Sexuality

Childhood, in most modern cultures, is defined in large part by its separation from adult sexuality. While many contemporary cultures recognize aspects of sexuality in children, such as the development of sexual curiosity or masturbation practices common among young children, they draw a clear line between such forms of childhood sexuality and children's exposure to adult sexuality and sexual experience. Prepubescent children, in most modern cultures, are not legitimate objects of adult sexual desire or behavior. Paradoxically, it is this very separation of childhood and adult sexuality that so closely links childhood to sexuality in modern cultures. Societies attempt to enforce that separation through elaborate systems of laws, institutions, and ideologies. Public debates about the proper role of sex and sexual images in the mass media and public culture often turn on notions of childhood innocence. A whole constellation of social practices have been created because modern societies attempt to protect children from sex and adult sexuality.

Puberty, the biological process of maturation into sexual and reproductive maturity, commonly marks the end of childhood. It does not, however, always mark the entry into adulthood or adult sexuality. Most modern societies see the years following puberty as directly linked to sex, but in many ways that direct relationship is more problematic than childhood's oblique one. While childhood is defined as a period deserving–demanding–protection from adult sexuality, the proper relationship between adolescence and sexuality is less clear. Adolescents are clearly sexual, but not clearly adult. Biological and social maturity are not always considered equivalent. How, then, should the sexuality of youth be regulated or controlled? These are not new problems in human history. Human societies have grappled with the common problems of biological and social maturation for thousands of years. But just as the meaning and experience of childhood has differed dramatically across cultures and through time, so have the social definitions of childhood, youth, and sexuality.

Ancient and Premodern Societies

Writing about the history of sexuality is always a complicated task, as it is difficult to find direct evidence about the meaning and practice of sex in history. We come to knowledge of sex indirectly, through debates about sex, regulations governing sex, representations of sex, prohibitions against sex, or demographic data (which may, for example, reveal something of the frequency of conception outside marriage but little about the acts of sexual intercourse that produced it or the meaning of such acts). The problem of access to historical information about sex and its meaning is compounded when dealing with children, who have largely been defined outside the licit realm of sex and sexuality. This problem is compounded further when writing about societies in the distant past or about premodern, nonliterate societies. Much of our knowledge, especially of ancient cultures, is drawn from codes of law, especially those concerned with inheritance of property. In the case of nonliterate tribal cultures, it is difficult to know how accurately the practices documented by travelers and, later, anthropologists, reflect actual practices and whether those practices are longstanding traditions or relatively recent developments. However, the works of classicists, historians, and anthropologists offer some insight into the distant past. Most strikingly, they reveal something of the enormous variety of cultural definitions of childhood, and of the relation of children and youth to sex and sexuality, that have existed in human cultures.

A survey of a single continent, Africa, offers some sense of the great diversity of cultural practices surrounding childhood, youth, and sexuality in premodern cultures (the discussion in this section is particularly indebted to the informative synthesis provided in A. R. Colón's A History of Children ). According to documentation from the late nineteenth century, about five thousand distinct tribes remained in sub-Saharan Africa at that time. The meaning and experience of childhood differed from tribe to tribe, and so did traditional attitudes toward youth and sexuality and the practices that regulated them. In many sub-Saharan tribes, though children learned gender-appropriate tasks from an early age, puberty marked a new stage of life and was marked by some sort of initiation ceremony, which might last days or even years. Here, recognition of sexual maturity often combined with entry into adult responsibilities and status. The Kpelle, a tribe in what is present-day Liberia, secluded boys for four years in a period of initiation and instruction, including ritual circumcision. Among the Pygmy, a boy was not considered ready for marriage until he had killed an antelope or buffalo. Among the Ngoni, boys celebrated puberty with a cleansing ceremony in the river after the first nocturnal emission. The nomadic Fulani gave boys charge of cattle at age ten, at which time ritual circumcisions were performed. Bedouin boys were also ritually circumcised and, in order to gain the endurance of a camel, were expected to eat a piece of bread that had been smeared with camel dung. The Ganda, who considered children property and rarely raised their own children, did not mark puberty in any way and had no rituals for passage into sexual or social adulthood.

For girls, puberty rites were frequently tied to menarche, or the onset of menstruation. Among the Ngoni in central Africa, as in many other African tribes, girls were placed in isolation huts during menstruation. After her first menstrual flow ended, a girl underwent a cleansing ceremony. With her father's sisters and other women from the village, she was led in a procession from the isolation hut to the river, where she was undressed and placed in the water, facing southeast. Afterwards, she was taken to the dwelling of her aunt and given instruction on proper behavior for her new stage of life. This new status included bimonthly vaginal examinations by elder women from the village who were charged with verifying and so maintaining the girl's virginity. Other tribes sought to guarantee girls' virginity through genital surgery. Female circumcision was a common initiation rite at puberty, though the procedure sometimes took place in infancy or during childhood. The sunna circumcision, performed by central Ethiopian tribes on infant girls, removed only the prepuce from the clitoris. Pharaonic circumcision was a major operation in which the girl's clitoris, labia minor, and parts of her labia majora were removed. The remaining portion of the labia majora were sewn together, or infibulated, and her legs bound together for up to forty days until her vulva fused closed. Infections of the urinary tract and vagina were common, as were difficulties in menstruation, and the fused vulva created pain during sexual intercourse and complicated eventual childbirth. Pharaonic circumcision or simple infibulation was practiced throughout Africa, though not by all peoples, and continues to this day in approximately twenty-six (or more than half of the total) African nations. About 90 percent of girls in the Sudan still undergo pharaonic circumcision.

As Islam and Christianity spread through Africa, these particular religious traditions merged with local tribal customs and influenced understandings of sexuality, childhood, and family. For example, tribes with traditional matrilineal patterns of inheritance switched to patrilineal models, thus shifting the control of property to men and increasing the importance of marriage for women's economic security and protection. Especially in areas influenced by Islam, by the eighteenth century marriages were contracted and performed at increasingly early ages, ranging from age seven in the San region to ten in Madagascar and twelve or fourteen in the Sudan and southeast Africa. Premodern Pacific Island cultures also illustrate the great range that existed in the social regulation of sexuality. Among the Tiwi, for example, girls were married before puberty while boys underwent a ten-year-long period of initiation, beginning at puberty, before they could marry. On Vanatianai, in Melanesia, sexual activity was seen as an appropriate and pleasurable activity for both boys and girls once they entered puberty at about the age of fourteen.

Through most of human history–and still today in many places–children and youth have been exposed to sex very directly. The vast majority of people lived in small dwellings. Privacy was scarce, and concepts of privacy were different from those of contemporary American and western European cultures. Children commonly slept in the same room with their parents; in many places, especially in cold climates, the entire family might share a single bed or its equivalent. In such conditions, children commonly heard and saw adults having sex. And it was not only people who lived closely together in small spaces. Animals were often a source of sexual knowledge. In rural areas and towns alike, children–often responsible for animal care–learned about sex from watching animals copulate and give birth. Just as people in pre-industrial and premodern societies were more directly exposed to the processes of birth and death, they were more directly exposed to knowledge of sex. Children shared that knowledge. They were not protected from exposure to sex. However, simply because children had knowledge of sex does not mean that they were not protected from adult sexuality and sexual contact. That protection did exist in many cultures. However, while the notion that "childhood" is an invention of modern times has been strongly refuted by many scholars, it is nonetheless important to note that children were not universally seen as deserving of society's protection, whether in the realm of sex or elsewhere, nor was there steady progress toward a protected status. Some ancient societies wrote the protection of children into law (though protections did not necessarily cover all children), while in others abandonment, infanticide, child slavery, and child prostitution were common.

Early written records of human civilization, reaching back to the Sumerians, specify to some extent the proper treatment of children. For example, the eighteenth-century b.ce. Code of Hammurabi forbids men to commit incest with their daughters or to "defile" their sons' betrothed. The Egyptian Book of the Dead gives some sense of the restrictions governing sex with children, including "sexual relations with a boy" in its list of acts that would prevent a man from entering into the next life. The ancient Hebrews also prohibited sodomy with children, considering it a form of idolatry related to the worship of the body. Sodomy with a boy under the age of nine was punished by flagellation, and by stoning if the boy were older than nine years. While these restrictions may have aimed less at the protection of children than the prohibition of certain sexual acts, they stand in significant contrast to other cultures in which children found little or no protection. Along the Mediterranean coast, the Phoenicians, who were active in the first millennium b.ce., were known for their cruelty to children. Infant and child sacrifice, in which babies and small children were burned alive, was common, and the Phoenicians maintained official "temple boys" or "sacred" prostitutes, who were sodomized by adult men.

Roman child-rearing practices combined signs of great affection for children with a striking lack of protection for them. Abandonment of children was common, and the abandoned child–if it survived–was likely to be enslaved or sold into prostitution. Abandoned male infants intended for prostitution were sometimes castrated in order to prolong their androgynous, boyish appearance. Such practices were prohibited by the emperor Nerva during his brief reign from 96 to 98 c.e. Subsequent emperors Trajan and Hadrian built upon these reforms, with Hadrian enforcing the law against castration of boys and prohibiting the sale of children for sexual purposes. Significantly, he extended these protections to slave children as well as to the freeborn. Regulations of sexuality for children and youth also developed around the issue of property. Commonly, elite families with inheritable property were much more concerned with controlling the sexual behaviors of their children. Legally recognized marriages and the production of legitimate heirs were proportionally more important to families with property, and such concerns fostered emphasis on the virginity of daughters before marriage. In ancient China, while among the lower classes young people commonly mated around the age of fif-teen, the sexual experiences of elite youth were closely monitored, indicating the greater significance of marriage to those with property. In ancient Persia, girls of elite families commonly entered into polygamous marriages at the age of fifteen. Familial control over sexuality and property here was extreme, as incest was not a taboo, and men could marry their own daughters.

In ancient Greece, a girl's virginity was closely linked to family honor, and unmarried girls were counseled to sleep on a bed of withy, or long, flexible twigs, as a way of preventing sexual desire. Marriage marked the passage to adulthood for girls; only through marriage did a girl become an adult woman. Boys, on the other hand, celebrated passage into manhood and citizenship at the age of eighteen or nineteen–a moment marked not by biological sexual maturation but by their relationship to the state. In medieval and early modern western Europe, the regulation and control of youthful sexuality was structured by the demands of economic subsistence and by the increasing power of religious authority. The highest priority, in what were primarily subsistence agricultural societies, was survival. Limiting reproduction (and thus the number of mouths to feed and the number of children among whom to divide resources) was critical, and families and communities regulated sexuality in order to limit fertility. Biology helped; puberty came relatively late, usually between fourteen and sixteen years of age for girls, because of poor nutrition. Combined with short life-spans (life expectancy in early modern England was thirty-five to forty years) and early menopause, women had a much shorter period of potential childbearing than is common today. However, young people did not commonly mate or marry at puberty. The average age at marriage in early modern western Europe was later than in most contemporary societies: approximately twenty-six years old for women and twenty-seven to twenty-nine years old for men.

While children began work at early ages, and were often sent away from home to serve as apprentices in their midteens, they did not move directly from childhood to adulthood at puberty or at the beginning of their work lives. Instead, the period of "youth" lasted until the young man and woman were able to marry and set up their own household. Thus, most were in the dependent category of youth for almost half of their lives. It was in part a question of resources–the labor of the young was needed to sustain the family, and it was often only upon the death of the older generation that youth inherited sufficient resources to set up their own households. However, even among affluent, elite families in which there were ample resources, sexual maturity was not the only criterion for marriage. Marriages did occur at earlier ages among the wealthy, but, for example, when the son of the Countess of Warwick was married at nineteen to a young bride, his mother sent him abroad while his wife remained with her; she felt they were too young and inexperienced to live together. And young men who completed their apprenticeships with sufficient means to marry sometimes delayed, for marriage and the responsibility for a household was understood not to be simply a matter of means, but of maturity. Certainly, among the poorest, such controls did not always obtain. But in much of medieval and early modern Europe, the family and the community attempted to control the behaviors of these sexually mature but not "adult" young people.

In that respect, they worked in concert with the church. Christian thought, from the High Middle Ages forward, clearly posed adolescence as a time of sexual danger, requiring spiritual control. As Guibert de Nogent wrote in his autobiography from the beginning of the twelfth century, "Thus, while my young body grew little by little, my soul was also aroused by worldly life, titillated in its own right by sexual desires and lust." Adolescence was a time of temptation for "still-naive" souls, and while theologians focused on human beings' propensity for sin, they saw the period of youth as particularly susceptible to the temptations of the flesh. The church, also, placed increasing emphasis on the virginity of girls and young women, praising virginity as a connection to the Virgin Mary, Christ's mother. Thus, religious tenets, the economic needs of communities and the related intensity of community supervision of young people, and cultural definitions of maturity combined to limit the sexual explorations of youth. Specific customs like bundling, where courting couples lay together fully clad, regulated courtship sexuality, usually–although not always–successfully. Nonetheless, for poorer, rural families without dowries and significant property, premarital virginity was less important, premarital sex more common, and marriage often more an informal but long-term pairing (animus matrimonii ) than the legal marriage that was important to elite families with property. Poorer rural communities accepted premarital sex with the understanding that pregnancy would yield marriage. In sixteenth-and seventeenth-century England, as many as one-fifth of brides were pregnant when they wed, but only about 3 percent of babies were born outside wedlock.

However, as towns and cities grew and more and more young people left rural areas to serve as apprentices or servants in the growing towns, community control weakened. Young women, especially, were increasingly vulnerable to sexual exploitation, often by their masters or other members of the master's household. It was not simply exploitation, however, for young men and young women alike–many of them "youth" in their early twenties–took advantage of the greater freedom they found in cities, and apprentices' masters often allowed a good deal of freedom, sexual and otherwise, to their older apprentices and servants. This freedom had its dangers. If a young woman or girl became pregnant and the man could not or would not marry her, she was likely to be dismissed from her position and prosecuted in court. Livelihood for herself and her baby was uncertain at best. Nevertheless, illegitimacy rates increased in Europe, mainly among young people, in the sixteenth century, and particularly in the eighteenth to early nineteenth centuries. With the growth of towns and cities, the varying customs of different social classes became more obvious and the church, along with members of the growing bourgeoisie who sought clearly defined marriage and familial relations to facilitate the transfer of property, pushed to foster a single standard of behavior. Premarital virginity for women was increasingly stressed, and the church no longer recognized the informal pairing typical of poor rural populations as a form of marriage.

Court records from western European cities during the High Middle Ages and Renaissance also show the prevalence of sexual "vice" and exploitation. Between about 1300 and 1700 c.e., men commonly participated in an age-structured system of sexual relations in which "beardless youths" between puberty and full sexual maturity (aged fifteen to twenty-two or so) were anally penetrated by men in their mid-to late twenties. Constrained from marrying until quite late because of economic factors, and in cultures that emphasized the virginity of girls from respectable families, men commonly had sexual relationships with boys and also with female prostitutes or with lower-class girls and young women who were vulnerable to exploitation or rape. The homosexual pairings between older and younger males were not permanent sexual relationships or roles. Once the youth's beard came in fully, he took the "active" sexual role with a younger boy, while his older partner came of age to marry and left behind the practice of sodomy with men. (Some men, of course, continued to practice sodomy beyond the appropriate age, but that was considered something quite different from the age-regulated system of sexual relations.) This age based system was illegal and not condoned by the Church, but was seemingly very common. In mid-fifteenth-century Florence at least fifteen thousand men were accused of sodomy in the courts, and–demonstrating tolerance for the practice–penalties were not severe: simply a fine, which was often not paid. This age-based system of relations between men and youths disappeared as common practice in northwestern Europe around 1700, but it persisted in other parts of Europe and the Middle East into the early twentieth century.

Industrializing Societies

The growth of industrial societies and the concomitant development of a larger middle class or bourgeoisie shaped the sexual lives of children and youth in almost diametrically opposite directions. The rise of factories and migration of the rural poor to urban areas led to enormous exploitation and suffering of children and youth. In western Europe, children as young as three years old were put to work in factories. Few protections existed for such children, who worked long and difficult hours and often lacked sufficient food, clothing, or shelter. These children and youths were increasingly vulnerable to forms of sexual abuse and exploitation. With large numbers of children living on the streets, many turned to prostitution or other forms of sexual activity for survival. In the United States, where slavery was not ended until 1865, enslaved African-American girls and women frequently were sexually exploited or raped.

At the same time, middle-class children in North America and western Europe were treasured and protected in new ways. Nineteenth-century religious beliefs and social philosophy defined childhood as a time of innocence, and art and literature from the time portrays children with great sentimentality, often as symbols of purity, innocence, and unspoiled religious sentiment. As children became more of an economic liability than an asset, families intentionally had fewer children. The fertility rate dropped by almost half during the nineteenth century in the United States. The change was most dramatic in urban middle-class and professional families, who devoted more attention to nurturing and educating each individual child. Children were also seen as malleable in their innocence, and mothers increasingly were held responsible for shaping the moral development of their children. In these new urban-industrial societies, that meant fostering self-control, discipline, and education as means to economic success–or at least stability. Girls were also inculcated with the virtues of self-control and industry, but with great emphasis on moral purity, which was seen as fundamental to their future roles as wives and mothers. Expectations about sexual behavior, however, differed by race, class, and region. Premarital sex, and even "outside" children that resulted, were much more acceptable to the rural southern poor, both black and white.

Middle-class notions of purity and self-control, not surprisingly, often centered upon sexuality. A growing advice literature combined medical and moral messages to warn about the dangers of masturbation. While such concerns may be traced back to a series of publications in the eighteenth century, including the anonymous Onania and S. A. Tissot's Onanism, middle-class North Americans and western Europeans encountered a flood of writing on the subject. This secret vice, it was claimed, could lead to sterility, insanity, idiocy, or a range of lesser effects. Health reformers such as Sylvester Graham offered dietary regimens designed to inhibit masturbation and nocturnal emissions, while others developed mechanical devices. One such device, intended to discourage sexual arousal in young men, encircled the penis with a ring of spikes; another restrained the hands and covered the genital area with a girdle of cold, wet cloths. Fears about masturbatory practices focused on boys and young men. A smaller and more discreet literature was devoted to girls. Mothers were warned to watch for evidence of masturbation, especially lassitude, in their daughters. But compared to their male peers, young women and girls largely escaped this form of sexual surveillance, in part because girls and women were not believed to be as sexual by nature as were men: purity and passionlessness were held up as female ideals. However, young women were much more closely chaperoned and supervised than young men of the same social class, for sexual virtue and a reputation for sexual modesty was critically important to the marriage ability of young middle-class and elite women, and for working-class women of many U.S. immigrant groups who held to their traditional cultures. Paradoxically, assumptions that women were less fully sexual than men would allow for greater sexual freedom in one sphere: relations between women or girls. "Romantic friendships" between young women were relatively common and quite acceptable into the early years of the twentieth century. Crushes, or "smashing," as it was sometimes called, were a major part of social life at women's colleges into the early twentieth century. The sexual content of such relationships varied, but young women did find relative freedom to pursue same-sex relationships during this era.

Nineteenth century middle-class ideology emphasized the difference between male and female, not only in adult roles but in prescriptions for childhood activities as well. Nineteenth-century understandings of puberty drew the line between male and female very clearly. By the nineteenth century, Western medical science portrayed menstruation as a debilitating monthly event, suggesting that it posed such a physical crisis, especially during puberty, that any strenuous physical or intellectual activity might ruin a girl's health, possibly rendering her a sterile, sexless being. Thus puberty led to the curtailing of girls' freedom of activity. This happened, on the whole, ever earlier. In the nineteenth century, the average age at first menstruation had dropped to fourteen years for European-American girls and eleven for African-American. While it is important to understand how the medicalization of normal menstruation worked to limit girls' lives, it is also worth pointing out that the process of menstruation was poorly understood, and doctors lacked the ability to accurately diagnose and treat painful disorders such as endometriosis or ovarian cysts. Ideology played the greatest role in limiting women's activities because of the "frailty" of their bodies, but modern medicine and products such as disposable sanitary napkins and tampons also helped to free women from limits imposed by menstruation itself.

