure 5). Sexual activity in single people tends to be sporadic and, in most regions, many fewer than half unmarried non-virgins report having had sex in the past month. Single men and women in many African countries are fairly sexually inactive, with two-thirds reporting recent sexual activity compared with three-quarters of those in industrialised countries.
    • p.4
  • Much is made of the effect on sexual health of the growing prevalence of sex outside marriage; yet marriage does not reliably safeguard sexual-health status. In Uganda, married women constitute the population group in whom HIV transmission is increasing most rapidly. A study in Kenya and Zambia showed that the sexual-health benefits of marriage for women were offset by higher frequency of intercourse, lower rates of condom use, and their husbands’ risk behaviour. Married women find negotiation of safer sex more difficult than do single women and few married women use condoms for family planning. Nor can marriage be relied on to ensure safer early sexual experience. In Asian countries where early marriage is encouraged to protect young women’s honour, early sexual experiences can be coercive and traumatic and, with respect to early pregnancy, dangerous for mother and child.
    Monogamy is the dominant pattern in most regions of the world(figure 6). Despite substantial regional variation in the prevalence of multiple partnerships, which is generally higher in industrialised countries, most people report having only one recent sexual partner. The data show pronounced asymmetry between men and women(figure 6). Worldwide, men report more multiple partnerships than do women; only in some industrialised countries are the proportions of men and women who report multiple partnerships more-or-less equal. Reporting bias doubtless accounts for some of the difference between the sexes. However, in Africa, where young people vastly outnumber older people (figure 6), the difference between men and women can be largely explained by the age structure and patterns of age mixing (i.e., older men having sex with younger women). In African countries, in the younger age-groups (those aged 15–19 years), sexual activity is higher in women; more men than women report having had no partner in the past year. In older age-groups (those aged ≥20 years), the reverse is true; women are predominantly monogamous, but large proportions of men report having more than one sexual partner. The partners of these men are likely to be the monogamous women from the younger age-group. Median age differences between spouses in Africa are high; 9•2 years in west Africa, 7•4 years in north and central Africa, and 5•5 years in east and southern Africa (age of non-spousal partners is not recorded) (table 3).
    By contrast, in South America (especially in Brazil) more men than women report having one or more recent sexual partners in all age-groups. These findings beg the question of who the men are having sex with. With a median age difference between partners of 4 years, patterns of age mixing and age structure do not account for the difference, and less than 1% of Brazilian men reported sex workers amongst their past three partners. The Latin macho culture might encourage men to over-report, and women to under-report, sexual activity.
    • p.8
  • In countries with wide differences between men and women in the prevalence of premarital sexual intercourse, young men are more likely to report having intercourse with sex workers. Estimates of the proportion of men who are clients of sex workers range from 1% to 14% dependent on region.30 Varying operational definitions of sex work frustrate efforts to interpret prevalence at different times and in different places. The continuum of sexual exchange ranges from expectation of gifts or favours within personal relationships, to more formal trading of sex for money. The proportion who reported having “sex in exchange for money, gifts, or favours” in the past year is highest in countries in central and southern Africa (medians 13•6% and 11•3%, respectively), followed by eastern and west Africa (9•8% and 8•9%, respectively).30More recent African surveys that used the more restricted definition of paying for sex30 have reported reduced prevalence. In the Caribbean, 6–7% of men reported having paid for sex, and estimates for Latin America, eastern and western Europe, and central Asia were less than 3%. Cautious estimates are available for northern Africa and the middle east (1–3%), south Asia (3–5%), southeast Asia (3–10%), and China and Hong Kong (11%).
    • p.10
  • Estimates from the WHO study on gender-based violence of lifetime prevalence of sexual violence by an intimate partner range between 10% and 50%.57 DHS data lend support to this finding; between 11% and 49% of women say they cannot always refuse sex. In more than half the WHO settings, more than 30% of women who reported first sexual intercourse before age 15 years described having been forced into it, and three-quarters of women who had been abused since the age of 15 years identified the perpetrator as their intimate partner.
    • p.10
  • The regional variation in sexual behaviour underlines the powerful role of environmental factors in shaping behaviour and its consequences for sexual health. Through the interplay between demographic and structural factors, social norms, and public policies, spatial differences can be properly understood. One of the most notable features of the data, for example, is the striking gender difference in sexual behaviour. Women might be disadvantaged in protecting their sexual health if their partner is older than them, of higher status than them, or if they are beholden to a man for favours, goods, or money in return for sex. Women’s power to maintain monogamous relationships might be diminished in locations in which they outnumber men with whom they might have sex. Women might outnumber men in this way as a result of the age structures of populations and patterns of age mixing, or where cultural practices such as polygyny are prevalent10,62,63 and where high levels of imprisonment of black men distort sex ratios in predominantly African-American communities—as in the USA for example.