Limitation of girls' activities at menarche was not confined to industrial, Western societies. In China, also, the onset of menstruation was treated as a sign of female weakness and of uncleanliness. Classical writings on health remained influential in the nineteenth century, including those of sixteenth-century medical writer Li Shizhen, who wrote of the menstruating woman: "Her evil juices are full of stench and filth, hence the gentleman should keep his distance; as they are not clean, they will harm his male essence and invite disease." Puberty, in late imperial China, was defined more broadly than in Western cultures. It was not simply the biological process that signaled physical reproductive maturity, but rather activation of the "true qi of heaven bestowed at conception" by the individual's parents. While the period of adolescence was not defined through specific rituals, classical works such as the Book of Ritual did provide for a period of youth, prescribing the appropriate age of marriage as twenty years for women and thirty years for men. These prescriptions for delayed marriage correspond with the belief that it took many years for the yin and yang of the young people to become "replete." However, age at marriage or mating varied greatly by social class and social circumstance; poor young men might experience greatly prolonged bachelorhood because they lacked resources to marry or maintain a family, while such families also might arrange the marriage of a prepubescent boy in order to gain a daughter-in-law needed for household work.

In Western societies, the problem posed by sexually mature but not "adult" youths was exacerbated by industrialization and urbanization. While middle-class Americans and western Europeans attempted to foster the development of self-control in their own sons, they feared the unsupervised and uncontrolled sexual energies of working-class youth in the growing cities, many of whom lived apart from family or effective community supervision. Some scholars have suggested that the actual physical growth of adolescents–in North America, on average, young men had gained two inches in height and fifteen pounds in weight between 1880 and 1920, due to better nutrition–made them more intimidating. No matter the cause, a great deal of effort was devoted to controlling the sexual energies and impulses of youth, especially of young working-class men. And as rates of pre-marital pregnancy in the United States rose from about 10 percent in the mid-nineteenth century to 23 percent between about 1880 and 1910, reformers sought to protect young working women from sexual exploitation. Building upon a campaign begun in England with an expose of child prostitution, America's largest women's organization, the Woman's Christian Temperance Union (WCTU), launched a drive to raise the age of consent, the age at which girls could legally consent to sexual intercourse. Reformers meant to offer girls and young women legal protection against seduction and sexual exploitation: age of consent laws rendered underage girls legally innocent, no matter their behavior, and placed responsibility for illegitimate sexual conduct on men. Under such laws, a man or boy who had sexual intercourse with an underage girl was guilty of rape, whether or not she had freely participated and whether or not he used force or threats.

In the mid-1880s, the median legal age of consent in the United States was ten. Over the following decade, the median legal age of consent rose to fourteen; by 1885 it was sixteen or older in twenty-two states. Resistance to raising the age of consent was strongest in the South, where opponents argued that such laws might "enable negro girls to sue white men" and sought to exempt girls who were not of "previously chaste character," with the understanding that few black women or girls would be presumed "previously chaste" by white male juries. Georgia did not raise the age of consent from ten to fourteen until 1918. The federal government, on the other hand, in 1899 raised the age of consent in places of federal jurisdiction to twenty-one. The age of consent campaign had mixed consequences. These laws did offer protection to young girls. But the laws were not limited to children. The WCTU waged the campaign in a language of childhood innocence, calling for the protection of "baby girls," "girl children," and "infants," but reformers sought to raise the age of consent to the late teens. By legislating "innocence," states denied young women (even up to the age of eighteen or twenty-one) the right of consent. Court records reveal that some parents used these laws to constrain rebellious daughters by charging their boyfriends with statutory rape in court.

Twentieth Century

The twentieth century was a period of dramatic and rapid change in North American and western European social definitions and experiences of childhood, youth, and sexuality. Fundamental to changing understandings of childhood and sexuality in the twentieth century were Sigmund Freud's writings on infant and childhood sexuality. Published first in 1905 as Three Contributions to the Sexual Theory, Freud's theoretical models were sometimes changed beyond recognition as they passed into public circulation, but were enormously influential. Freud argued that sexuality did not first appear at puberty, but instead defined the stages of development from infancy to the age of six, at which point the child passed into a period of latency that lasted until puberty. According to Freud, the ways in which the child passed through the childhood stages of sexuality (oral, anal, and phallic) would determine in large part their experiences as adults. Acceptance of Freudian theories of child and infant sexuality did not undermine the widespread belief that young children should be protected from adult sexuality. Instead, well into the 1960s, explanations for sexual and personal problems in adulthood were sought in the family dynamics of early childhood, and well-educated parents often paid great attention to managing familial relations and childhood sexual development because they understood it to have great consequences for their child's life course and future sexual adjustment.

The early years of the twentieth century were a time of struggle over youth and sexuality, especially in the United States. Increasingly, young people claimed the right to sexuality, if not to sex itself. Working-class girls and young men enjoyed the new commercial amusements of the city–dance halls, amusement parks, nickelodeons. Often without money to pay their own way, "charity girls" traded their favors (ranging from flirting to sexual intercourse) for entertainment. By the 1920s, appearances reflected a new sexualized culture. The flappers of the 1920s shed yards of fabric from their clothing, including most of the undergarments worn by their mothers' generation. With rouge and lipstick, rolled stockings and bobbed hair, they were frankly sexual. College men copied the sexualized image of movie star Rudolph Valentino. Popular music and dance styles were also more frankly sexual. U.S. college students were mad for jazz, which the Ladies Home Journal condemned for its "voodoo rhythms." In cities throughout the nation, young whites adopted (and adapted) physically expressive dances from working-class black culture, such as the shimmy and the turkey trot.

Over the course of the twentieth century, children and youth in the United States and western Europe spent more time together in age-segregated peer cultures. By the early 1940s in the United States, four out of five boys and five out of six girls attended high school. In the peer-oriented confines of high schools and colleges, young people developed elaborate social and sexual practices. Dating emerged as the new style of courtship in that era, especially in the United States, and young people "went out" on dates, thus partially escaping the supervision of parents and community. "Necking" and "petting" (which one mid-twentieth century sociologist described as "includ[ing] literally every caress known to married couples but … [not] complete sexual inter-course") became expected parts of dating, one of the ways in which young people demonstrated their belonging in an emerging youth culture. Not all young women found such freedom: Mexican-American girls, for example, were often closely chaperoned by parents to whom these new "American" customs were unacceptable.

In the years following World War II, the average age at marriage in the United States dropped dramatically. By 1959, fully 47 percent of all brides married before they turned nineteen, and the percentage of girls between the ages of fourteen and seventeen who were married increased one-third between 1940 and 1959. Teenagers were having babies: 27 percent of first births were to married teenage girls in 1950; by 1965, that figure had risen to 39 percent. (In 1960, only 16 percent of births to teens were outside marriage; in 1996, 76 percent of births to teens were non-marital.) As American teens married in large numbers, their younger siblings moved toward marriage more quickly. Dating, by the late 1940s, had evolved into a system of "going steady," monogamous and frequently intense (though usually short term) relationships that almost mimicked the marriages of the steadies' slightly older peers. Pressure to enter the world of heterosexual dating intensified, as eleven year olds commonly went steady and thirteen year olds who were not yet paired off might be described as developmentally slow, or "late-daters." Not unreasonably, parents and other adults charged with monitoring the sexual behavior of youth worried that going steady increased the desire and opportunity for sexual exploration. Girls, especially, found themselves in a difficult position: "reputations" were easily lost, but necking and petting were an expected part of going steady.

The "sexual revolution" of the 1960s and 1970s brought about major changes in the sexual behaviors of young people in North America and western Europe. In France, for example, the average age at first intercourse dropped five years for women and six years for men between 1968 and 1989; by 1989, 90 percent of French teenage girls had sexual inter-course by the age of eighteen. Average age at marriage also increased sharply, so that few married during their teenage years. In the United States one trend is toward a "single standard" for sexual experience: in 1995, almost equivalent percentages of male and female high school seniors reported having had sexual intercourse (67 percent for males; 66 percent for females). Racial differences in sexual experience remained pronounced, however: in 1995, black high school students were more likely to have had sexual intercourse (73 percent) than their Hispanic (58 percent) or non-Hispanic white peers (49 percent). Teen pregnancy rates decreased 17 percent during the 1990s in the United States, but remained at least four times that of France or Japan.

Gay and lesbian youth also found greater acceptance at the end of the twentieth century, compared to the years before 1973 when homosexuality was classified as a mental illness by the American Psychiatric Association. Many schools and colleges have active lesbian-gay-bisexualtransgendered-queer organizations. However, some studies suggest that gay and lesbian teenagers are at relatively high risk for suicide (representing almost 30 percent of teen suicides), and the 1998 murder of twenty-one-year-old college student Matthew Shepard in Laramie, Wyoming, is an example of the homophobic violence gay and lesbian teens may confront.

Concerns about the control and regulation of adolescent sexuality in North America and western Europe continue, despite greater acceptance of adolescent sexual experience. Abstinence campaigns have been highly visible in the United States since the 1980s Reagan administration, and conservative groups have argued for premarital chastity on moral grounds. However, concern about the spread of sexually transmitted disease, high rates of unintentional pregnancy, and the social and economic costs of unwed teenage parenthood also motivates debates among governmental agencies, scholars, parents, and social critics.

The liberalizing trajectory of change in North American and western Europe should not obscure the continuing differences among cultures. Arranged marriages remain common in India, and to a lesser extent in Japan. In Nepal, 7 percent of girls are married before the age of ten, and 40 percent by the age of fifteen. Premarital sex and homosexuality are strictly outlawed by Islamic law. In 2000, a teenage girl in Nigeria was sentenced to 180 lashes for having premarital sex (one hundred lashes were administered); and into the 1990s in Turkey, young women were legally subject to forcible "virginity control" exams. The average age at first sexual intercourse for boys in Jamaica is 12.7, while fewer than 12 percent of female Chinese college students surveyed in 1990 admitted that they had had sexual intercourse. Such differences, often embedded in strong religious or cultural traditions, pose both practical and philosophical difficulties for child advocacy and human rights groups who seek to improve the conditions for young people worldwide.

In the early twenty-first century, the belief that children deserve protection from adult sexuality, and from sexual exploitation and violence, is widespread if not universal. Article 34 of the UN Convention on the Rights of the Child calls upon all nations to protect children from sexual exploitation and abuse. In a globalizing world, social definitions of childhood have become more homogenous, as has the experience of youth. However, enormous variety remains in the sexual experiences of youth, and in understandings of the proper relationship between children and youth and sexuality.

See also: Child Abuse; Female Genital Mutilation; Gendering; Homosexuality and Sexual Orientation; Infant Sexuality; Pedophilia; Teen Pregnancy; Theories of Childhood.

bibliography

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internet resource

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Beth Bailey

SEXUALITY AND SEXUAL BEHAVIOR

SEXUALITY AND SEXUAL BEHAVIOR. Since the 1970s, new approaches to the history of sexuality have combined to transform understanding of early modern sexual practices and beliefs. Social historians began by recovering sexualized aspects of the life cycle such as marriage and childbirth. Historians of women and gender examined longstanding patterns of sexual socialization relative to such issues as coerced sex and arranged marriage and the patterns of community response to such sexually marked populations as prostitutes and nuns. Michel Foucault's Histoire de la sexualité (1978; History of sexuality) provided a new intellectual framework for sexuality studies by arguing that modern sexuality ought to be understood as discursively organized and marked by technologies of power. That is, patterns of language such as confession and silencing around sexual acts operate in complex ways within structures of power (such as the family, church, state, and science) to form sexual identity. Foucault's work stimulated and reformulated questions and approaches to the history of sexual behavior even as he was criticized both for the lack of historical specificity in his account of ancient sexuality and for contending that the beginning of the modern notion of sexuality was fundamental to identity in eighteenth-century Europe.

Since Foucault, much empirical historical work on sexuality has filled gaps in his chronology and challenged a number of his particular assertions. Nonetheless, the work of historians of sexuality on such issues as birth control, prostitution, pornography, and homosexuality remains indebted to Foucault for his insights regarding the patterns of meaning and significance with respect to sexuality and sexual behavior. What follows takes into account both the empirical and the discursive understandings of the history of sexuality and sexual practices in early modern Europe. For purposes of clarity, "sex" throughout refers to sex acts, while "biological sex" refers to male or female bodies. "Sexuality" refers to the complex of ideas associated with sex and often inflected by "gender," by which is meant the cultural meanings attached to biological sex.

SEXUAL PRACTICES

From the emergence of Catholic Christianity in late antiquity, suspicion of corporeal matters as detracting or distracting from the Christian's duty to focus on eternal salvation was especially strong with regard to sex. Procreation was permitted, but pleasure was generally frowned upon by the church. Persistent beliefs and strictures indicate that fears of sexuality remained very much in play throughout the Middle Ages. Theologians were adamant that sex was primarily procreative and ought to be confined to legitimate marriage. In general, any sort of sex in which procreation was impossible (anal, oral, homosexual) or even made difficult (by means of withdrawal, for instance) was regarded as "against nature." Although other factors were not entirely excluded, strictures regarding marital sex reflected the predominance of procreation to the exclusion of other factors. Couples were not supposed to have sex when the woman was already pregnant, since the sexual act could not possibly produce children. Men were supposed to be on top during the act in part because of the belief that if the woman was on top, the man's seed would spill out, preventing conception. As long as procreation was the aim and a reasonable expectation, sex was permissible.

Procreation as the goal did not eliminate the understanding that sex was an important form of marital intimacy. From St. Paul and medieval theologians, early modern Europeans inherited the concept of the marriage debt, which was seen as a crucial element in the maintenance of marriage. Tensions over the marriage debt are manifest in the extensive discussions about mutual obligation and exceptions to it. While both partners were expected to provide sex on demand, most assumed that men would be more demanding, despite the widespread cultural belief that women were the lusty sex because of their inferior capacity for reason. The marriage debt was enforceable, but it also could be evaded. Women resisted unwanted marital sex by observing church-defined days and periods of abstinence. Three days of abstinence were required on either side of participation in the sacrament of Communion. The penitential season of Lent was a period of sexual abstinence. Sexual relations were also forbidden before a woman was blessed by a priest after childbirth in a "churching" ceremony. These evasive strategies functioned in effect as birth control and supported the cultural climate that regarded sex as inferior to chastity and devotion to God.

Sex and medicine. Medical knowledge about sex was largely organized around procreation. The understanding and treatment of diseases of both men and women centered around making certain that their bodies were properly balanced for insemination, conception, and pregnancy. Ancient medical authorities remained a significant source of (often dubious) knowledge about sexuality in the early modern period. Greco-Roman humoral theory continued to dominate thinking about conception and pregnancy, with women described as cold and wet, while men were dry and hot. Following Galen in particular, early modern medical practitioners believed that failure to conceive was often the result of an imbalance in the fluids—blood, black bile, bile, and phlegm—that corresponded to the humors (hot-wet, cold-dry, hot-dry, and cold-wet, respectively). Medical intervention for complaints such as irregular menstrual cycles, improper configuration of the womb for conception, and lack of sperm of the proper consistency and potency was organized around making certain that the humors were properly balanced within each partner and between the partners. While historians have been careful for lack of direct evidence, Roy Porter and Lesley Hall have argued that sex advice was used both positively and negatively. An explanation of the best conditions for conception, for instance, implied that the converse might prevent conception. Advice to prevent miscarriages by avoiding spicy foods, heavy lifting, and jumping suggested what exactly to do in order to induce a miscarriage.

Humoral theory was combined with assumptions about gender hierarchy inherited from the ancients as well. From elaborate potions and poultices to reminders that women should lie on the right side and avoid sneezing after intercourse, advice manuals, herbal recipe books, and medical texts were replete with ways to facilitate conception. Since Aristotle had defined male qualities as superior, and because men were generally considered more valuable and of higher status than women, many questions about sex revolved around making certain that proper humoral balance would result in male children. Failure to conceive, in the Aristotelian tradition was entirely the woman's fault, but popularizers of medical knowledge in the Renaissance were not so certain. Experts contended that factors such as uterine environment, physical conditions during intercourse, and frequency of intercourse could influence the biological sex of the child. While medical writers such as Laurent Joubert (Erreurs populaires [1578; Popular errors]) and Giovanni Marinello (Delle medicine partenenti all'infermità delle donne [1563; Medicine for the infirmities of women]) debated who was responsible for the biological sex of the offspring, they accepted the Aristotelian claim that only men produced seed thought to produce the infant's soul. Women were thought to provide only the matter necessary to produce the baby. Others agreed with Galen that women provided a necessary seed of their own that joined with the male seed to form a fetus.

Information about dysfunction was abundant; consensus was not. Consider impotence, a topic of central importance, as family lineages depended on successful reproduction. Causes and cures of impotence, male and female, filled thousands of pages of commentary. Numerous, exceedingly complicated recipes claimed to help men enhance desire, sustain erections, and produce high quality sperm. Following humoral theory quite literally, some thought excessive coldness or dryness in a man caused impotence, and advised adding heat or moisture. If the specified imbalance was corrected and the impotence remained, perhaps the problem was a penis either too short or too long. For the latter condition, the advice was to choose a tall bride. No advice was forthcoming for the man with a small penis. Others looked to the Malleus Maleficarum (c. 1486; The hammer of witches), blaming witchcraft for male impotence. For women too, the range of possibilities was vast. Diets, baths, and douches in a bewildering array were prescribed for sterile women. If these remedies were unavailing, one might try remedies to alter the shape or orientation of the uterus. Issues of sexual mood and timing mattered as well: if the woman was not sufficiently aroused, her seed would not be released. The husband was advised to engage in foreplay to make certain that this did not happen. The air of desperation in the range of remedies was in part because failure to reproduce disrupted social norms. But the remedies themselves—both in their complexity and their vast number—only increased anxiety about sex.

Indeed, the failure of medical authorities to reach consensus contributed to the development of scientific efforts around sexual issues. While physicians like Leonardo Fioravanti in his 1564 Dello specchio di scientia universale (Mirror of universal science) started publicly rejecting the established medical wisdom about sex, others sought to utilize debate to further sexual knowledge. Anatomists, for instance, engaged in controversies, particularly over female sexual anatomy: whether the womb was stationary or mobile; if it could be influenced by smells; whether the hymen existed; and also whether the penis was made of ligaments, muscles, or cartilage. As strictures on dissecting human bodies loosened, such questions could increasingly be answered by reference to empirical evidence. Gradually, such empirical efforts started to replace the medieval and Renaissance habit of fitting observed data into predetermined frameworks formulated by ancient authors and shaped by the need to reconcile pagan knowledge with Christianity.

One key idea that shifted with the development of science was about the relationship of the biological sexes. Thomas Laqueur has argued that medieval Christians generally accepted the Aristotelian hypothesis of one sex—male—with women as inferior and inverted versions of men. Anatomists and physicians beginning in the early modern period increasingly allowed that men and women were sexually distinct. Some contended that men and women constituted two sexes designed to complement each other. This more egalitarian image of sexual biology competed with the older, hierarchical model until the Enlightenment, and even then, remnants of the one-sex model remained. Laqueur's account has been criticized as overly schematic. But as with other aspects of sexual knowledge, the lack of fixity about sexual difference prompted investigations that increased the information available about male and female sexual anatomy.

Disease and adultery. The gradual increase of knowledge about sex and sexuality was slow to allay everyday sexual anxieties and ambiguities. While sex was believed to have positive effects—doctors allowed that sex combated melancholy and stimulated the senses—commentators were in rare agreement that too much sex was harmful. Frequent intercourse supposedly drained a man of his vital fluids, resulted in weak or degenerate offspring, and even caused death. For women, too much sex could contribute to excessive moist, cold humors. There was, however, little consensus on what was meant by "frequent." Similarly, old people were told to avoid sex for the most part, but texts rarely agreed on what constituted "old" and varied on whether sex ought to stop entirely or just happen less often. With the emergence of syphilis in the late fifteenth century, anxiety about venereal disease ran high as well. As the origins of syphilis were unclear, national groups blamed each other for the disease (the French called it the "Neapolitan pox," and the Italians, the "French pox"), and some claimed women who mixed the seed of several men in their wombs were responsible for the disease.

By far the most prominent anxiety was the fear of adultery. Fictional texts, legal tracts, and abundant case law warned that uncontrolled female lust could destroy the household: the wife would exhaust her husband, and then seek her pleasures elsewhere. Early modern commentators maintained the story from Hippocrates that women imprinted what they saw on the child developing in the womb. A woman could get pregnant by any man and pass the child off as her husband's as long as she thought about her husband during intercourse. As the jurist Jacques Buchereau noted in his 1580 commentary on the Institutes of Justinian (Les Institutes imperiales de Justinian), adultery provisions in legal codes typically penalized adultery with confiscation of goods, corporal punishment, and banishment. These penalties weighed more heavily on women, however, because of their more limited resources. Jurists considered the disproportional punishment of women to be reasonable because women could introduce illegitimate offspring into the family lineage.

GENDER ASYMMETRY

That the penalties for male cheating were rarely so severe points to the enormous asymmetry in power relations between men and women where sex was concerned. Seemingly benign manifestations included the tendency to sequester women in the home, with greater seclusion for women of higher socioeconomic status. In Venice, respectable middle-class and noble women left their homes to go to church, but otherwise hardly at all. Lower-class women could move more freely but were often subject to sexual violence. In some Italian cities, gangs of young men raped unprotected women, and isolated peasant women in the countryside were similarly vulnerable to sexual violence. Sexual honor for women centered on chastity and sexual fidelity, while (in addition to factors such as prowess in war) male honor included acquiring and maintaining sexual mastery over women. Sexual insults, even if completely untrue, could destroy a woman's reputation and make her effectively unmarriageable. Slander cases often included disputes over one party calling a woman a whore or a slut. Sexual honor, lost through words or deeds, might be regained if a woman could prove she had been tricked into sexual relations, but generally only if the man married her. Men lost some sexual honor if they were thought to be out of control sexually or if they allowed themselves to be treated as the passive partner. A man who was thought a cuckold was regarded as having failed to control, or worse, having failed to satisfy his wife sexually. These were serious complaints, but where sexual honor was primary to a woman's reputation, it was only one of several components of male identity.

The combination of cultural anxiety, increased availability and spread of information, and lack of consensus about sex figured prominently in the early modern organization of families. Freedom in terms of choosing marriage partners was virtually nonexistent for men, but was especially unavailable for women. As Christiane Klapisch-Zuber noted regarding Renaissance Florence, men defined membership in "houses," or families. This was true throughout Europe, as male family members controlled most aspects of economic, legal, and political life. Women brought goods into the family lineage in marriage, managed the household, and were necessary for reproduction, but the family lineage passed through husbands and fathers to sons, rather than to daughters, who married into other families. One implication of this configuration was the sharp difference in age of marriage: men were often in their late twenties or thirties, while women were usually in their teens when first married. Men had to be relatively secure financially to start a new household, while the desire to be certain of chastity and purity made early marriage more likely for women. Women who survived childbirth were often widowed, and often while still young and with small children because of the age differential at marriage. Whether a woman could remarry was determined by negotiation between her marital family and her family of birth. Especially if she had children, the marital family would try to keep the woman and her dowry within their family, but the birth family might return her to the family home and seek a new marital alliance with another lineage.

The sexual pressures on women were in many ways far more extensive than those on men. A woman could lose her sexual honor even if she was raped, especially if she got pregnant: common belief held that conception was only possible if the woman felt pleasure. Finally, female sexuality was heavily subject to familial strategies organized by male family members, often throughout a woman's life cycle.

DISCIPLINE AND DEVIANCE

Catholics and Protestants alike measured sexual transgressions against a combination of theological and communal standards upheld by church courts, the family, and state institutions. Together these loci of power defined sexual behavior in such a way that non-normative sexual behavior was subject to scrutiny and even criminal penalties.

Catholic theology as confirmed at the Council of Trent (1545–1563) retained marriage and holy orders as sacraments, and the notion that marriage was the best state for those who did not take vows of celibacy remained implicit in Catholic belief. Protestants rejected both holy orders and marriage as sacraments on the grounds that they lacked scriptural warrant, but the main Protestant groups (Lutherans, Calvinists, and Anglicans) continued to emphasize marriage as a means of controlling sexuality. More radical sects (such as Anabaptists) were sometimes persecuted because of their rejection of the dominant sexual mores. Catholic ecclesiastical courts and Calvinist consistory records are among the richest sources regarding regulation of sexuality. Fornication was especially prominent in these records, but issues surrounding marriage, illegitimacy, and sexual violence also appear regularly.

The immediacy of the parish in the life of virtually all Europeans meant that religious courts and strictures had much more influence than state efforts to regulate sexuality, but states engaged in efforts to control sexuality as well. The patriarchal and hierarchical structure of society meant that state legislation and jurisprudence tended to uphold paternal power in matters of sexuality. The most common areas of state intervention were around clandestine marriage, adultery, rape, fornication, and prostitution. Across Europe, parental consent was generally required for marriage. The French monarchy produced a series of ordinances against clandestine marriage, beginning with Henry II's 1556 edict condemning it as a crime against God and king. In 1579, the penalty was changed from disinheritance to death for those convicted of "rapt" (abduction or seduction of a minor for purposes of clandestine marriage). Ordinances in 1639, 1697, and 1730 upheld the state's interest in marriage, utilizing the language of the king's sacred authority, even as the monarchy encroached on areas traditionally reserved to the church and its courts.

State intervention in cases of rape and fornication tended to vary by social status, marital status, and reputation. Seduction of a woman of high status typically received greater penalties than if the woman was of lower status. Virginity raised the stakes, with jurisdictions often willing to force the man either to marry the deflowered woman or provide her with sufficient dowry to enable her to marry respectably. Monetary penalties in many Italian cities were graded explicitly by social status, with the most vulnerable population—female servants—virtually unprotected. State authorities generally did not intervene when men attacked women who were at a comparative social disadvantage.

The efforts of the state with respect to prostitution were often complicated by the mixed inheritance from the Middle Ages and the practical needs of particular jurisdictions. While the church regarded sex as distracting from salvation, it grudgingly allowed unmarried men recourse to prostitutes on the grounds that fornication under controlled circumstances was less sinful than allowing sexual urges to spill over into violence. Because women were regarded as lustier by nature than men, prostitutes were often seen as women indulging their carnal desires. Few recognized the economic pressures on poor women. Many municipalities, moreover, regarded brothels as revenue sources. Brothels and prostitutes were regulated by such measures as special clothing to distinguish prostitutes from "respectable" women, limits on access to prostitutes, and bans on freelance prostitution. As Reformation and Catholic Reformation rhetoric about morality took hold, municipal brothels gradually disappeared, while religious foundations to redeem repentant prostitutes, such as the Convertite House in Venice (founded in 1552) and the Magdalen Hospital in London (founded in 1758), sprang up.

State attempts to control prostitution were generally ineffective. The focus on the prostitute as a fallen moral agent rather than on the economic problems that produced prostitution, combined with the inattention to male customers, ensured that prostitution flourished. The major change resulting from state antipathy was the decline in management of prostitution by women and the rise of the pimp. This made prostitutes increasingly vulnerable to violence and economic exploitation. States often accepted more or less open prostitution in less respectable parts of towns. To satisfy moral crusaders such as the Society for the Reformation of Manners (founded in the early 1690s in London), states engaged in or allowed occasional raids of such areas, but generally allowed business as usual, as long as order was not routinely disrupted. Higher class prostitutes (courtesans) were often prominent culturally as mistresses of kings and courtiers. Vulnerable to the vagaries of favor, such women were hardly subject to state pressure. By the outbreak of the French Revolution (1789), prostitution was much more "illegal" than it had been at the beginning of the Renaissance, but it remained a prominent feature of the sexual landscape.

Cross-dressing, infanticide, and sodomy were also subject to state regulation. While early modern jurists did not use the vocabulary of gender, these crimes were all violations of gender norms. Cross-dressing threatened the social hierarchy that presumed that men and women were in a stable relation to each other by virtue of biology. Men who cross-dressed were deemed effeminate, while women who did so were regarded as unnatural and were pressured to conform. By the eighteenth century, cross-dressing men who frequented private clubs, notably in London, were subject to police harassment and prosecution. Prison terms, fines, and periods of standing in the pillory were often the penalties for those caught and convicted. Infanticide was punishable by death, but lesser penalties (fines, banishment) were often substituted. Women accused of infanticide were regarded as unnatural mothers who violated the primary purpose of their sex. Statutes required unmarried women to declare their pregnancies or risk being charged with infanticide if the baby died. Many women convicted of infanticide had tried to hide their pregnancies with the help of clandestine networks in larger European cities.

Sodomy was more complicated in that it meant a number of things. Sodomy was "sinning against nature," and it encompassed nonreproductive sexual techniques such as masturbation, sex between two men, between human and animal, or between a man and woman in such a way that conception was impossible. Sodomy was associated with weakness, and passive male sodomy was often seen as resulting from a deficiency of proper male gender characteristics. But male homosexual sodomy, as Michael Rocke has argued, was a significant mode of political socialization in Renaissance Florence, and the efforts to prosecute it suggest that it was widely practiced. Officially, sodomy often carried the death penalty, but this seems to have been carried out primarily against socially disadvantaged individuals. By the eighteenth century, the state occasionally attempted to disrupt the meeting places of "sodomites," particularly when pressured by moral crusaders. The social pattern of prosecutions persisted as members of the elite caught in raids were usually fined, while harsher penalties were reserved for poorer men.

While Foucault asserted that sexual identity categories only developed in the nineteenth century, historians such as Alan Bray have argued that the earlier emergence of identifiable homosocial institutions such as "molly houses" (private residences where men could meet other men for sex) created a sense of sexual difference. Where Foucault contended that Europeans thought in terms of sexual acts rather than identities marked by systematic sexual preferences, his critics argue that institutional settings, linguistic practices such as pet names for those "in the know," and sartorial indicators formed basic elements of sexual identity. In the face of official hostility, deviant practices had some organizational structures that made it easier for those who participated in them to recognize themselves as different from the dominant sexual ethos.

THE MEANINGS OF SEX

Both church and state maintained that sex was procreative in purpose, but sex had a number of other meanings. The infusion of classical texts in the Renaissance increased the prominence of secondary meanings. Over the course of the early modern period, these additional ideas threatened aspects of the religious and cultural hegemony of Christianity.

The association of sex with pleasure was not new in the early modern period, but the idea that pleasure was a positive good received several endorsements, beginning in the Renaissance. The revival of Plato, especially by Marsilio Ficino (1433–1499) and his followers, suggested that sexual pleasure was an important aspect of love. Since Neoplatonic theory held that love was the means to salvation, carnal love had a significant role to play. While most Neoplatonists tried to downplay the corporeal elements, every important thinker who advocated Neoplatonic notions of love addressed pleasure as an element of sex and love. Protestants such as Lutherans, Calvinists, and Anglicans allowed that sexual pleasure within marriage created stronger emotional ties between husband and wife. Rather than distracting from salvation, in Protestant thought sexual pleasure facilitated harmonious relations that enabled men and women to focus on matters of grace, faith, and scriptural knowledge. The Protestant rejection of non-biblical sources of doctrine downplayed the ascetic tradition that regarded pleasure as dubious.

The printing revolution was crucial to Renaissance humanism and the Protestant Reformation, but it also played a significant role in disseminating ideas regarding sexual pleasure. Sexual poetry and prose were not invented in the Renaissance, but both the recovery of ancient writers of sexually explicit material such as Catullus and Juvenal and the development of hermeneutical techniques that allowed for new readings of old texts brought the issue of pleasure to the fore. Ovid's Metamorphoses had been read allegorically before Renaissance humanists developed critical techniques to situate ancient texts in context and recover the range of explicit sexual behavior in antiquity. Figures like Pietro Aretino (1492–1556), notorious for sexually explicit poetry and ribald dialogues, took advantage of the openness of humanist culture to ancient sexual ideas and texts. Aretino utilized the print medium to disseminate erotic and pornographic materials, and generations of imitators produced images and texts in the same vein. "Aretino's Postures" (c. 1524)—sexually explicit engravings by Giulio Romano based on ancient images to which Aretino appended even more explicit, very raunchy sonnets—took the "high culture" of humanism and put it in the comparatively accessible format of the cheap print. Often regarded as a precursor to modern pornography, Aretino's work loomed large throughout Europe as the paradigm of sex emphatically devoted to pleasure. Audience demand for explicit sexual material grew to such an extent that novels like John Cleland's Fanny Hill, or Memoirs of a Woman of Pleasure (1748–1749) remained perennial popular sellers despite official censorship.

The valorization of pleasure had proponents whose ideas expanded into a full-scale challenge to Christian orthodoxy, with sexual pleasure as a core element. Libertines as described by Molièreinhis 1665 play Don Juan were amoral and atheistic. The title character married or promised to marry women indiscriminately, and left one as soon as another caught his eye. Don Juan's pursuit of pleasure leads to his death in Molière's play, and more famously in Wolfgang Amadeus Mozart's opera, Don Giovanni (1787). Libertine men who rejected the notion of familial domesticity in favor of homosocial gatherings that celebrated sexual pleasure often also rejected Christian sexual mores. Groups like Sir Francis Dashwood's Dilettanti Society (established in 1732) were organized ostensibly to share research about ancient Greece and Rome. Members of the society undertook to reconstruct the supposed rites of Priapus, a minor Roman deity famous for his oversized, perpetually erect penis. Libertine organizations remained small in size, but their ideas about sexual pleasure in place of marriage and advocacy of pagan sexual ideas over Christian ones impressed and shocked mainstream European society. The fear of libertine influence often made their ideas more prominent because of their shock value.

The early Enlightenment libertines like Dashwood still drew on Renaissance modes of producing meaning. That is, they looked to the ancients for information and for authority for their own ideas. Later Enlightenment libertinism, partly in reaction to the growing popularity and hegemony of sentimental domesticity, advocated most famously by Jean-Jacques Rousseau (Émile, 1762), made a rather different case for libertine sexual ideas. Following the lead of materialist philosophers like the physician Julien Offray de la Mettrie (L'homme machine [1747; Man a machine]), pornographers increasingly described sex through reference to materialist philosophy, which posited that everything, including human beings, was simply matter. The extreme version of this tendency is exemplified in the works of the Marquis de Sade. His Philosophy of the Bedroom (1795) took Enlightenment language about reason and nature to the logical extreme. Any form of pleasure, even if it involved pain or death, was justified as reasonable and natural. Because pleasure was naturally occurring, Sade explicitly rejected any other criteria for evaluating sexual acts. Sade was, and to many still is, outrageous for his exploitative view of human behavior and sexual violence, in part because he effectively yoked sexual pleasure to reason and nature within an Enlightenment intellectual scheme.

The significance of libertine discourse in early modern Europe underscores the shift between the Renaissance and the Enlightenment in terms of the meanings of sex. In keeping with the larger cultural understandings of the production of knowledge, Renaissance advocates of pleasure as a central meaning of sex looked to the ancients. Enlightenment thinkers, generally dubious about tradition as well as religious belief, framed sexual pleasure in terms of reason and nature. Sade's version was extreme to be sure, but the notion that pleasure was a natural part of sex permeated much Enlightenment thinking.

The other side of Enlightenment thinking about sex—the association of sexuality with gender roles in ways that presume men to be sexually aggressive and women passive—has remained more prominent. The Enlightenment inheritance has in fact included both the assumptions about gender roles and the multiple logics that resulted from the application of reason to nature and sexuality. The family, church, state, and science were not replaced by Enlightenment reference to reason, but rationality, largely envisioned on a personal level, shifted assessments of sexual behavior to the individual. Sexuality as a matter of preference or desire could then much more easily be imagined as integral to the self. But modern sexual identity was, and is, clearly built on the structures and habits of early modern European society.

See also Biology ; Divorce ; Enlightenment ; Family ; Gender ; Homosexuality ; Humanists and Humanism ; Marriage ; Medicine ; Pornography ; Prostitution ; Rousseau, Jean-Jacques ; Sade, Donatien-Alphonse-François de ; Sexual Difference, Theories of ; Women .

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Klapisch-Zuber, Christiane. Women, Family and Ritual in Renaissance Italy. Translated by Lydia Cochrane. Chicago, 1985.

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Migiel, Marilyn, and Juliana Schiesari, eds. Refiguring Woman: Perspectives on Gender and the Italian Renaissance. Ithaca, N.Y., 1991.

Moulton, Ian Frederick. Before Pornography: Erotic Writing in Early Modern England. Oxford and New York, 2000.

Porter, Roy, and Lesley Hall. The Facts of Life: The Creation of Sexual Knowledge in Britain, 1650–1950. New Haven, 1995.

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Katherine Crawford

Sexuality

Sexual behavior is behavior that produces sexual arousal and increases the chance of orgasm (Hyde and DeLamater 2003). Sexuality refers to sexual behavior, and the thoughts and feelings the person has in relation to that behavior. Every society controls the sexuality of its members, by embedding it in the institutions of family, religion, and law. The core social arrangement within the institution of the family is the marital relationship. The right to engage in sexual activity is a defining characteristic of marriage in all cultures; at the same time, marriage limits sexuality, separating the couple from all other sexually active adults in the society (Potts and Short 1999).

Contemporary analyses of sexuality emphasize that sexuality is not merely a biological phenomenon whose character is the same across time and space; it is also a cultural construct (DeLamater and Hyde 1998). Who engages in sexual behavior with whom and under what circumstances reflect cultural norms and values; even the behaviors in which partners engage reflect social and cultural influence (Gagnon and Simon 1973). The meaning of sexuality in contemporary society is situated "in a dense network of interrelated categories, including the body, maleness and femaleness, reproduction, sensuality, health, selfhood and so on" (Seidman 1991, p. 3).

Certain constructions are found in most or all societies. "Even in the face of great international diversity, . . . rules for sexual behavior often are found to be rigidly defined, strictly enforced, and ultimately used to uphold heteronormative family relations" (Nagel 2000, p. 114). In other words, sexuality is hetero, marital, and oriented toward reproduction.

Despite this normative framework, there is variation. Sexuality varies in its specifics by culture, by race/ethnicity, and by subgroups (e.g., religions) within society. Within each group, there is a perspective on sexuality. Michel Foucault (1978) refers to a way of thinking and talking about sex as a discourse. The discourse gives meaning to sexual behavior and relationships, and is the basis of norms that are policed by group members. The meaning of sexuality for particular persons reflects the discourses with which they have come in contact.

Cross-Cultural Variations

Social norms and practices related to love, sex, and marriage vary across cultures. A valuable reference is The International Encyclopedia of Sexuality, Vols. 1–4, edited by Robert Francoeur.

The role of the ideology of romantic love varies widely across societies. Love is typically the basis for the formation of long-term relationships in the United States and other Western developed societies. Love is less relevant or irrelevant to mate selection in Iran, China, and many South American and African societies (Francoeur 1997). In these societies, especially in rural areas, marriages are influenced or arranged by parents, based on the interests of families, clan, and class. This variation has been interpreted as reflecting an independence-interdependence dimension. Cultures that emphasize the individual and his/her goals encourage mate selection based on individual attraction and love, whereas cultures that emphasize the person's dependence on the collective or family will encourage arranged marriages (Hatfield and Rapson 1996). Societies experiencing westernization, such as Russia and urban areas of China, appear to accord increasing emphasis on love. The acceptance of romantic love as a basis for mate selection appears to be associated with greater sexual permissiveness, the acceptance of sexual intimacy before marriage, and with a single standard for the sexual behavior of both men and women.