    • p.11
  • Poverty, deprivation, and unemployment work with gender relations to promote change of partner, con-currency, and unprotected sex. Economic adversity restricts the power of men and women to take control of their health; deprivation and unemployment might drive men and women to sell sex or travel greater distances to work. Being away from home is associated in both developed and developing countries with concurrency of partnerships69 and an increase in risk behaviours. Possibly the most powerful influences on human sexuality are the social norms that govern its expression. Morals, taboos, laws, and religious beliefs used by societies worldwide circumscribe and radically determine the sexual behaviour of their citizens. The scale of the regional diversity in sexual behaviour is matched only by the range of cultural constraints on practice. In some societies, for example, homosexual behaviour is celebrated in public parades of pride; in others it carries the death penalty. In some countries, such as Brazil, condoms are available to young people in schools; in others, for example in parts of Indonesia, their possession is a criminal offence. Such strictures hinder attempts by men and women to protect their sexual health. The sexual double standard, whereby restraint is expected of women, whereas excesses are tolerated for men, compounds the problems for both men and women.
    • pp.11-12
  • With the diversity of sexual behaviour, a range of preventive strategies are needed to protect sexual health. And in view of the importance of the broader determinants on sexual behaviour, approaches focusing exclusively on expectations of individual behaviour change are unlikely to produce substantial improvements in sexual-health status. They are especially inappropriate to poor country circumstances, where sex is more likely to be tied to livelihoods, duty, and survival, and where individual agency is restricted. In wealthier countries, personal choice is greater than in poorer countries, yet power inequalities persist. Numerous calls have been made for public-health interventions to pay greater heed to the social context within which sexual intercourse occurs. Interventions encouraging adoption of risk reduction practices remain a cornerstone of sexual-health promotion but the evidence shows that they need to go beyond mere provision of information to be effective (table 4). Systematic reviews have focused mainly on assessment of interventions to change individual behaviour and show increased effectiveness where information is supplemented by skill building and counselling, such as use of condoms and safe sex negotiationwhere theory guides design, where several delivery methods are used, and where context and the need for sustainability are taken into account.
    • p.12
  • Individual-based interventions also need to be targeted to be successful. Men have been successfully targeted in occupational contexts with consequent reduction in sexual-risk taking. Young people are most commonly targeted in schools and the evidence is that curriculum-based sex education does not increase risky sexual behaviour as many fear. Systematic reviews have shown school-based sex education to lead to improved awareness of risk and knowledge of risk reduction strategies, increased self-effectiveness and intention to adopt safer sex behaviours, and to delay, rather than hasten, the onset of sexual activity. Broad-spectrum strategies to achieve behaviour change, with mass-media communication, have proved effective in increasing awareness and knowledge, and in reducing high-risk behaviour. In this context, techniques used in social marketing, which target individuals according to their lifestyles, values, and risk status are an improvement on conventional targeting approaches with demographic characteristics alone.
    • p.13
  • Tailoring of behaviour-change interventions to individual needs and circumstances is also essential. A range of messages is needed that respect diversity and preserve choice. Enough studies have shown that first intercourse is retrospectively regretted by many women, and some men, for efforts to help young people to achieve the best timing of first sex to be justified. Yet, abstinence might not be an option where first sexual relations are forced, where the sexual abuse of adolescents is common, and where financial circumstances force young people to sell sex. Moreover, people do not adhere to only one type of sexual behaviour. Many men who have sex with men also have sex with women, and different preventive strategies might be used for these two behaviours. Broader sexual repertoires need to be taken into account. The issue of recommending non-penetrative sex (such as mutual masturbation) is seldom tackled. Risk reduction messages need to .take account of the diverse reasons for having sexual intercourse and for changing sexual behaviour.
    • p.13
  • Reviews of individual-based interventions also emphasise the importance of interventions to address social norms that act against safer sex. The effects of behaviour change interventions will be transient if participants return to an unsupportive environment. Actions such as deferring or denying sex are not intrinsically rewarding and need to be supported by group norms. Community interventions have been effective in mobilising local groups in support of preventive strategies. The prompt response from homosexual communities to the prevention of HIV/AIDS in industrialised countries in the early 1980s owed much to the preexistence of non-governmental organisation (NGO) infrastructures and to the visibility and mobilisation of homosexual men. The evidence is that information gained through social networks is more salient, and more likely to lead to behaviour change, than that conveyed by more impersonal agencies.