The meaning of sexual behavior also varies across societies. The dominant discourse in some societies defines sexual activity as an important means of fulfilling the person's emotional and physical needs. This perspective places great value on the person's sexual satisfaction. This leads in turn to a concern with foreplay and the occurrence of orgasm for both parties. In such societies, there will be a concern with sexual technique, and perhaps the development of goods and services to enhance sexual pleasure. This pattern is observed, for example, in the United States, Sweden, Mexico, and urban areas of Russia. In other societies, such as China and Iran, the discourse that defines sex as procreative persists. Sexual behavior is primarily vaginal intercourse, often with little or no foreplay, and perhaps therefore painful for the female.

Finally, there is variation across societies in the social organization of long-term relationships, especially in whether lifestyles other than marriage are accepted. In some societies, the only acceptable arrangement is marriage. In Iran, for example, most young people live at home until they marry, and mothers of the bride and groom live with the newly married couple, exercising continuing surveillance over their behavior. This leads to infrequent and hurried sexual interactions. (Drew 1997). In other societies, cohabitation is accepted as a prelude to marriage; these are societies, like the United States, where couples can be economically independent and have access to housing. In Sweden, most couples live together before marriage, and most marry. There seems to be great flexibility in Mexico, where marriage may be civil, religious, or both, cohabiting is an alternative to marriage for some couples, and men with sufficient economic resources may have a second family, supporting a second woman and their children.

The Ideology of Romantic Love in the West

The understanding of contemporary sexuality is enhanced by reviewing the changes that have occurred in views of sexuality, love, and marriage in Western developed societies since the Victorian era. In the 1800s, sexuality, love, and marriage were seen as distinct and separable experiences. Between 1880 and 1940, they came to be defined as integrated, with the emphasis on marriage. Since 1940, sexuality has gradually been separated from marriage.

Sexuality was severely repressed in the West during the Victorian era. Both sexual behavior and public discussion of topics related to sexuality were suppressed. Women were thought to have no sexual desire. The only legitimate reason for engaging in sexual behavior was to reproduce, and the only acceptable behavior was heterosexual vaginal intercourse, because only that behavior can result in conception. Furthermore, reproduction was to be limited to married couples; the only acceptable partner was one's spouse. Thus, sexuality was tied to the family, a system of marriage, kinship, and inheritance. Nonprocreative sexual activity was prohibited (Foucault 1978).

One of the first empirical studies of sexuality was carried out between 1885 and 1915 by Clelia Mosher ( Jacob 1981). Contrary to the discourse of the time, most of the forty-seven women who completed her questionnaire reported that they experienced sexual desire and orgasm. Mosher's research shows that sexual behavior may deviate from social norms. Much information about sexuality in the past is from written documents, which tend to reflect norms and not necessarily behavior.

A new construction of love, the romantic love ideal, gained currency in the West during the nineteenth century (Lantz, Keyes, and Schultz 1975). This ideal includes five beliefs: (1) love at first sight; (2) there is one "true love" for each person; (3) love conquers all; (4) the beloved is (nearly) perfect; and (5) one should marry for love. The growth of this ideal can be seen in the increased number of references to it in popular magazines from 1740 to 1865. This ideal encourages people to marry for love.

At the beginning of the twentieth century, another change in construction occurred, the sexualization of love. Eroticism came to be seen as an appropriate basis for or component of love. People who were in love were expected to be sexually attracted to each other (and people who were sexually attracted to each other were expected to be in love). Sexual gratification became a goal of romantic relationships. "Mutual sexual fulfillment was intended to enhance intimate solidarity in a social context where other unifying forces (e.g., kinship, patriarchy, economic dependency) were losing their power" (Seidman 1991, p. 2).

These changes reshaped marriage. "Duty, moral character, personal sacrifice, and spiritual union were fast losing their appeal as the defining characteristics of . . . the conjugal relationship" (D'Emilio and Freedman 1988, p. 265). Instead, men and women sought happiness and mutual sexual gratification. Closely related was the gradual acceptance of sexual interest and motivation in women, at least within the marital relationship. The effect of these changes was to increase the expectations of and the demands made on marriage.

During the 1920s, numerous social changes occurred in the United States that both reflected and encouraged these new constructions of love and sexuality. The pursuit of love became a major theme in popular culture, especially in magazines and films. Young people gained autonomy and financial independence, which they used to create their own culture. Erotic themes and expression in art, music, and film created a new, more open public discourse. A popular, if minority, view uncoupled sexual behavior from marriage. Sexual expression was seen as legitimate in its own right. This view led to the creation of new types of relationships and lifestyles. These changes were not universally accepted; there was and is continuing support for the old discourse that limits sexual behavior to marriage.

The institution of dating was established during the 1920s and 1930s in the United States, primarily by white, middle-class youths in cities (D'Emilio and Freedman 1988). Large numbers of these people came together at work, in schools and colleges, and in leisure settings. With help from advice columns, they developed norms about various aspects of these interactions, especially the extent to which sexual intimacy was appropriate. Necking and petting were generally accepted and practiced. Some observers believe that up to 50 percent of young men and women engaged in intercourse (Smith 1973), although most women had intercourse only with the man they expected to marry (D'Emilio and Freedman 1988). Dating and sexual intimacy gradually diffused to high-schoolage and lower-class youths in cities.

Literature giving advice regarding sexuality, much of it by physicians, has been available since the early 1800s in the United States. In the 1920s, this literature extolled physical pleasure as the goal of marital sexual expression. It provided elaborate instruction in sexual technique (Seidman 1991). Male sexuality was portrayed as quickly aroused and physical in nature, whereas female sexuality was slowly aroused and diffuse. Since simultaneous orgasm was the goal, the male was instructed to exert self-control and engage in the elaborate foreplay necessary to arouse his wife. If a couple did not experience mutual fulfillment, this was attributed to poor technique, and at least implicitly was the man's responsibility. This demonstrates the effect of beliefs about gender on public discourse about sex within marriage.

These major changes in the construction of marriage, love, and sex in the United States from 1850 to 1940 increased the demands on the marital relationship; in addition to the traditional expectations, husbands and wives were now expected to love each other and to provide mutual sexual gratification. Falling out of love or failing to experience sexual gratification were defined as problems. These problems became the bases for seeking help (from books, marriage counselors, or sex therapists) or for divorce.

Changing Views of Sex

Social constructions of sex continued to evolve throughout the twentieth century in Western societies. The pioneering surveys conducted by Alfred C. Kinsey and his colleagues (Kinsey et al. 1953; Kinsey, Pomeroy, and Martin 1948) found widespread premarital and extramarital sexual behavior among both men and women. This challenged the popular view that women were not interested in sex, or less interested in it than men. The work of William Masters and Virginia Johnson (1966) demonstrated that the processes of sexual arousal were similar for men and women, in contrast to the earlier view that they were different. These findings led to what has been termed the "eroticization of female sexuality" (Seidman 1991), the view that men and women were equally erotic. However, there are some gender differences in sexual behavior. Surveys in the United States (Smith 1991), Britain ( Johnson et al. 1994), and France (Spira et al. 1992) find that men report a larger number of sexual partners than women, both lifetime and in the recent past. Studies also find that men are more accepting of sexual activity in casual relationships than are women (Oliver and Hyde 1993).

A major change in the discourse about sex is the uncoupling of sex from marriage. As sexual gratification became accepted as an end in itself, people began to challenge the belief that intimate sexual activity should be limited to marriage. A liberal discourse emerged, which argued that sexual intimacy involving consenting people who are not married nor planning to marry is acceptable. In the 1970s, some argued that extramarital sexual intimacy is acceptable if the spouse approves (O'Neill and O'Neill 1972). This discourse led to expansion of available sexual lifestyles, including nonmarital relationships, cohabitation, and open marriage.

Since the mid-1960s, in the United States and elsewhere in the West, a minority discourse has developed that separates sex from love. According to this view, engaging in sexual intimacy for physical pleasure, or to express affection for one's partner, is legitimate. This discourse is the basis of a best-selling sexual advice book of the 1970s, The Joy of Sex (Comfort 1972), and its sequel, The New Joy of Sex (Comfort 1991). This discourse views male and female as essentially equal in sexual potential and in the right to sexual gratification. It challenges the double standard that sexual intimacy outside marriage or a committed relationship is acceptable for men but not for women. This discourse is consistent with the view that sex need not be limited to heterosexual couples. Thus, it facilitated the movement toward acceptance of casual heterosexual and homosexual contacts and living in committed gay and lesbian relationships.

The most visible change in the United States and other Western cultures since the mid-1970s is the increasing explicitness of public discourse about sexuality. Explicit sexual representations are found in newspapers, magazines, novels, and films. The individual's desire for sexual fulfillment is used to sell lipstick, colognes, beer, clothing, travel, and automobiles. Personal advertisements, singles magazines, and dating services cater to the desire to find the (nearly) perfect spouse or the perfect sexual partner. The sex industry provides lubricants, vibrators, erotic clothing, and explicit videos to people seeking sexual fulfillment. Thus, stimuli associated with arousal are almost everywhere, creating a culture in which the sexual is ever-present. This sexualization of the culture undoubtedly contributes to the occurrence of sexual activity in places and among persons formerly prohibited.

The Social Organization of Sexual Relationships

Scientific knowledge about and research on sexuality have developed since 1950. Data on the sexual behavior of various groups have been obtained via surveys, often using self-administered questionnaires. However, the samples surveyed often do not represent the population as a whole and thus yield biased results. The bias is typically in the direction of inflated estimates of sexual behavior.

A variety of sexual lifestyles are evident in the late twentieth-century United States. Data from the National Health and Social Life Survey (NHSLS) (Laumann et al. 1994), based on a representative sample of persons aged eighteen to fifty-nine, indicates that 24 percent (29% of men, 20% of women) are single and never married. Some persons in this group intentionally choose this lifestyle and affiliate with the singles' subculture; others have been unable to form a live-in relationship. Twenty-five percent of this group had no sexual partners in the preceding year, whereas 9 percent reported five or more partners in the preceding year. Number of partners is negatively related to age; older men and women are much more likely to report having no partners.

Seven percent of the respondents were cohabiting (living with a person of the other gender). Most cohabiting couples (94%) expect sexual exclusivity and some consider themselves married; several studies report, however, a higher rate of infidelity among cohabitors, suggesting lower levels of commitment compared to married couples (Treas and Giesen 2000). A few cohabitors report no sexual partners, in other words, no sexual activity, in the past year.

A relationship with a same-gender partner was reported by 2.7 percent of the men and 1.3 percent of the women. Survey data suggest that 40 to 60 percent of gay men and 45 to 80 percent of lesbians are involved in a steady romantic relationship (Patterson 2000). Limited data suggest that members of lesbian couples are as faithful as members of heterosexual couples, whereas gay men are less likely to be monogamous. Regardless, both gay and lesbian couples report levels of satisfaction with their sexual relationships that are as high as married and cohabiting couples.

Almost 54 percent of the participants in the NHSLS were married. Virtually all of these persons expect the partner to be faithful, and most are; only 4 percent of the married respondents reported more than one partner in the preceding year. Data from the National Survey of Families and Households indicates that the average couple engages in sexual activity 6.3 times per month (Call, Sprecher, and Schwartz 1995). According to the NHSLS, 95 percent of the married men and women engaged in vaginal intercourse the last time they had sex. Sexual behavior within marriage became more diverse between 1940 and 1990. Compared to the data reported by Kinsey and his colleagues, subsequent surveys (Blumstein and Schwartz 1983; Johnson et al. 1994) have found that married persons are more likely to engage in oral-genital activity and that they use positions other than man-above during intercourse. The incorporation of these practices into sexual expression reflects acceptance of the belief that sexual activity should be pleasurable for both men and women. Although marriage sanctions sexual intimacy, not all married couples are sexually active; 2 percent of the married respondents in the NHSLS reported no sexual intimacy in the past year. If one broadens the definition of a nonsexual marriage to engaging in sexual intimacy less than ten times per year, 20 percent of the couples in the NHSLS would be in the category (McCarthy 1999); such infrequent physical intimacy may threaten the marital bond.

Fifteen percent were separated, widowed, or divorced. Forty to 58 percent of these persons reported one sexual partner during the preceding year, suggesting an on-going relationship. One-third of these people reported no sexual partner in that period, with the number increasing sharply for older respondents.

Among married couples, there have been studies of the impact of normative transitions on sexual expression and satisfaction. The transition into a marital or live-in relationship may be associated with an increase in the frequency and variety of sexual expression. This reflects both the social legitimacy of sexual activity in these relationships and the opportunity afforded by ready access to the partner. Several studies report that frequency of activity is high in the first three years of marriage (the honeymoon effect), and then declines; the decline probably reflects habituation to the partner and the couple's sexual script (Call, Sprecher, and Schwartz 1995). A similar effect has been noted following remarriage. A normative transition experienced by many couples is the transition to parenthood, via birth or adoption. Research on heterosexual couples indicates that pregnancy and the birth of a child is associated with a reduced incidence of sexual activity at one month postpartum, and an increase in frequency over the following year; satisfaction with the sexual relationship of both men and women follows the same pattern (Hyde et al. 1996). Many contemporary couples fall in the dual-earner category, creating concern about the impact on sexuality; research utilizing two large samples finds that hours of work per week of one or both persons is not related to sexual behavior or satisfaction with the sexual relationship (Hyde, DeLamater, and Durik 2001). A transition experienced by many cohabiting (both heterosexual and same gender) and married persons is the termination of the relationship; research using data from the NHSLS finds that such persons report an increase in number of partners and frequency of activity during the year following dissolution (Wade and DeLamater 2001).

Conclusion

The connections observed between sexuality and marriage in any society reflect the social constructions of love, sexuality, and marriage found in that society. The individual's experience of love, sexuality, and marriage reflects the public discourse about these phenomena. This experience may result in sexual fulfillment or frustration, marital satisfaction or dissatisfaction, seeking counseling/treatment or engaging in adultery, or divorce. Therefore, the health of the institution of marriage reflects, in part, beliefs about sexuality.

See also:Abstinence; Acquired Immunodeficiency Syndrome (AIDS); Attraction; Circumcision; Cohabitation; Dating; Family Planning; Gender; Gender Identity; Infidelity; Intimacy; Love; Marital Sex; Menstrual Taboo; Sexual Communication: Couple Relationships; Sexual Communication: Parent-Child Relationships; Sexual Dysfunction; Sexuality Education; Sexuality in Adolescence; Sexuality in Adulthood; Sexuality in Childhood; Sexually Transmitted Diseases; Sexual Orientation; Singles/Never Married Persons

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john delamater

janet shibley hyde

SEXUALITY

SEXUALITY, along with race and gender, is an aspect of identity that historians paid relatively little attention to before 1975. Since then, however, it has become a very important topic for historical investigation, albeit one around which considerable theoretical debate swirls. Perhaps more than any other area of historical scholarship, the history of sexuality necessarily involves not only historians but anthropologists, literary critics, classicists, and philosophers. It is impossible to describe sexuality as a topic for historical inquiry in the United States without attending more than usual to historiographical debates, and to larger theoretical questions that encompass multiple disciplines. Regardless of whether one agrees that sexuality itself has a history, the history of sexuality as a topic for inquiry and debate in the late twentieth century is undoubtedly a major event in the intellectual and cultural history of the period. Recent research has demonstrated considerable variation in sexual practices and identities among different racial, ethnic, regional, and class groups even as it has demonstrated the centrality of sexuality to definitions of American national identity.

Indigenous Americans and Europeans

European conquerors and colonists saw sexual practice as distinguishing them from indigenous Americans starting with Columbus's first landing. About 1516, Vasco Nunez de Balboa, an early Spanish explorer of Central America, discovered men dressed as women and fed forty of them to his dogs. In North America and the United States, sexuality has consistently served since the beginning of European colonization as a basis for differentiating among racial and ethnic groups. This is so in the empirical sense that observers noted significant differences among the sexual practices and identity categories available to indigenous Americans, Africans and their descendents, and Europeans and their descendents in America. It is also the case in the sense that Europeans and their descendents have consistently relied on attributions of sexual immorality as justifications for discrimination against racial and ethnic minorities. Thus, sexuality has been a key to American national identity, and a major site for establishing and negotiating differences of power along lines of gender, race, and class, since 1607. The accounts of European observers throughout the Americas from the sixteenth century forward make clear that they could not separate their observations of indigenous sexuality from their European worldview, in which Christian prescriptions for proper gender roles and prohibitions on sodomy played a prominent role.

Consequently, understanding of indigenous and African sexual practices and identities in early America will always remain more partial and provisional than most historical understanding because the vast majority of the sources are highly moralizing or voyeuristic accounts by Europeans that tell us more about the European observers than about those they observed. However, most, if not all, of the indigenous peoples of North America had some institutionalized identity and role for males who wished to adopt a female role, and for females who wished to adopt a male role. Contemporary anthropologists and historians use "berdache" to describe this phenomenon. The specifics of the identity and role that these third-gendered natives assumed varied among tribes. In some instances parallel identities existed both for males who lived as females and females who lived as males, while others only institutionalized males living as females. In some cases berdaches had clearly defined social roles, such as undertaking and other funereal services in the Chu-mash and neighboring cultures around what is now Santa Barbara, California.

Sexual practice served not only to differentiate Europeans from native and African Americans, but as a vehicle for establishing and perpetuating European control over conquered peoples. Troops accompanying Columbus and later Spanish conquerors routinely used rape as one tactic for subjugating native populations. Venereal diseases, along with more well known infections, may have contributed to European dominance of the Americas. The Catholic Church as well as the Spanish and French governments tried to prohibit sexual contact between settlers and natives, but to little avail. French missionaries in Quebec complained that marriages between fur traders and Native women typically produced nativized Frenchmen rather than Frenchified Native women.

British North America

Slave owners routinely assumed sexual exploitation as a lagniappe of ownership. Beginning with the expectations of British planters in the Caribbean, however, North American planters started out relying primarily on male slaves and were slow to recognize the profit potential in slave women's reproduction. Slave sex ratios began to even out in North America during the middle of the eighteenth century primarily because of the fertility of those slave women whom traders brought over. The presence of wives and children helped solidify owners' control over male slaves by creating the threat of retribution against loved ones for the slave's misconduct, even as owners' sexual exploitation of slave women served as further demonstration of male slaves' powerlessness.

Europeans' voyeuristic attitudes toward images of naked, virile Native Americans and Africans as contrasted to supposedly more civilized Europeans, combined with the other deeply entrenched power differentials of slavery, made attributions of sexual prowess and immorality key parts of the racist stereotypes that white Americans consistently used to justify and perpetuate discrimination against black Americans. After slavery, the charge that a black man had raped a white woman was the most reliable way to initiate a lynching. In some senses, black women could enjoy greater sexual freedom than white women, as reflected in the songs and other self-representations of black singers from Bessie Smith to Aretha Franklin. On the other hand, the overwhelming desire for respectability as an avenue to equal opportunity and treatment led many African American leaders to deny black sexuality altogether, creating difficulties for African American lesbian, gay, bisexual, and transgender persons and for efforts to reduce the spread of HIV starting in the late twentieth century.

Puritans strove to confine sexual activity within marriage, but encouraged it there. Changes in sexual practices and expectations contributed to the new sense of American identity in religious and political matters that emerged with the great awakening of the early eighteenth century. Times of political and social upheaval tend generally to reduce the effectiveness of restraints on sexual activity; the American Revolution was no exception. Judged by reports of children born too soon after marriage, premarital sex increased significantly in British North America during the late eighteenth century even as a longer-term shift from a general perception of women as morally weaker than men to a perception that women were sources of moral uplift and instruction for men generally, and especially for sons, took hold during the early national period. Regional variations became more pronounced as the growing distinction between public and private in the commercial north allowed women a measure of power in their homes that predominantly rural women of the south continued to lack.

Birth rates among European Americans remained unusually high in North America and the United States until 1800, at which point they began to drop steadily. In 1900, the birth rate was half its 1800 level, and it continued to fall, dropping below the replacement rate during the Great Depression and rebounding only during the Baby Boom from 1946 to 1964. Although historian Nancy Cott described a nineteenth-century ideal of "passionlessness" for middle-class white women, this notion can easily be overblown. One should emphasize its specificity in terms of race and class. The earliest explorations in the history of sexuality relied primarily on the elite discourse of magazines and marriage manuals. Subsequent research has revealed much greater variation in practice, with significant populations that either disregarded or remained largely unaware of white, middle-class ideals in matters of sexuality.

Birth rates consistently remained higher in the South than in the North and for black than white women. The birth rate decline long preceded significant declines in infant mortality. At the frontier, the birth rate was very low because almost all inhabitants were men. Recently settled areas just behind the frontier tended to have very high birth rates while urban commercial areas had low rates. Thus, race, class, and geography helped to determine the spread of sexual practices that reflected women's demands for increased autonomy, as in the burned-over district of New York and New England, and/or the calculation for middle-class urbanites that children were becoming a long-term cost rather than an asset because of their educational needs. This attitude contrasted with that of farmers, for whom children could provide labor at the earliest possible age.

The late nineteenth century produced both the largest cohort of never-married women in U.S. history and the idea of "voluntary motherhood," according to which women should control sexual activity in marriage as a means of controlling fertility. Although reforming middle-class women's efforts to "rescue" prostitutes dated to the antebellum period, some evidence indicates that voluntary motherhood carried with it a tacit acceptance that men who respected their wives' periodic demands for celibacy in the name of birth control would turn to prostitutes. While it is impossible to establish any clear links, the correlation between never-married women and the reform movements of the Progressive Era suggests that women's sexual relationships with men have political consequences at numerous levels. Whether they had sexual relationships with each other or not, many of the prominent women reformers of the late nineteenth and early twentieth centuries drew strength and inspiration from networks of close women friends. Changes in women's expectations and in men's roles in the new industrial, managerial economy contributed to the development of companionate marriage, more egalitarian and based on the expectation of love and fidelity, as the ideal for middle-class white couples beginning in the late nineteenth century. For many working-class white, immigrant, and African American couples, however, marriage remained as much an economic as an emotional and psychological arrangement.

The Administration of Sexuality

Sexual practice and identity attracted growing attention from the researchers and clinicians of the emerging biological, psychological, and social sciences and related professions during the Gilded Age and Progressive Era. Concerns about women's increased autonomy, combined with fears for the implications of absorbing an enormous number of immigrants, contributed to the pathologizing of intense romantic friendships between women as part of a larger move to connect deviant sexual activity with psychiatric diagnoses. Modern terminology for describing persons in terms of their sexual practices and presumed identities, such as "homosexual" and "heterosexual," emerged after 1870 as part of this new sexological dis-course. Concerns and discussions about the relationship between sexual practice and national identity spread rapidly among professional and political elites. In 1905, President Theodore Roosevelt expressed concerns about "race suicide," because he noted that native-born middle-and upper-class white women typically had far fewer children than immigrant women. He did not notice that the children of immigrants usually adopted the fertility patterns of their new land. In 1917, Congress created for the first time a category to exclude aliens with "abnormal sexual instincts," which would remain in immigration law in varying forms until 1990.

Mirroring Roosevelt, pioneering birth control advocate Margaret Sanger initially linked contraception to radical politics with her newspaper, The Woman Rebel, which she published briefly in 1914. Sanger learned of contraception after working with "Big Bill" Haywood of the Industrial Workers of the World and anarchist Emma Goldman in the early years of the twentieth century. She traveled to France, where she discovered that women routinely practiced contraception. She initially characterized contraception as a form of class warfare in which workers would deprive capitalists of wage slaves. Sanger's agitation accompanied a significant shift in sexual mores in the United States, at least in the major cities, beginning around 1910. Sexual experimentation outside of marriage increased, and popularized discussions of Sigmund Freud's psychoanalytic theories provided a new vocabulary of sexual repression as an omnipresent motivation in human action. Sanger's own career paralleled a general increase in the spread of knowledge about sexuality as both gradually lost their radical associations and the field became more professionalized from World War I on.

World War I precipitated further French surprises for Americans, as military leaders resisted the French solution to venereal disease—inspecting and licensing prostitutes. The large-scale population movements, such as African Americans moving from south to north, and workers generally moving to cities, contributed to the social disruption that created new opportunities for sexual experimentation among many Americans, especially young adults. In this respect as in many others, World War I anticipated trends that would occur on an even larger scale during World War II. The 1920s typically have a reputation as a decade of sexual permissiveness, with women smoking in public and wearing shorter skirts, but the same decade saw the recrudescence of a Ku Klux Klan that policed illicit sexual relationships, especially across racial and ethnic lines, as part of its culturally conservative program to sustain its ideal of American identity. With the onset of the Great Depression, employers including the federal government fired married women in order to create jobs for men. Virtually all couples began to count more closely the cost of each child, driving the birth rate to its lowest point in U.S. history.

World War II

World War II demanded long work hours from parents, leaving them less time to supervise their children. It also inspired some female adolescents to demonstrate their patriotism by bestowing sexual favors on soldiers. The war put large numbers of young adults, mostly men, but many women as well, into sex-segregated military environments and perhaps in large cities, away from parental supervision, for the first time. These changes contributed substantially to increased sexual activity among opposite-sex couples, but also among same-sex couples. At the same time, World War II saw the first use by the U.S. military of psychological tests and diagnoses in order to determine soldiers' aptitude as well as to exclude undesirables, especially lesbians and gay men. The effort largely failed, but it did result in significant punishments for many soldiers who got caught in same-sex activity, which in turn contributed to the growth of postwar lesbian and gay civil rights movements by creating a self-conscious group of veterans who saw their dishonorable discharges as an injustice.

Post World War II

The post–World War II period has seen an explosion of interest in and discussion about sexuality in the United States. The publication of the Kinsey reports on the sexual behavior of males (1948) and of females (1953), with claims that many women engaged in premarital inter-course and many men had at least some same-sex activity, touched off a frenzy of debate and revealed the capacity of the American public to find fascination in information about its own sexual practices. During the red scare of the 1950s, political leaders equated the foreign threat of communism with the domestic threat of homosexuality as part of a general effort to restore "normality" to American life via domesticity. The federal government fired more work-ers for suspicion of homosexuality than for suspicion of communist activity. One fired federal worker, Franklin Kameny, would spend the next thirty-five years fighting discrimination in federal employment and security clearances. The early 1950s also saw the formation of the first two "homophile" organizations, the Mattachine Society and the Daughters of Bilitis, which approached lesbian and gay civil rights as a reformist campaign for respectability through cooperation with psychiatrists and other influential professionals.

Most observers identify the 1960s as a key decade for changes in Americans' sexual attitudes. The anovulent pill became available as a means of contraception, protest on college campuses included resistance to curfews and restrictions on visitation, and theorists such as Herbert Marcuse linked sexual repression to other political problems. Feminists and lesbian and gay rights activists drew inspiration from the civil rights movement to make their demands and their tactics more militant. On the other hand, federal policymakers, lacking historical information about Africans' adaptation of their family forms under slavery and refusing to acknowledge the ongoing effects of racism, claimed that overly powerful black women were responsible for the widespread breakdown of black families.

Late Twentieth Century

From the 1970s onward, sexual practices and identities became major topics of cultural and political debate in the United States. The conservative movement that had coalesced around opposition to communism and support for Barry Goldwater took up lesbian and gay civil rights, the Equal Rights Amendment, and abortion as causes that, in their view, undermined long-standing moral principles that buttressed the American way of life. They pointed to the rising divorce rate, widespread use of sexual imagery in advertising and television programs, and the increasing visibility of lesbians and gay men as indicators of a nation in moral decline. Conservative President Ronald Reagan routinely made statements supporting "traditional" ideals of gender and sexuality, cut off the access to the White House that lesbian/gay civil rights activists had enjoyed during the Carter administration, and steadfastly ignored the new epidemic of Acquired Immune Deficiency Syndrome (AIDS) that emerged during his first year in office, 1981, because the vast majority of victims in the United States were gay men who transmitted the AIDS virus via anal intercourse.

During the closing years of the twentieth century, technological advance spread debates over sexuality into new areas. In vitro fertilization and surrogate motherhood raised legal issues that American institutions proved ill prepared for. The U.S. government granted an asylum request to a woman who feared she would suffer genital mutilation if she returned to her home country. Trans-gender activists, including transsexuals but also others who defied gender norms, struggled for recognition even from the lesbian and gay civil rights movement, much less conventional political and legal institutions. Intersexed persons, born with ambiguous genitalia, began to speak publicly against the medical practice of surgically assigning a sex to such babies at birth.

Sexuality as a Topic for History and Theory

Amidst such political confusion, major scholarly work on the history of sexuality began to emerge. Carroll Smith Rosenberg, Jonathan Ned Katz, Lillian Faderman, Jeffrey Weeks, and John D'Emilio all published important articles and books that explored sexual practice and identity as historical topics between 1975 and 1983. Much the way the African American and women's movements sparked increased interest in African American and women's history, so the increased visibility of the lesbian and gay civil rights movement after 1969 led a growing number of scholars to wonder about the history of sexual minorities. Historical study of sexuality depended on the belief that sexual minorities merited study and that sexuality was as much a historical as a medical or psychological topic. Both the politics of the scholars who conducted the re-search, and the evidence they found, contributed to the conclusion that definitions of sexuality varied not only on their own terms and with respect to gender, but in relation to race and class as well. The Radical History Review published a special issue on the history of sexuality in 1979.

Because of his status as an established scholar in France and his willingness to make provocative claims, Michel Foucault came to overshadow most American scholars during the 1980s and to define the field with volume one of The History of Sexuality, which appeared in English in 1978. Foucault's work has proven more valuable for the conceptual framework it provides than for the empirical claims it makes. It has also provoked considerable intellectual and political debate, with important scholars such as John Boswell dissenting vigorously from the claim for the recent provenance of "homosexuality" and "heterosexuality" as identity categories. Regardless, sexuality as a matter of individual, cultural, and national identity will continue to motivate considerable historical research for the foreseeable future.

BIBLIOGRAPHY

Abelove, Henry, Michele Aina Barale, and David M. Halperin, eds. The Lesbian and Gay Studies Reader. New York: Rout-ledge, 1993.

Bailey, Beth. Sex in the Heartland. Cambridge, Mass.: Harvard University Press, 1999.

Berube, Allan. Coming Out Under Fire: The History of Gay Men and Women during World War II. New York: Free Press, 1990.

Chauncey, George. Gay New York: Gender, Urban Culture, and the Making of the Gay Male World, 1890–1940. New York: Basic Books, 1994.

D'Emilio, John, and Estelle B. Freedman. Intimate Matters: A History of Sexuality in America. New York: Harper and Row, 1988.

D'Emilio, John, William B. Turner, and Urvashi Vaid, eds. Creating Change: Sexuality, Public Policy, and Civil Rights. New York: St. Martin's Press, 2000.

Duberman, Martin Bauml, Martha Vicinus, and George Chauncey, Jr. Hidden from History: Reclaiming the Gay and Lesbian Past. New York: New American Library, 1989.

Foucault, Michel. The History of Sexuality: An Introduction. Volume 1. New York: Random House, 1978.

Gordon, Linda. Woman's Body, Woman's Right: A Social History of Birth Control in America. New York: Penguin Books, 1977.

Howard, John, ed. Carryin' on in the Lesbian and Gay South. New York: New York University Press, 1997.

Katz, Jonathan Ned. Gay American History: Lesbians and Gay Men in the U.S.A., a Documentary History. New York: Meridian, 1976; rev. ed., 1992.

———. The Invention of Heterosexuality. New York: Dutton, 1995.

Peiss, Kathy, and Christina Simmons, eds., with Robert A. Padgug. Passion and Power: Sexuality in History. Philadelphia: Temple University Press, 1989.

Roscoe, Will. Changing Ones: Third and Fourth Genders in Native North America. New York: St. Martin's Griffin, 1998.

Smith, Merril D., ed. Sex and Sexuality in Early America. New York: New York University Press, 1998.

Turner, William B. A Genealogy of Queer Theory. Philadelphia: Temple University Press, 2000.

William B.Turner

See alsoBirth Control Movement ; Gay and Lesbian Movement ; Gender and Gender Roles ; Military Service and Minorities: Homosexuals ; Pornography ; Prostitution .

Sexuality in Adulthood

Since the early part of the twentieth century, sex and sexuality have been crucial elements of both private and public discourse. From the bedroom to the living room to the classroom, from religious venues to the streets, and via television, movies, magazines, and other media, sex and sexuality are prevalent topics.

Although there are many facets of sexuality in adulthood, the available research tends to be focussed on Western countries and white populations. It is important to recognize that other cultures may view this topic differently. The interactions of women and men from cultures other than the dominant Euro-American needs further investigation with an openness that does not deem them to be other, less than, or somehow deviant from the so-called Western norm.

Why has so much stress been placed on sexual performance, satisfaction, and identity? One reason may be that for the majority of people in Western cultures, sex is a life-long interest. Although it may be a life-long interest for most people, what constitutes sex and sexuality can vary considerably (Aiken 1998; Francoeur 1987; Lauer and Lauer 1997). Part of that variation stems from cultural, ethnic, class, religious, cohort, and gender differences. The time period in which people reach adulthood, what they learn from their elders, what they learn from their peers, cultural and religious expectations/norms, as well as gender identity, all influence how people perceive themselves and interact with others as sexual beings. What has helped to form many of these perspectives, in modern times, are social movements and technological advances that have made sweeping changes to concepts of sex and sexuality.

Sexual Revolution

Throughout the nineteenth and onset of the twentieth century, sex was not a socially acceptable topic of conversation (Abramson and Pinkerton 1995; Scanzoni 2000). Sex was seen as a means of procreation. Couples, within the bounds of marriage, engaged in sexual intercourse for the sake of reproduction (Abramson and Pinkerton 1995; Scanzoni 2000; Francoeur 1987; Tuttle 1984). Men could enjoy it, whereas women needed to endure it.

When did sex and sexual interaction become a means of expression and pleasure? According to John Scanzoni (2000), it was not until the 1920s that terms such as necking, petting, and french kissing found their way into the U.S. vernacular. This coincided with the practice of dating. What was new about this practice was that those involved were not necessarily planning to marry the person that they were dating. Couples shared some physical intimacies without the expectation of marriage. Although sexual intercourse, prior to marriage, was still a social taboo, these couples engaged in activities that could be considered foreplay. This meant that women and men were more likely (or at least had the opportunity) to experience, even if to a limited degree, sexual intimacy with someone other than the person they would marry. This is not to suggest that males and females, prior to this time, had never engaged in sexual activities but now many of these activities were more socially acceptable. A girl was not necessarily doomed for life because she engaged in necking with a boy that she was not engaged to, although there was still a double standard as to what was acceptable behavior for boys/men and girls/women (Scanzoni 2000).

The ability to date and explore one's sexuality, to a limited degree, continued in this manner for some time. It was not until the 1960s that there was a dramatic shift in sexual practices among late adolescents and adults (Abramson and Pinkerton 1995). This shift occurred not only in dating practices but in marital sexuality as well. The sexual revolution not only opened the doors for sex outside of marriage, it also liberated sexual practices within marriage (Aiken 1998; Scanzoni 2000; Tuttle 1984). Up to this point, procreation was still the focus of sexual intercourse within marriage. Now a shift in emphasis—or at least an addendum to that focus—became sex for the sake of pleasure. It was to be enjoyed by both men and women. Sexual intercourse no longer had to be the only venue of married sexual expression. Foreplay made its way into the marital sexual domain. Mutual stimulation and oral sex became components of married sexual relationships.

Although the sexual revolution may have been liberating to many, the concept of sex for pleasure also placed a tremendous amount of pressure on married couples and singles alike. Sexual performance was essential to pleasure. Advice columns appeared in a variety of places such as women and men's magazines. In addition, sex therapy became a viable component of marriage counseling. Discussions of sex and sexuality became part of the public discourse.

Women's Movement

Coinciding with the sexual revolution was the women's movement, which urged women to look beyond the bounds of motherhood and housewifery to discover their untapped potential. This potential was to be sought in the classroom, boardroom, courtroom, and the bedroom.

What the women's movement added to the sexual revolution was the concept of women being equal partners in the bedroom. Women no longer had to wait for a man to initiate sex and it was important that the experience be filled with as much pleasure for her as it was for him.

It is interesting to note that the concept of women enjoying sex and the importance of a woman experiencing orgasm is not a phenomenon of either the sexual revolution or the women's movement. In the 1600s it was believed, throughout much of Western Europe, that in order for a woman to become pregnant she must experience orgasm. Just as a man ejaculates sperm it was believed that a woman only releases her "seed" when she experiences an orgasm (Szuchman and Muscarella 2000). Therefore, it was imperative that a man did all that he could to ensure that this happened.

As medical knowledge advanced this concept was disproved. Foreplay and a woman experiencing orgasm were no longer an integral function of reproduction and therefore not deemed necessary. Sexual intercourse once again became primarily a venue for procreation (Szuchman and Muscarella 2000).

Three hundred years later women were demanding, not asking, that sex and pleasure no longer be mutually exclusive or a male prerogative. Sexual intercourse was not to be considered a wife's duty. Women could be the initiator, instructor, and full participant.

This change created further possibilities for sexual activity outside of marriage. For many it was no longer a necessity for a woman to be a virgin when she married. In the past those that "lost" their virginity prior to marriage were considered abnormal, whereas today maintaining one's virginity until marriage may be looked at as aberrant (Scanzoni 2000). Of course these trends are often mediated by an individual's moral, religious, cultural, and ethnic/racial affiliation. This is especially significant as many women delay marriage to build a career. Many women and men may be more reluctant to wait to engage in sexual intercourse until they marry.

In addition to delaying marriage, women are also delaying childbirth. The advent of the pill made it more possible for women and men to engage in sexual intercourse without the fear of pregnancy.

Contraception

There have always been means of trying to prevent pregnancy. From herbal applications to understanding the cycles of the moon and fertility, to sexual positions and praying, men and women have sought to engage in sexual intercourse without consequent pregnancy. Diaphragms, intrauterine devices (IUDs), and condoms have been available for a long time. However, these do not always work, can inhibit spontaneity, and therefore are not always used. It was not until the development of the contraceptive pill that women were able to take real control of reproduction (Abramson and Pinkerton 1995; Francoeur 1987; Montague 1969). Women could be sexually active without worrying about pregnancy. Couples could plan when to have a family and could engage in intercourse without being concerned about the time of the month. Of course a woman had to remember to take the pill for it to be effective. As with diaphragms and condoms it only works if you use it. There was also the possibility of side effects. These had to be taken into consideration when deciding what form, if any, of contraception would be used.

Of course not everyone who is sexually active worries about getting pregnant nor sees sexual activity as a means of reproduction. There is a bias, in Western culture in particular, of viewing sex and sexual intercourse as synonymous (Abramson and Pinkerton 1995; Aiken 1998; Tuttle 1984). The fact that foreplay is the prelude to intercourse is a prevalent notion. But what some may consider foreplay may be the mainstay of sexual expression for others and intercourse does not always involve a man and a woman.

Same-Sex Relationships

Along with the sexual revolution and the women's movement, the advent of the Gay Rights movement brought the notion of same-sex relationships "out of the closet." Women fall in love with and are attracted to women just as men fall in love with and are attracted to men. The Gay Rights movement provided a venue for gays, lesbians, bisexuals, and transgendered persons to meet, discuss issues, and advocate for their rights. These rights have included same-sex marriage and benefits for same-sex partners.

Heterosexual couples often take for granted the social acceptability for them to be openly affectionate. To hold hands and to kiss in public is not shunned. Except for a few localities this is not the case for same-sex couples. Same-sex relationships are part of the modern fabric of sex and sexuality. Within the medical and mental health fields, homosexuality is no longer listed as aberrant or deviant. It is no longer listed as criminal activity, although certainly many people are still persecuted for being openly gay.

Although there are still immense barriers, same-sex relationships have greater potential for flourishing today than in previous years. Although their union is not often recognized legally, it has not deterred couples from forming committed relationships, which often includes the raising of children.

The evolution of sexuality continues over the course of our adulthood. This will include changes that may occur with children, length of a relationship, aging, and health (including prevalence of sexually transmitted diseases).