    • p.13
  • Where population groups are marginalised and NGOs and community-based service programmes are weak, the starting point might be the informal groups in which norms are maintained. Preventive programmes that use naturally occurring social networks have reduced risky behaviour in homosexual men in Russia, increased contraceptive use in married women in Bangladesh, increased condom use in sex workers in India, and have proved more effective in changing norms than more orthodox approaches using conventional health care and field workers. Strong social prohibitions and sanctions, especially those underpinned by legislation, might present greater challenges. In general, laws protect the young and those vulnerable to coercion and exploitation, but they might also impede safer sex practices. If practices are illegal, they are more likely to be engaged in a furtive or clandestine manner, and opportunities for protection are constrained. The success of preventive strategies is heavily dependent on acceptance of the reality of sexual practices that are socially censured. Condom use is uncommon in sex workers in India for example, where commercial sex is heavily socially proscribed. By contrast, condom use is near-universal in those in Kampala and in Mexico, where public-health agencies have actively and openly engaged in co-operation with female sex workers. The mass media have been powerful in shifting social norms and, in some instances, achieving legislative reform. In the Lebanon, where homosexuality is illegal, a popular weekly television programme includes a homosexual voice. In South Africa, the strategic use of entertainment as education, media advocacy, and social mobilisation to change public opinion and influence decision-makers has led to implementation of the Domestic Violence Act.
    • pp.13-14
  • To address the broader structural determinants of sexual behaviour is daunting. To do so demands a broader definition of public health than many might feel comfortable working within. Social determinants are the least amenable to intervention. Structural factors such as poverty, unemployment, and gender are difficult to modify, and social and political norms are slow to shift. Yet, efforts are being made to address forces such as gender and poverty in innovative ways. These efforts include mainstreaming of HIV and sexual health services in development; empowerment of sex workers to avoid sex work through business and information-technology training; and integration of sexual-health education into microfinance schemes. Success has also been achieved in tackling of social attitudes, for example, those of young men towards fatherhood, relationships, and contraception.
    • p.14
  • The evidence shows that, where improvements in sexual health have been achieved, a combination of factors has contributed to the success. Behaviour change in Thailand and Uganda, for example, has been attributed to an array of preventive policies and strategies, mounted by different agencies, with strong partnerships between the media, government, NGOs, sex workers, people living with HIV/AIDS, and international and local public-health agencies, endorsed at the highest political level. Yet, the polarity of views on abstinence, be faithful, and use condoms (ABC) strategies, about which of these three elements has contributed most to reductions in rates of HIV in Uganda or teenage pregnancy in the USA (panels 4 and 5), stems from a search for single-factor explanations to support particular ideological positions. The preoccupation with ABC strategies has the negative effect of distracting attention from the need for broader, integrated programmes in which all components are mutually reinforcing.
    • p.14
  • This is the first time an attempt has been made to bring together comprehensive survey data for sexual behaviour from around the world. The data show perhaps less change over time than might have been supposed. People who fear a tide of youthful promiscuity might take heart from the fact that trends towards early and premarital sex are neither as pronounced nor as prevalent as is sometimes assumed. Similarly, the apparent absence of an association between regional variations in sexual behaviour and in sexual-health status might also be counterintuitive. In particular, the comparatively high prevalence of multiple partnerships in developed countries, compared with parts of the world with far higher rates of sexually transmitted infections and HIV, such as African countries, might hold some surprises. Only rates of condom use are predictably lower in countries with lower sexual-health status, and this is likely to be attributable to factors relating to access and service provision. The data make a powerful case for an intervention focus on the broader determinants of sexual health, such as poverty and mobility, but especially gender inequality.
    The comparative data are important in countering misinformation and quelling fears relating to sexual behaviour. The selection of public-health messages needs to be guided by epidemiological evidence rather than by myths and moral stances. The greatest challenge to sexual-health promotion in almost all countries comes from opposition from conservative forces to harm-reduction strategies. Governments tend to be wary of controversy and, faced with resistance from groups with a strong moral agenda, shy away from supporting interventions other than those with orthodox approaches. Policy-makers and programme planners need strong evidence of beneficial effect to make the case to address stigmatised groups and adopt messages that do not support the dominant ethos of monogamous, procreative, and heterosexual sex. Policy-makers and programme planners need to be able to show that the effect on sexual-health status of providing services to unmarried young women, supplying condoms, decriminalising commercial sex and homosexual activity, and prosecuting people who commit sexual violence is likely to be beneficial rather than detrimental, and that to do otherwise will force stigmatised behaviours underground, leaving the most vulnerable people unprotected. Scientific evidence of effectiveness will counter misconceptions (for example, that sex education encourages promiscuity).
    • p.16
  • Sexuality is an essential part of human nature and its expression needs to be affirmed rather than denied if public-health messages are to be heeded. As we have seen, men and women have sex for different reasons and in different ways in different settings. This diversity needs to be respected in a range of approaches tailored to whole societies, and to particular groups and individuals within them. Public-health strategies include health promotion, social marketing, media advocacy, legislative activities, and community empowerment. Strategies used should enable people to make their own choices, rather than have them imposed on them. Goals related to the improvement of sexual health need to be linked with development goals, and the lynchpin here is partnership between statutory agencies, between sectors, and between national and local agencies, underpinned by political leadership.
    • p.16

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