Children

Although many view children as a blessing and a natural progression or outcome of a committed relationship, they can have a formidable affect on a couple's intimate relationship. Marital satisfaction tends to decrease with the advent of children (Aiken 1998). This fact does not imply that children are not wanted or loved but that their presence can change the nature of an intimate relationship. Focus can shift from we (meaning two) to us (meaning family). In lives that are already complicated by work and social obligations children can take what little time a couple may have reserved for one another. Infants need constant attention and as they get older the demands that children place on parents' time do not necessarily diminish. Although parents may be happy to fulfill the parental role, it can erode the sexual intimacy they once experienced. If a couple wants to enjoy intimacy they must make time for it.

Sexual expression is an important part of communication that must be accommodated (Coltrane 1998; Higgins and Tuttle 1984; Scanzoni 2000). If it was important before the advent of children into their lives, a couple should ensure its continuation. Frequency may decrease but that does not mean that satisfaction and pleasure has to as well.

Length of a Relationship

Often when a couple first gets together there is urgency for sexual expression. There is the thrill of exploration, finding what pleases the self and one another. They make being together a priority. As time passes and there is an increased familiarity and comfort, some of the urgency and intensity may diminish. The majority of studies conclude that sexual frequency decreases the longer a couple has been together (Aiken 1998). These findings include heterosexually married and cohabitating couples as well as same-sex couples (Edwards and Booth 1994; Kurdek 1991). One should not necessarily conclude that the couple's love for one another has decreased because they engage in sexual intercourse less frequently. In fact, studies show that when a couple is in the earlier stages of a relationship sexual frequency is higher than in the later stages regardless of age (Aiken 1998; Edwards and Booth 1994).

Aging

A prevalent stereotype suggests that individuals lose interest in and ability to engage in sexual intimacy once they reach later adulthood (Aiken 1998; Brecher 1984; Higgins and Tuttle 1984; Levy 1994). This stereotype is particularly reinforced in Western popular culture. Television shows and movies ridicule older adults that engage or try to engage in sexual activity. Men have heart attacks because they are too excited and women are grateful that anyone shows an interest in them. Even language connotes this behavior as aberrant. If an older man is sexually interested or active he is called a dirty old man. This is considered so abnormal for women that there is not an equivalent term for older women. Rather the language for older women is sexless. Crone, hag, biddy, and spinster conjure up a picture of one who is sexually unattractive and undesirable.

Sexuality and aging is similar to most aspects of aging (Aiken 1998; Utley 1984). Age does not necessarily change our need or desire to be sexually expressive (Higgins and Tuttle 1984; Kaye 1993; Levy 1994; Willert and Semans 2000). If a couple is in a long-term relationship their frequency may decrease but not necessarily their satisfaction. Many couples find that the mode of expression may change and that with age and length of relationship there is increased intimacy. If sex and sexual intimacy are important aspects in one's life during young and middle adulthood they will continue to be factors in older adulthood (Aiken 1998; Kaye 1993; Levy 1994; Utley 1984).

One aspect of aging that is particular to a woman's experience is menopause. This process, which occurs with age, has also been imbued with myth. Many women are made to feel that because they are no longer able to reproduce they are no longer able to be sexual (Doress-Worters and Siegal 1994). Some women may experience a decline in sexual desire, whereas many others report an increase in desire and activity. There is no longer a concern about pregnancy, children are generally self-sufficient and the postmenopausal woman may even be more assertive in expressing her needs. Changes that women need to pay attention to are a decrease in vaginal lubrication as well as a thinning of the vaginal walls (Doress-Worters and Siegal 1994). These changes can be accommodated through the use of lubricating gels and sexual positioning.

Although men do not experience the same physical changes that women do with menopause they do experience physical changes with age that can affect their sexuality. Erections may not be as firm or last as long, and there may be a longer waiting period between erections (Aiken 1998). Once again these changes can be accommodated by increased manual stimulation and other modes of expression in addition to intercourse.

What can impact sexuality in old age is partner availability and health (two factors that have an impact throughout the lifespan). For older heterosexual women partner availability is a crucial issue (Brecher 1984). Women outnumber men by increasingly larger proportions as they age. The available pool of heterosexual males decreases with age. Many divorced, widowed, and never-married older heterosexual women may find themselves alone and looking increasingly more towards masturbation for sexual gratification (Brecher 1984).

There are certain diseases, health situations, and medications that can have an impact on sex and sexual expression. There are ways to accommodate these changes. Medications can be altered and the way we express ourselves sexually can be changed to accommodate physical limitations. The need for intimacy continues throughout the lifespan. This need does not necessarily change with age. The myths, mentioned above, not only permeate the popular culture but have also seeped into the medical and mental health arena. Children and young adults have venues for getting information about sex but there are few avenues for the older adult. This is not just a matter of life satisfaction but as older adults are one of the faster growing populations being infected by HIV/AIDS it can be a matter of life and death (Lauer and Lauer 1997).

Sexually Transmitted Diseases

Although sexually transmitted diseases are unfortunately not a new concern, the deadly nature of a disease like acquired immunodefiency syndrome (AIDS) is. Certainly one could die from syphilis or gonorrhea if left untreated, but if diagnosed early enough both diseases are treatable. AIDS has had an impact on how and with whom individuals engage sexually. The condom is no longer primarily a means for the prevention of pregnancy. It has become a primary tool in the prevention of AIDS.

The fact of a disease like AIDS has had an impact on the concept of casual sex. Once again heterosexuals and gay male singles may be waiting to be in a committed relationship before being sexually intimate. Fear of pregnancy has been replaced by fear of death.

Other Influences

There are several other factors that influence sexual identity and how it is expressed. Religion, ethnicity, culture, and gender can have an overwhelming effect (Aiken 1998; Coltrane 1998; Francoeur 1987; Lauer and Lauer 1997; Sterk-Elifson 1994). These factors may determine how individuals respond to any or all of the areas mentioned previously. If one is religious what does the religion teach about sexuality and sexual practices? Are birth control, premarital sex, heterosexuality, and/or homosexuality sanctioned? People learn what is expected of them as well as what they are not supposed to do. How they interpret religious teachings can be influenced by their ethnicity and cultural and gender identities (Coltrane 1998; Francoeur 1987; Lauer and Lauer 1997; Sterk-Elifson 1994). This influence is a reciprocal one. Everyone is influenced by many different factors and to different extents.

Conclusion

Human sexuality is an intricate and integral component of adulthood. For most people it is essential for physical and mental well-being. The nature of sexuality has evolved to include the concept of mutual pleasure. Sexual practices are not limited to intercourse regardless of one's sexual orientation. Self-pleasure is also a component of human sexuality. Many people no longer consider masturbation deviant behavior. In fact it is suggested as a means to discover what one finds pleasurable. Oral sex and mutual stimulation are now more common sexual practices both within heterosexual and same-sex relationships. This coincides with the advent of viewing sex as something more than intercourse and something more than a means of reproduction.

Sex and sexuality may mean different things and be practiced in different ways according to a number of influences that people encounter. What is right for one person or group may not be right for another. The majority of people need to be in close contact with other people. They need to touch and be touched. This need does not end simply because they get older.

See also:Abstinence; Adulthood; Assisted Reproductive Technologies; Elders; Fertility; Gender Identity; Incest; Incest/Inbreeding Taboos; Later Life Families; Menopause; Sexual Communication: Couple Relationships; Sexual Dysfunction; Sexuality; Sexuality in Adolescence; Sexuality in Childhood; Sexual Orientation

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phyllis a. greenberg

Sexuality in Adolescence

Research about adolescent sexuality has traditionally emphasized sexual intercourse. Most studies have focused on whether teenagers have had intercourse, how often, and with how many partners. Such simple measures of sexual behavior, narrowly defined as coitus, do not properly acknowledge the varied dimensions of adolescent sexual development. Sexuality, as opposed to sex, includes a wide range of attitudes, emotions, expectations, sexual orientation, and both coital and noncoital behaviors. Although sexual behavior can be distinct and separate from romantic or emotional relationships, they often develop together, and are frequently dependent on each other (Miller and Benson 1999).

Sexual Intercourse Patterns in the United States

As depicted in Figure 1, about 50 percent of girls and 56 percent of boys in the United States age fifteen to nineteen have had sexual intercourse at least once (Alan Guttmacher Institute 1999). Of course the percentages increase dramatically with age. Among fifteen-year-old youths, sexual intercourse experience is still unusual (22% for girls and 27% for boys), whereas more than half of seventeen-yearolds have had intercourse. Among nineteen-yearolds, the large majority (76% of females and 85% of males) are sexually experienced regardless of gender. About 20 percent of teenagers (15% of males and 24% of females) do not have sexual intercourse during their teenage years (Alan Guttmacher Institute 1999). Intercourse among teenagers is most often voluntary but not always welcome. About one in four women report that their first coital experience was unwanted, but the proportion is 70 percent unwanted among those whose first intercourse experience occurred before age thirteen. Adolescent females tend to be involved sexually with young men near their own age: 61 percent have partners who are within two years of their own age, 27 percent have partners who are three to four years older, and 12 percent have partners who are five or more years older. Conversely, teenage males tend to have sexual partners younger than themselves. Among nineteen-year-old males, 76 percent had seventeen- to eighteen-year-old partners, 13 percent had sixteen-year-old partners, and 11 percent had thirteen- to fifteen-year-old partners (Alan Guttmacher Institute 1999). Sexual intercourse is sporadic and infrequent for most sexually experienced teenagers. In one study (De Gaston, Jensen, and Weed 1995), half of sexually experienced teenagers had been involved with only one partner, and many of them reported regrets about not having waited. According to Debra Haffner (1998), 65 percent of adolescent girls and 45 percent of boys felt that their sexual debut occurred too early.

Racial, National, and Ethnic Diversity

Sexual intercourse experience among female adolescents in the United States tends to be comparable to other industrialized nations, below rates of many sub-Saharan African nations, and higher than most Latin American nations. About 81 percent of females in the United States experience sexual intercourse before the age of twenty compared to 81 percent in Germany, 73 percent in France, and 87 percent in Britain (Alan Guttmacher Institute 1998). In sub-Saharan Africa, a higher proportions of female adolescents have sexual intercourse: over 90 percent experience intercourse in nations such as Botswana and Uganda (91%), Burkina Faso, Niger, and Togo (92%), Cameroon and the Central African Republic (94%), Côte d'Ivoire (Ivory Coast) and Mali (95%), and Liberia (98%) (Alan Guttmacher Institute 1998). Females in Burundi and Rwanda differ from other African teenagers, with only 46 percent and 43 percent respectively having intercourse before age twenty. The percentage engaging in sexual intercourse as teenagers seems to be linked with patterns of early or delayed marriage in several of these African nations. In Botswana and Burkina Faso, the percentage who have sex before age twenty is similar, but marital status is very different: 81 percent of female Botswanans first have intercourse as teenagers before marriage, whereas only 25 percent of women in Burkina Faso experience sexual debut before marriage. In Latin American countries, lower percentages of young women are sexually experienced before age twenty than in either sub-Saharan Africa or the United States. From lowest to highest, the percentages are Peru (45%), Mexico (46%), El Salvador (49%), Dominican Republic (50%), Ecuador (51%), Trinidad and Tobago (57%), Bolivia (58%), Paraguay (61%), Brazil (62%), Colombia (62%), and Guatemala (64%) (Alan Guttmacher Institute 1998). Table 1 summarizes percentages of teenage sexual intercourse in select Latin-American, sub-Saharan African, and developed nations (Alan Guttmacher Institute 1998).

Premarital adolescent sexual intercourse varies widely between the various racial and ethnic groups within the United States. In the United States 79 percent of African Americans and 54 percent of Latinos between fifteen and nineteen years of age have had sexual intercourse (Perkins et al. 1998). European-Americans have a much lower rate of sexual intercourse experience (37%) and Asian-Americans have the lowest rate (16%). Among teenagers age fifteen to nineteen years, African-American and Latino teenagers tend to have the earliest sexual debut, greatest number of sexual partners, and highest frequency of intercourse (Perkins et al. 1998). Such findings are explained, at least in part, by racial/ethnic differences in socioeconomic status and other demographic factors.

Relationships and Sexual Activity

Patterns of physical maturation are parallel throughout the world, but the development of sexuality varies dramatically from culture to culture. As seen in Table 1, the timing of marriage and sexual intercourse varies widely. Cross-cultural differences in marriage patterns, courtship rituals and sexual norms are also related to differences in adolescent sexual behavior (Miller and Benson 1999).

Social and cultural norms can either encourage or inhibit romantic and sexual behavior; the cultural context in which sexuality develops is important to the outcomes of that development. Romantic love has been associated more with Western cultures than traditional cultures, but romantic love (intense attraction that involves the idealization of the other within an erotic context, with the expectation of enduring some time into the future) is found in 88.5 percent of cultures ( Jankowiak and Fischer 1994). Despite the prevalence of romantic love, the ways in which it is expressed varies widely. In the United States, sexual behaviors are normatively experienced in dating relationships; that is, adolescents usually first engage in sexual intercourse as part of romantic, dating relationships. Romantic feelings become prominent among adolescents by the mid-teenage years, and for most adolescents, especially females, these feelings are the basis for entry into sexual experience. Casual or nonromantic sexual experiences are also part of the teenage sexual landscape (Miller and Benson 1999). Although the double standard allowing males but not females to pursue purely sexual relationships is disappearing, gender-based differences remain in what is considered most important in a relationship. Females are likely (75%) to first engage in coitus in a relationship they characterize as being serious or steady, whereas males more often report (50%) that their first coitus was in a casual dating relationship. Males choose partners based on physical attractiveness, whereas females tend to associate sex with commitment. Dating relationships tend to follow a natural progression from casual to steady to permanent, although sequential stages have become less predictable in recent years (Miller and Benson 1999).

Noncoital sexual activity. Although adolescent coitus patterns mentioned previously provide important facts about teenage sexual behavior, adolescents usually do not go from being nonsexual to having sexual intercourse. Couples tend to follow a continuum from embracing and kissing to fondling, then petting, and finally more intimate behaviors that include vaginal intercourse (Miller and Benson 1999). Haffner (1998) reported that nearly 90 percent of teenagers say they have a boyfriend or girlfriend and that they have kissed someone romantically. By age fourteen, half of the boys reported having touched a girl's breasts and a quarter have touched a girl's genitals, and 75 percent report heavy petting by age eighteen. As many as half of the adolescents in the United States report experiencing cunnilingus or fellatio (oral sex) (Haffner 1998) with very little known about the percentage who experience sexual behaviors with partners of the same sex. Although most teenagers move through a progression of sexual behaviors, adolescents living in poverty are more likely to move directly from kissing to intercourse. Older teenagers tend to behave more responsibly in romantic relationships, basing relational decisions on mutual feelings, long-term plans, and commitment rather than desire for sexual relations (Miller and Benson 1999). Recent studies also have shown that early age of first romantic relationship is associated with early age at first intercourse (Flanigan 2001). Internationally, little information is available on the noncoital sexual activities of adolescents.

Although the majority of teenagers in the United States follow the patterns mentioned above, some do not. Sexual coercion is one possible explanation of why some move more quickly to sexual intercourse without first developing romantic attachments. About 22 percent of women and 2 percent of men in the United States report being forced into unwanted sexual acts at some time in their lives (Michael, Gagnon, Laumann, and Kolata 1994). Women who have intercourse in early adolescence are much more likely to have been coerced. Three out of four women who first had intercourse before age fourteen, and three out of five of those experiencing intercourse before age fifteen, reported doing so against their will. Having a coerced sexual experience can have long lasting effects on young women. Brent C. Miller and Brad Benson (1999) summarized studies that women who experienced forced sex at an early age also tended to be younger at first voluntary intercourse, less likely to use contraceptives, had more frequent sexual experience, greater numbers of sexual partners, higher incidence of drug and alcohol abuse, and greater risk of emotional problems. Those coerced into early sexual intercourse are also more likely to trade sex for money, drugs, alcohol, or a place to stay. Other research has reported similar outcomes (Miller, Monson, and Norton 1995). These patterns are apparent among African Americans, Latinos/Latinas, and European Americans (Perkins, Luster, Villarruel, and Small 1998).

Correlates and Outcomes

A wide range of factors influence and are affected by the timing and frequency of adolescent sexual activity (Kirby 2001). Neighborhood characteristics, socioeconomic status, parent's marital status, sibling characteristics, sexual abuse, and biological factors all have been shown to be related to teenage sexual behavior (Miller, Benson, and Galbraith 2001). Living in neighborhoods with low socioeconomic status (Ramirez-Valles, Zimmerman, and Newcomb 1998), high disorder or hazards (Upchurch et al. 1999), or in predominantly African-American neighborhoods (Sucoff and Upchurch 1998), is associated with higher risk sexual behavior whereas high neighborhood monitoring and high neighborhood religious practice are associated with lower sexual risk behavior.

High socioeconomic status of parents most often has been found to be associated with lower risk of having had intercourse and later sexual debut for adolescents (Taris and Semin 1997; Ramirez-Valles, Zimmerman, and Newcomb 1998; and Upchurch et al. 1999). Kathleen E. Miller and her colleagues (1998) found no relationship between family income and teenage sexual behavior and other investigators reported mixed results; parents socioeconomic status was related to lower risk for teenage pregnancy among Latinos and higher risk for African Americans.

Brent C. Miller and colleagues (2001) also reported that in most studies, living in other than a two-parent home (e.g., single parent, step, divorced, or other nontraditional family setting) is associated with increased risk of adolescent sexual intercourse. Miller and Benson (1999) reported that this trend was less evident among African-American and Latino samples. Also, having sexually active, pregnant, or parenting older siblings was found to be related to younger sibling's more risky sexual behavior (East 1996; Whitbeck et al. 1999), although this effect may be mediated by a positive sibling relationship.

Several biological factors also predict adolescent sexual behavior, including young age of menarche, high androgen levels in males and females, early pubertal development, and higher free testosterone levels (Miller, Benson, and Galbraith 2001). Miller and colleagues (2001) synthesized research on family factors influencing teenage pregnancy. Across the various studies, parent/child closeness was remarkably consistent in its inverse relationship to adolescent sexual behavior. Measures of parent/child closeness were positively related to at least one of the following outcomes: increased probability of abstinence, later sexual debut, fewer sexual partners, or increased use of contraceptives ( Jaccard, Dittus, and Gordon 1998; Miller et al. 1998; Ramirez-Valles, Zimmerman, and Newcomb 1998; Rodgers 1999; Upchurch et al. 1999; and Whitbeck et al. 1999).

Parental control and monitoring were generally found to be related to decreased probability of sexual intercourse among teenagers (Miller, Benson, and Galbraith 2001). Parental rules, monitoring and presence were related to decreased and more responsible sexual activity (Perkins et al. 1998; Miller, Benson, and Galbraith 2001; Rodgers 1999; and Whitbeck et al. 1999). Les Whitbeck and colleagues (1999) found a mixed outcome by age, with parental monitoring of younger adolescents leading to decreased sexual activity and among older adolescents leading to increased sexual activity. In another study (Rodgers 1999), parental monitoring was associated with lower risk sexual behavior, but parent's psychological control was related to higher risk sexual behavior. Dawn Upchurch and colleagues (1999) also found that intrusive control by parents was linked to increased sexual behavior among teenagers.

The relationship between parent/child communication and adolescent sexual activity is less well understood. Although several studies report that frequent and positive parent/child communication about sex is related to less risky adolescent sexual behavior (East 1996; Miller, Benson, and Galbraith 2001), others report no relationship (Chewning and Koningsveld 1998; Rodgers 1999), and a few even reported a positive association between parent/child communication and riskier sexual behavior in teenagers (Miller, Benson, and Galbraith 2001). These counterintuitive findings could be due to methodological problems of the research.

Parent's values relating to teenage sexual activity are clearly associated with teenager's reported sexual behavior. Recent research shows that teenagers whose parents disapprove of teenage sex are less likely to have intercourse ( Jaccard, Dittus, and Gordon 1998; and Miller, Benson, and Galbraith 2001). Conversely, mothers' permissive attitudes were found to be related to increased adolescent sexual intercourse (Taris and Semin 1997). Parents' attitudes alone are not responsible for this effect, because some studies suggest that adolescents' perception of their parents' attitudes is more important than the parent's actual attitude.

Conclusion

Much of the interest in adolescent sexual intercourse is driven by several of its serious consequences, including sexually transmitted diseases (STDs), unwanted pregnancy, and birth. The rate of sexual intercourse among teenagers varies a great deal between cultures. Even within the United States there is considerable variation according to age, socioeconomic status, geographic location, and race/ethnicity. Most of these differences can be attributed to a wide range of biological and social factors. Rates of sexual activity among teenagers leveled off in the United States during the 1990s, and teenage pregnancy declined, a fact that is partially attributable to less teenage sexual intercourse and an increase in the use of contraceptives among sexually active adolescents (Flanigan 2001). Adolescent sexuality is less often studied than sexual intercourse. As a result, the wide range of noncoital sexual activity that adolescents experience is less understood. Continued research can create a better understanding of sexual activity and the factors that influence it, and provide a scientific basis for policy to more effectively encourage responsible sexual behavior among adolescents.

See also:Abstinence; Adolescent Parenthood; Childhood, Stages of: Adolescence; Eating Disorders; Family Life Education; Gender Identity; Incest; Incest/Inbreeding Taboos; Menarche; Nonmarital Childbearing; Sexuality; Sexuality Education; Sexuality in Adulthood; Sexuality in Childhood; Sexual Orientation

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brent c. miller

spencer c. leavitt

Sexuality

OUR VICTORIAN FOREMOTHERS

INVESTIGATING MARRIAGE: NARROWING THE DEFINITION OF SEX

KINSEY AND FOLLOWERS: THE QUANTIFICATION OF SEX

THE SEXUAL REVOLUTION: GAYS, LESBIANS, AND WOMEN

THE GENDER GAP IN SATISFACTION

CONCLUSIONS

BIBLIOGRAPHY

Surveys of human sexuality serve several purposes. They provide reports of sexual norms to supplement information from sources such as media, church, and medicine. They expand the vocabulary for discussing sexual desire and behavior. They offer a unique and fascinating lens through which to examine social trends. Finally, findings from scientific sex surveys provide evidence for public policy initiatives, education, treatment, and funding regarding sexual health and the prevention of sexually transmitted infections.

Nearly 750 sex surveys were conducted in twentieth-century America. These range from massive nationwide investigations to small scholarly studies to questionnaires in consumer magazines such as Redbook, Cosmopolitan, and Playboy. The focus of these surveys ranges widely as well, covering subjects as diverse as marriage, divorce, fertility, contraception, masturbation, intercourse, orgasm, abstinence, gender equality, homosexuality, rape, adolescence, aging, sex education, pornography, and sexually transmitted infections. This entry highlights a few of the large American sex surveys and indicates their contributions and the story they tell about our culture.

OUR VICTORIAN FOREMOTHERS

The earliest American sex survey was a study of forty-five wives by Stanford physician Clelia Mosher (1863-1940), conducted between 1892 and 1912. Mosher’s findings

suggest that women at the turn of the twentieth century may have been much more erotically responsive than the stereotypical corseted, repressed Victorian housewife. In fact, for Mosher’s respondents, marital unhappiness was caused less by wifely frigidity than by sexual desires their husbands were unable to gratify.

In 1929 another female physician, Katharine Bement Davis (1860-1935), surveyed 2,200 women, including unmarried women and lesbian women. Her findings reveal how little sex education was available to women at that time. Although 56 percent of her sample reported that they had had “adequate instruction” before marriage, their responses show that information was limited to anatomical facts and that these women longed for more knowledge about the relational aspects of sex and the “sex emotions.” (Davis 1929, p. 64). Again, these women were more sexually responsive than one might predict of early twentieth-century women. Nine percent of Davis’s respondents reported intercourse daily or more often, some over a span of many years. Many reported sexual fantasies, frequent masturbation, and also mutual masturbation with male and with female partners. One woman reported experiencing sleep orgasms (Davis 1929, p. 359), another said she became “drunk on erotic passages in books” (p. 291), and another reported the ability for spontaneous orgasm, that is, orgasm without physical touch: “I can induce ‘that queer feeling’ almost any time by thinking about it” (p. 191). The sexological literature did not investigate the phenomenology of spontaneous orgasm until more than sixty years later, when researchers Gina Ogden and Beverly Whipple did so (Whipple, Ogden, and Komisaruk 1992).

INVESTIGATING MARRIAGE: NARROWING THE DEFINITION OF SEX

During the 1920s, 1930s, and 1940s, sex surveys were generally conducted by male researchers and funded by universities or government agencies, practices that have continued into the first decade of the twenty-first century. The best-known surveys of this period focused on preserving the institution of marriage—at a time when social values had been disrupted by economic depression, two world wars, and increased independence for middle-class women, who were moving into workplaces traditionally occupied by men. While Davis was conducting her survey, psychiatrist Gilbert Hamilton (1877-1943) surveyed one hundred white, married, “highly cultured” New York couples. His questions were based on assumptions that narrowed the definition of sex and laid down the pattern for subsequent surveys. Some of these assumptions were:

• Sex meant penis-vagina intercourse, whereas romance, kissing, and petting meant preparation for intercourse (hence the notion of foreplay ).
• Sexual satisfaction meant physiological orgasm with vaginal spasms that could be measured.
• Sexual interest was proportional to the number of partners a respondent reported.

Hamilton’s survey did not inquire about physical aspects of sexual response beyond intercourse, or about the emotions or meanings of sex. This and subsequent surveys found men to have more interest in sex than women—more partners, more frequent intercourse, and earlier first intercourse. Women were found to be less interested and satisfied—with some 80 percent anorgasmic on intercourse.

KINSEY AND FOLLOWERS: THE QUANTIFICATION OF SEX

Alfred Kinsey (1894-1956) and his colleagues introduced quantitative methods and random sampling that set the gold standard for all future sex survey methodology. The Kinsey Reports were the first massive investigations of American sexual behavior. Sexual Behavior in the Human Male (5,300 men) was published in 1948. Sexual Behavior in the Human Female (5,940 women) was published in 1953. These Kinsey surveys addressed six “outlets” of sexual response: masturbation, petting, homosexuality, premarital intercourse, extramarital intercourse, and intercourse with animals. Perhaps Kinsey’s best-known contribution was his notion that sexual orientation is not necessarily fixed, but often fluctuates over a range of behaviors and fantasies during the lifespan. He placed heterosexuality and homosexuality on a continuum—using a zero-to-six scale. On this scale, “zero” indicates that sexual desires and behaviors involve only partners of the opposite sex, and “six” indicates that sexual desires and behaviors involve only same-sex partners. Most of us fall somewhere between, said Kinsey—hence a “Kinsey-three” indicates bisexuality.

The Kinsey questionnaires were exhaustive, with hundreds of questions, many doubling back to validate earlier ones. In addition, Kinsey trained interviewers to ask questions that were designed to be nonjudgmental and to minimize yes-or-no evasions. He assumed that all of his respondents had rich sexual experiences. For instance, to explore the still taboo subject of masturbation, Kinsey instructed his interviewers to ask: “How do you masturbate?” rather than “Do you masturbate?” This technique placed the burden of negative proof on the respondents— and as illustrated in the 2004 movie Kinsey, gave permission for even shy respondents to tell eloquent stories.

Far-reaching as these Kinsey questions were, they nonetheless focused on the performance aspects of sex and omitted emotions and meanings, which Kinsey stated had no place in scientific inquiry. For Kinsey, orgasm was the index of sexual health, and number of partners was the index of sexual interest.

Two large random surveys acted as follow-ups for American sexual attitudes in the generations after Kinsey. Morton Hunt’s 1974 survey of 2,026 women and men, Sexual Behavior in the 1970s, was sponsored by Playboy magazine and showed an increase in oral sex and intercourse outside of marriage. Edward Brecher’s (1911-1989) survey of 4,246 women and men, Love, Sex, and Aging (1984), sponsored by the Consumer’s Union, showed that the Kinsey generation, now age fifty and older, was still sexually active.

THE SEXUAL REVOLUTION: GAYS, LESBIANS, AND WOMEN

In 1969 the Stonewall riots in New York City ignited national consciousness about gay rights (Carter 2004). During the 1960s and into the pre-AIDS 1980s, a number of sex surveys focused on gay and lesbian behaviors. Allen Bell and Martin Weinberg (1977) surveyed 4,639 gay men and lesbian women. Their questionnaire, too, was based on performance; the findings suggested that gay men were more interested in sex—as defined by genital stimulation, physical orgasm, and number of partners— and that lesbian women were more interested in romantic emotional commitment. The Gay Report (1979) by Karla Jay and Allen Young surveyed another 5,000 gays and lesbians and came to a more complex conclusion: that lesbians engaged in plenty of sex, but defined it more broadly than gay men did—including love, relationship, and their partners’ pleasure, as well as genital stimulation and multiple partners. In 1983 sociologists Philip Blumstein and Pepper Schwartz corroborated this view in their survey of heterosexual and gay couples—a total of 6,066 individuals. In their report, American Couples, they wrote that lesbians’ reports of sex were usually not genitally focused and that heterosexual men and women diverged on what they considered sexual experience to include.

The changing roles of women were a major focus of this period. Sociologist Shere Hite’s 1976 survey of 3,019 women popularized the notion of clitoral orgasm to challenge the male-centered focus on penis-vagina intercourse. Her findings were criticized by the scientific establishment because her respondents, drawn largely from the National Organization for Women (NOW), were self-selected rather than randomly selected. Nonetheless, The Hite Report became an international best seller as it reflected women’s political and medical advances toward sexual freedom. In 1960 the birth control pill had provided a means of avoiding unwanted pregnancy, in 1973 the U.S. Supreme Court’s Roe v. Wade decision legalized abortion throughout the country, and various sex-positive books for women had paved the way for Hite’s material, especially Our Bodies, Ourselves (1970), Betty Dodson’s Liberating Masturbation (1974), and Lonnie Barbach’s For Yourself (1975).

Hite’s popularity ushered in a boom of further sex surveys by women in the 1980s and 1990s, especially questionnaires in large-circulation women’s magazines. The Redbook Report on Female Sexuality (1977) by social psychologists Carol Tavris and Susan Sadd had over 100,000 respondents—married women, who disclosed “the good news about sex.” Yet these women’s surveys reverted to the usual indicators for sexual satisfaction: interest in intercourse, number of partners (usually heterosexual), and orgasm as goal.

THE GENDER GAP IN SATISFACTION

The last large institutional sex survey of the twentieth century (3,432 men and women) was conducted by Edward Laumann and three colleagues: John Gagnon, Robert Michael, and Stuart Michaels. Published in 1994 as The Social Organization of Sexuality, the survey’s purpose was to research risk factors for HIV/AIDS and other sexually transmitted infections. But the findings harked back to pre-Kinsey surveys that focused on commitment and marriage while downplaying affairs, casual sex, and gay and lesbian relationships. Also like the pre-Kinsey surveys, the Laumann findings underscored the sexual shortcomings of women. The highly publicized statistic that emerged from the Laumann findings is that 43 percent of the women respondents reported sexual dissatisfaction or dysfunction, as distinct from 31 percent of the men. This gender discrepancy in satisfaction was reaffirmed in Laumann’s 2006 survey of 27,500 people in twenty-nine countries and reflected what has become a thematic limitation of sex survey research: focus on intercourse and omission of meaningful issues such as attraction, love, intimacy, and commitment.

In the late 1990s, two large independent surveys were conducted by sex therapists. Their survey questions, largely drawn from their clinical practices, focused on feelings and meanings. Carol Rinkleib Ellison’s 2000 study of 2,632 women, Women’s Sexualities, conducted with Bernie Zilbergeld, underscored the developmental and intergenerational aspects of sex and love. Gina Ogden’s study, “Integrating Sexuality and Spirituality” (ISIS) (2002), showed that for 3,810 American women and men, sexual experience involved emotional, intellectual, and spiritual dimensions as well as physical. Her multidimensional ISIS model is in The Heart and Soul of Sex: Making the ISIS Connection (2006).

Into the first decade of the twenty-first century, however, institutional sex surveys continued to explore intercourse as the primary index of sexual behavior—as evidenced by the fourth cycle of the Guttmacher Institute’s National Survey of Family Growth from 1982 to 2002 (38,000 men and women), which reported that nine in ten Americans engaged in premarital intercourse. But this study did not explore the emotional or cultural dynamics that might help us understand the motivations for premarital sex, or why it is important for us to know about this behavior.

CONCLUSIONS

Sex surveys influence the national conversation about sex, but their definitive value is limited. First, these surveys skew the overall understanding of human sexual experience by omitting significant portions of the population, such as the immigrant, uneducated, and poor, who are also most at risk of sexual violence and disease, and also top echelons of the upper class, who control many of our ideas and institutions. Another limitation of sex surveys is their attempt to reduce sexual experience to numbers, which tends to reinforce stereotypes and assumptions rather than provide the nuanced information needed for assessing norms, medical interventions, and public policy initiatives. Another limitation is researcher bias. Institutional sex surveys, such as the Kinsey and Laumann studies, profess scientific objectivity. But true objectivity is impossible; all sex surveys are effectively prejudged by the questions they ask and by how the results are interpreted.

For sex surveys to expand their usefulness and influence, researchers at the institutional level need to acknowledge the intrinsic complexity of sexual experience and broaden their focus to include feelings and meanings as well as intercourse-related frequencies. In addition, they need to reach populations previously undersurveyed. Perhaps some may be reached via the Internet if the constraints of electronic reporting do not further oversimplify questions, answers, and analysis of results.

SEE ALSO Gender; Gender Gap; Hite, Shere; Kinsey, Alfred; Marriage; Romance; Sexual Orientation, Determinants of; Sexual Orientation, Social and Economic Consequences

BIBLIOGRAPHY

Bell, Allen P., and Martin S. Weinberg. 1977. Homosexualities: A Study of Diversity among Men and Women. New York: Simon and Schuster.

Blumstein, Philip, and Pepper Schwartz. 1983. American Couples: Money, Work, Sex. New York: William Morrow.

Brecher, Edward M. 1984. Love, Sex, and Aging: A Consumers Union Report. Boston: Little, Brown.

Carter, David. 2004. Stonewall: The Riots that Sparked the Gay Revolution. New York: St. Martin’s.

Davis, Katharine Bement. 1929. Factors in the Sex Life of Twenty-Two Hundred Women. New York: Harper.

Ellison, Carol Rinkleib. 2000. Women’s Sexualities: Generations of Women Share Intimate Secrets of Sexual Self-Acceptance. Oakland, CA: New Harbinger.

Eriksen, Julia A., with Sally A. Steffen. 1999. Kiss and Tell: Surveying Sex in the Twentieth Century. Cambridge, MA: Harvard University Press.

Hamilton, Gilbert V. 1929. A Research in Marriage. New York: Lear.

Hite, Shere. 1976. The Hite Report: A Nationwide Study of Female Sexuality. New York: Macmillan.

Hunt, Morton. 1974. Sexual Behavior in the 1970s. Chicago: Playboy.

Jay, Karla, and Allen Young. 1979. The Gay Report: Lesbians and Gay Men Speak Out about Sexual Experiences and Lifestyles. New York: Summit.

Kinsey, Alfred C., Wardell B. Pomeroy, and Clyde E. Martin. 1948. Sexual Behavior in the Human Male. Philadelphia: Saunders.

Kinsey, Alfred C., Wardell B. Pomeroy, Clyde E. Martin, and Paul H. Gebhard. 1953. Sexual Behavior in the Human Female. Philadelphia: Saunders.

Laumann, Edward O., John H. Gagnon, Robert T. Michael, and Stuart Michaels. 1994. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago: University of Chicago Press.

Mosher, Clelia Duel. 1892-1912. Statistical Study of the Marriages of Forty-Seven Women. Microfilm: 1 reel. 1975. Redwood City, CA: Mark Larwood. Originals at Stanford University Archives.

Ogden, Gina. 2002. Sexuality and Spirituality in Women’s Relationships: Preliminary Results of an Exploratory Survey. Working Paper 405. Wellesley, MA: Wellesley College Center for Research on Women.

Ogden, Gina. 2006. The Heart and Soul of Sex: Making the ISIS Connection. Boston: Shambhala.

Whipple, Beverly, Gina Ogden, and Barry Komisaruk. 1992. Physiological Correlates of Imagery-Induced Orgasm in Women. Archives of Sexual Behavior 21 (2): 121-133.

Gina Ogden

Sexuality in Childhood

Because children are naturally sexual human beings, gaining a better understanding of childhood sexuality is important for parents, educators, and developmentalists. However, research in this field has been limited because of a culture that is profoundly ambivalent about human sexuality in general and, more specifically, reluctant to recognize the existence of children's sexuality. In fact, compared to other areas of child development, sexuality is one of the least discussed topics and was wholly unrecognized until Sigmund Freud's (1963, 1965) research in the early 1900s disputed the traditional image of children as asexual beings (Heiman et al. 1998).

Formation of Sexuality in Childhood

Although each child comes to form his or her sexuality in a unique way, there are patterns of sexuality formation common for both boys and girls. At an early age, children begin to form an understanding of the ways that bodies look and function for both sexes, often through a process of body discovery in which children become aware of their bodies as part of themselves and part of their identity (Schuhrke 2000). As children become aware of their own body parts, specifically their genitals, fundamental learning about sexuality begins. During the first year of life, the mouth is the main zone in which children derive pleasure as they associate comfort with feeding and often explore their world by using their mouth as a "third hand." From ages one to three, toilet training becomes the source of sexual information as children frequently come into contact with their genitals through this learning process. Children that are three to six years old often masturbate to gratify their increasing sexual desires although this is not a means of sexual expression at this age but simply a means of deriving pleasure. From ages six to twelve, children often explore their bodies and have a great deal of sexual curiosity even though they may not express their sexuality overtly. However, sexual and obscene language is often prevalent among this age group, a covert signal that this sexual curiosity is present (Renshaw 1971).

Through the early years of childhood, children's understanding of their sexuality focuses on visible body parts and functions, making diapering and toilet training opportune times to speak with children about sexuality and sexual functioning (Couchenour and Chrisman 1996). However, children often receive mixed messages about their sexuality. For example, touching their genitals feels pleasurable, yet they frequently receive negative feedback when exploring their bodies. In providing feedback about genital exploration, parents have a major influence on children's sexuality formation.

Janet Kahn (1985) explains:

Parents play a role in a child's learning about what it means to be a male or female, what are appropriate ways to express intimacy, affection, and other interpersonal or individual emotions, how a child feels about his or her body both in terms of its appearance and its capacities for pleasure and accomplishment, the ideas the child forms about family roles and other aspects of lifestyle, as well as all of the issues related to reproductive and erotic behavior and their social consequences. (p. 262)

Children also begin to recognize the way others evaluate and handle their own bodies and integrate this information into the ways in which they see their own bodies (Schuhrke 2000). Because children learn predominantly through observation, their parents are the conveyers of the messages they receive about sexuality: from how they are touched to what sexual topics are appropriate to discuss to the sexual behaviors that are rewarded or punished (Kahn 1985). Close and nude physical contact with parents brings attention to children's bodies and sparks sexual interest. For example, exposure to nudity within the home and sleeping in the parental bed is correlated with higher comfort levels with physical contact and affection, self-esteem, and sexual activity (Schuhrke 2000), whereas secrecy, disapproval, and inhibition in parents about sexuality may breed guilt in children (Renshaw 1971). Cross-cultural studies have shown that children are not born with sexual guilt or anxieties; they acquire them (Tannahill 1992).

Childhood Sexuality and Later Sexual Behavior

Healthy sexual interactions in childhood set the stage for healthy relationships in adolescence and adulthood. For example, parent-child communication during childhood about sexuality appears to have a significant influence on adolescent and adult sexual behavior. However, much of this communication comes in the form of silence about sexuality, and "one of the clearest messages received by many children from their parents' silence about or discomfort with discussing sexuality is that the issue should not be raised" (Kahn 1985, p. 268). When communication does take place about sexuality, it is often between mothers and daughters with sons getting less sexual information in the home and fathers being almost entirely absent during this type of parent-child communication (Kahn 1985).

Despite the infrequency of communication about sexuality with children, there are many ways in which parental communication with children concerning this issue affects later sexual behavior. Parents have less and less influence on their children's sexual information as children get older but can have a profound effect on children's sexuality if they speak to them when they are younger. Parents who speak to their children about sexuality have a strong influence on the development of their children's values concerning homosexuality, abortion, sex roles, and nudity. Children who feel free to speak to their parents about issues surrounding sexuality are more likely to come to their parents if they are sexually abused and also have an increased ability to resist sexual coercion (Kahn 1985). In addition, if sexuality is learned in the home, intercourse is likely to be delayed, whereas in homes where sexuality is not discussed, early coital experience and promiscuity is more common among adolescents and young adults (Kahn 1985).

Another major factor that influences later sexual behavior is the type and frequency of sexual behavior in childhood. Although negative sexual experiences in childhood, such as those that are not mutual or are painful, may have negative effects on adolescent and adult sexual functioning, positive sexual experiences in childhood, often in the form of sex play, have positive benefits for later sexual functioning. Young adults who reported exclusively positive and consensual sexual experiences before age sixteen reported less anxiety and more current sexual arousal and pleasure than those who had no childhood sexual experiences (Bauserman and Davis 1996). In general, a child's perception of early sexual experiences as either negative or positive, consensual or nonconsensual, is most significant in relation to later sexual functioning and attitudes about sexuality, and the frequency of some early sexual activities is positively correlated with frequencies at later ages (Bauserman and Davis 1996).

Gender Issues

Two key issues related to gender are gender identity and gender roles. Gender identity refers to the ways in which people come to recognize themselves as male or female. For young children, identity as a boy or girl is typically based on clothing (Couchenour and Chrisman 1996), hair length, and toy and game preferences (Byer, Shainberg, and Galliano 1999). For example, Johnny wears pants so he must be a boy, and Susie has a pink coat so she must be a girl. As children grow and develop, however, they often enhance their identities by comparing their bodies with other children's and adults' bodies and learning to more strongly identify themselves with people of their same sex based on the physical aspects they have in common (Schuhrke 2000). Although researchers originally thought gender identity was an inborn, genetic factor, it is now commonly understood that gender identity is greatly influenced by environmental experiences, specifically parental response. Many researchers have also found that the sense of maleness or femaleness a child has is established by the age of three (Renshaw 1971).

Gender roles, as defined by Curtis Byer, Louis Shainberg, and Grace Galliano (1999), are the totality of social and cultural expectations for boys/girls, men/women in a particular society at a particular time in history. Through gender role socialization, culture, conversation, and interactions significantly affect children's ideas about appropriate gender roles (Couchenour and Chrisman 1996). A major source of information concerning gender roles comes from within the home and often involves parents' nonverbal communication, as children are just as likely to learn from parents' behavior and expressions as they are to learn from verbal communication. In many ways, parents nonverbally communicate to their children that males and females are different. One way in which this difference may be communicated is in the ways parents deal differently with sons and daughters. From the time of birth, boys are generally handled more roughly, girls are spoken to more gently, each are given sex-stereotyped toys to play with, and are encouraged to play in different ways with girls playing in small groups and boys playing in larger groups (Kahn 1985). A second way in which gender roles are conveyed nonverbally is through modeling. Parents often demonstrate a differentiation of sex roles in their division of household labor which gives children a "strongly sexdifferentiated view of family life" (Kahn 1985, p. 282). Bettina Schuhrke (2000) asserts that as parents teach their children about sexuality, "they are transmitting expectations of future ability to perform traditional sex roles skillfully and vigorously" (p. 29). Thus, parents repeatedly, though often inadvertently, reinforce the idea that males and females are different and should act according to their prescribed gender roles.

Exploring Sexuality in Childhood

Children often explore sexuality through sex play, for example, by "playing doctor." Sex play refers to sexual peer interactions in childhood that are participated in on a voluntary basis with children of similar age, size, and developmental status (Cavanagh Johnson 1999). This sex play generally takes place among peers (children within three years of one another of similar size and developmental status) and are voluntary experiences (Bauserman and Davis 1996; Byer, Shainberg, and Galliano 1999). Although these early sexual experiences within the context of play tend to be fairly routine, information about sexuality can be gathered from these encounters. Through sex play, children participate in information exchange in which they learn to label their sexual thoughts and functions (Langfeldt 1990). By looking and touching, children start to build an understanding of "what the body looks like, what differences exist between boys and girls, and what it feels like to touch another's body" (Cavanagh Johnson 1999, p. 12). Childhood sex play can also have an effect on later adult sexual functioning as these early experiences can later influence the adults' ability to achieve orgasm and reduce sexual dysfunction because they have learned early on how to manage their sexuality (Langfeldt 1990). If parents are supportive of sex play, children can learn the guidelines for social behavior concerning sexuality in terms of appropriate time and place for expression of sexuality (Langfeldt 1990).

Toni Cavanagh Johnson (1999) explains that children also frequently use their own bodies as a map and have a natural interest in discovering the different functions of their body parts. When children do explore their bodies, they not only learn about their bodily functions but also begin to understand what various people think about sexuality based on their reactions to the child's exploration. These reactions also provide children with rules for physical interaction (Schuhrke 2000). Based on adults' responses to their body exploration, children learn if their behavior is considered "good" or "bad," which will have an effect on the frequency with which they will engage in body exploration.

Another way that children explore their sexuality is through bathroom humor and games in which children begin to learn about the capabilities of their bodies (Cavanagh Johnson 1999). The most common situations in which genital nudity occurs, such as bath times or toilet training, are significant moments in the child's learning process as children discover their parents' or caregivers' openness to nudity and sexuality (Schuhrke 2000). Furthermore, because humor provides information to children regarding sexuality, a good deal of sexual information comes from sexual jokes, stories, and songs (Langfeldt 1990).

Children also gather information about sexuality through the media (Cavanagh Johnson 1999). Books, magazines, videos, and the Internet are all sources of material with sexual content whose messages tend to be indirect, nonverbal, ambiguous, or inconsistent. However, parents and caregivers can turn the discovery of sexual material into a constructive opportunity for sex education.

Conclusion

It is important to note that there are wide differences in the sexual development and interest of children (Cavanagh Johnson 1999). Also, curiosity about sexuality is just part of the whole picture; children are also curious about other parts of the universe. Nevertheless, the more children feel free to explore the characteristics of their bodies and therefore learn about sexuality and body functioning, the easier it may be for them to understand information that is given to them pertaining to reproduction and birth (Schuhrke 2000). Although children's exploration of their own bodies and others' bodies may seem abnormal, body exploration is natural, and curiosity is an important part of any child's sexual development (Schuhrke 2000) and should be accepted and fostered.

See also:Childhood; Gender; Gender Identity; Incest; Incest/Inbreeding Taboos; Sexual Communication: Parent-Child Relationships; Sexuality; Sexuality Education; Sexuality in Adolescence; Sexuality in Adulthood; Sexual Orientation

Bibliography

bauserman, r., and davis, c. (1996). "perceptions of early sexual experiences and adult sexual adjustment." journal of psychology and human sexuality 8(3):37–59.

byer, c.; shainberg, l.; and galliano, g. (1999). dimensions of human sexuality, 5th ed. boston: mcgraw-hill.

cavanagh johnson, t. (1999). understanding your child'ssexual behavior: what's natural and healthy. oakland, ca: new harbinger.

couchenour, d., and chrisman, k. (1996). "healthy sexuality development in young children." dimensions of early childhood 24(1):30–36.

freud, s. (1963). three essays on the theory of sexuality. new york: basic.

freud, s. (1965). normality and pathology in childhood. new york: international universities press.

heiman, m.l.; leiblum, s.; esquilin, s.c.; and pallito, l.m. (1998). "a comparative survey of beliefs about 'normal' childhood sexual behaviors." child abuse and neglect 22(4):289–304.

kahn, j. (1985). "sexual messages: parental influences on children's sexual development." in contemporarymarriage: special issues in couples therapy, ed. d. goldberg. homewood, il: dorsey.

langfeldt, t. (1990). "early childhood and juvenile sexuality, development and problems." handbook of sexology 7:179–200.

renshaw, d.c. (1971). "sexuality in children." medical aspects of human sexuality 5(10):62–74.

schuhrke, b. (2000). "young children's curiosity about other people's genitals." journal of psychology and human sexuality 12(1–2):27–48.

tannahill, r. (1992). sex in history, rev. edition. new york: scarborough house.

sara moorhead phillips

debra l. berke

SEXUALITY

Sexuality as understood by Sigmund Freud is "psycho-sexuality," and should be taken "in the same comprehensive sense as that in which the German language uses the word 'lieben ' (to love)." (1910k, pp. 222-23)

In his clinical work during the closing years of the nineteenth century, Freud noticed how significant a role sexuality played in the mental conflicts of his patients, eventually concluding that it was invariably one of the poles of any symptom-generating conflict. In The Interpretation of Dreams (1900a), he evoked the importance of childhood sexuality solely in connection with neurotics, but beginning with the first edition of the Three Essays on the Theory of Sexuality (1905d) he asserted its presence and its essential role in all children. Thereafter Freud conceived of human sexuality in a broadened sense that included childhood and perverse sexuality. Childhood sexuality had three main characteristics: it was autoerotic, subject to the primacy of erotogenic zones and component instincts, and anaclitically dependent on the self-preservation instincts or ego-instincts.

It would take twenty or so years for Freud to arrive at the theory of the four stages of psychosexual development that we now find in the manuals. Each stage was characterized by the dominance of a different erotogenic zone: oral, anal, phallic, genital. The child was polymorphously perverse in that the primacy of the genital zone and of the relationship to the object was not yet established. The pervert remained fixated in, or regressed to, a subordination to one or other of the non-genital zones, ruled by component instincts. Despite this broadening of the concept of sexuality, Freud continued to define a so-called normal sexuality, reached at the end-point of development and characterized by the primacy of the genital zone and of the relationship to the object. But he had trouble completely detaching normal sexuality from the goal of procreation, something he had been able to do in the cases of infantile and perverse sexuality (see the twentieth of the Introductory Lectures [1916-17a]).

Another point, often insufficiently stressed, is the distinction Freud drew between two currents, the affectionate and the sensual, "whose union is necessary to ensure a completely normal attitude in love" (1912d, p. 180).

The whole of childhood sexuality falls under the rubric of the "Oedipus complex," a term first used by Freud in "A Special Type of Choice of Object Made by Men" (1910h, p. 171), even though he had referred to Sophocles' Oedipus Rex as early as 1897 in a letter to Fliess. The Oedipus complex was at first presented by Freud from the young boy's point of view, and in a simplified form: the little boy is in love with his mother and so becomes his father's rival. In the complete form, bisexuality came into play: the boy also wants to take his mother's place vis-à-vis his father (inverted Oedipus complex). The Oedipus complex of the girl was not in Freud's view symmetrical with that of the boy, for the girl did not experience the tragic conjunction of love for the mother and a rivalry with the father provoking murderous wishes.

A sexuality that could be called perverse inasmuch it activated erotogenic zones other than the genital nevertheless had a place in normal sexuality in the shape of "fore-pleasure." What characterized perverse sexuality proper was the rigidity and exclusiveness of the manner of achieving orgasm.

Until 1920 Freud described mental conflict as a clash between the sexual instincts and the self-preservative instincts, also known as ego-instincts. Beginning with Beyond the Pleasure Principle (1920g), however, a new opposition came to the fore in Freud's thinking, though without eradicating the earlier: that between Eros (life instincts or sexual instincts) and Thanatos (death instincts). This was yet another broadening of the concept of sexuality: Eros—love—sought to hold things together, while Thanatos—death—strove to tear them apart and destroy them. As noted above, Freud gave sexuality the same extension as the verb "to love"; since one side of the conflict is always sexuality, it may reasonably be deduced that all mental disturbance has a connection with sexuality conceived as love, as a tie to an object.

Freud was accused by some of "pansexualism." It is true that sexuality was present everywhere in his theory, yet it was always seen as in conflict with other instinctual forces, so that Freud was surely right to defend himself against this charge.

On the other hand, the issue of the relationship between sexual disturbances and psychopathology is not simple. It is quite possible to encounter dysfunctional sexuality in the strict sense in a person who presents no particular mental symptoms in other areas, while a perfectly satisfactory orgasm may occur in otherwise deeply disturbed individuals. But the libidinal tie and the relationship to the object are always implicated in the organization of the personality and in mental pathology. In psychoanalytic treatment, the transference instates a relationship of libidinal dependence with the analyst that repeats the relationship with parental figures. The transference—the motor of psychoanalysis—may become an obstacle to treatment if it takes a totally eroticized form.

For Freud, then, human sexuality was psychosexual, and individual and cultural ideas played an important role therein; yet in his view it was also biological, and he was certainly not mistaken in this. The object of the instinct is not given with the instinct itself. The history of the individual, which is to say the history of that individual's relationships with his mother, father, and other key people in the entourage, contributes to the constitution of his particular sexuality. Freud wrote that the infant's relationship with the mother who gave it the breast supplied the prototype for the adult's later love relationships. Weaning brought about the loss of the breast as libidinal object, and thereafter the individual would seek to rediscover that lost object. But some infants are not breast-fed, in which case weaning will not have the same character, and may not be so late. The breast has become a metaphor for all bodily attentions from the mother (Donald W. Winnicott), or else as a part-object (Melanie Klein). In language, and for the infant—even an infant which has not been breast-fed—the breast symbolizes the mother, and is an object of desire. Freud seems never to have heard little boys crying because they cannot have breasts like their mother, and he retained only the little girl's penis envy as a mark of the child's confrontation with the anatomical difference between the sexes. Freud's patriarchal and phallocentric assumptions echo his culture, and he was unaware of them. Only rarely do we now see the typical neuroses and disturbances of sexuality that Freud described in his "Contributions to the Psychology of Love" (1910h, 1912d); and when we do, patients usually come from families where they have received a traditional patriarchal upbringing.

Freud never suggested that unbridled sexual activity could remedy sexual and mental problems. Certainly, he at first emphasized the conflict between sexual wishes and the external world, and made "civilized sexual morality" responsible for "modern nervous illness." (1908d). But later on he located the essential conflict—that between the forces of binding and the forces of unbinding—within the psyche. A strong superego, constituted by means of identification with the father as prohibitor of incest—and also (as something of an afterthought on Freud's part) by the mother—he judged necessary not only to morality but also to creativity, to sublimation, that is to say to the inhibition and diversion of strictly sexual instinctual aims. Libido seemed to Freud to be masculine in essence, and he considered the woman's superego—and hence her moral sense and creativity—to be weaker than the man's. Women were destined to passivity, or at least to activities with passive aims. Freud rejected feminist aspirations to equality between men and women.

Colette Chiland

See also: Bisexuality; Death instinct (Thanatos); Female sexuality; Heterosexuality; Homosexuality; Life instinct (Eros).

Bibliography

Freud, Sigmund. (1900a). The interpretation of dreams. SE, 4-5.

——. (1905d). Three essays on the theory of sexuality. SE,7.

——. (1908d). "Civilized" sexual morality and modern nervous illness. SE,9.

——. (1910h). A special type of choice of object made by men (contributions to the psychology of love I). SE, 11.

——. (1910k). "Wild" psycho-analysis. SE, 11.

——. (1912d). On the universal tendency to debasement in the sphere of love (contributions to the psychology of love II). SE, 11.

——. (1916-17a). Introductory lectures on psycho-analysis. SE, 15-16.

——. (1920g). Beyond the pleasure principle. SE, 18.

Further Reading

Chodorow, Nancy. (1989). Feminism and psychoanalytic theory. New Haven: Yale University Press.

Friedman, Robert. (2001). Psychoanalysis and human sexuality. Journal of the American Psychoanalytic Association, 49, 1115-1132.

Kulish, Nancy. (2002). Female sexuality: Pleasure of secrets and the secret of pleasure. Psychoanalytic Study of the Child, 57, 151-176.

Sexuality

Definition

Sexuality can be defined as the quality or state of being sexual. Quite often it is an aspect of one's need for closeness, caring, and touch.

Cancer and sexuality

Faced with a disease such as cancer most people initially lose interest in sex. Sexual desire is overshadowed by concern for one's health. Certain cancers directly affect sexual organs making sexual activity impossible or painful. Chemotherapy , radiation and surgical treatments of cancer can affect sexual activity making it difficult or undesirable. The side effects of cancer treatments such as nausea and pain can lessen sexual desire. Cancer treatments that disturb the normal hormone balance can also lessen desire. Many cancer patients are also worried that their partner may feel negatively about them because of the changes in their body and the fact that they have cancer.

Sexuality can be expressed in many different ways. It is possible to continue a healthy and satisfying relationship and maintain a healthy sexual image even after any changes brought about by cancer. Sexual intimacy can be a source of comfort during treatment and recovery from cancer. This may require some adaptation and change of the patient's current sexual patterns but with the right support groups and encouragement from the partner it should be possible to maintain healthy sexual activity.

Cancer and female sexuality

Women undergoing chemotherapy, radiation therapy , or pelvic surgery may experience pain during inter-couse. This could be caused by changes in the size and moistness of the vagina, or infection of the bladder or vagina. Sometimes the pain is so severe that it sets off an involuntary contraction of the vagina called vaginismus. This contraction makes intercourse impossible. Extra lubrication is necessary to make intercourse comfortable. Vaginisimus can be treated by counseling and special relaxation training.

Radical surgery that will drastically change the physical aspects of the vagina and vulva pose an additional challenge for the affected woman and her partner. The woman may be affected psychologically by the change in appearance and also by the fear of pain or bleeding. The genitals may be physically altered so that sexual intercourse is difficult or impossible. Sex therapy, reconstructive surgery , or altering habits so that sexual needs are met without intercourse all may be options after surgery that radically affects the genitals.

Another common effect of cancer treatment is premature menopause. This may follow removal of ovaries by surgery, suppression of ovaries by chemotherapy or radiation therapy of the pelvis. The symptoms are much more severe than normal menopause causing vaginal dryness and tightness, hot flashes and sometimes low androgen levels which can also reduce sexual desire. Women who do not have hormone-sensitive tumors may want to consider hormone replacement therapy, after consultation with their doctor. Radiation treatment of the pelvis, cervix or vagina may cause scarring of the vagina. This makes it tighter and difficult to penetrate. Series of vaginal dilators of different sizes can help to relieve this problem. It is important to use these early to prevent vaginal shrinkage. Counseling may also be beneficial for the affected woman and her partner.

Cancer and male sexuality

Radiation therapy of the pelvis can impair sexual function. Circulating testosterone levels may come down temporarily and during this time men may have a loss of sexual desire. But this does not seem to be a permanent effect in all cases. It may be possible to get aroused by taking more time and experimenting with different kinds of caressing and love making. If erection does not occur after a significant period of time the doctor may suggest tests to check for sleep erections. Some are take-home tests and if they suggest that erection occurs normally during sleep, it is clear the physiological mechanism is intact and sexual counseling may relieve the problem. Sexual counseling may also be helpful to allow enjoyment with sexual caressing in the absence of erections. Men with medical impotence may also be helped by the use of Viagra. Men need replacement with hormones in only very rare cases. In fact, extra testosterone can cause undetected prostate cancer to grow.

Surgery for various cancers can cause sexual problems. Surgery for bladder cancer can lead to decreased sexual desire, lowered ability to obtain an erection, and less frequent or less intense orgasms. Surgery for penile cancer and testicular cancer can result in decreased fertility and desire, difficulties with erections and orgasms, and decreased volume of semen. In treating prostate cancer, the biopsy obtained to confirm diagnosis may decrease semen levels, and, after a man has had his prostate gland removed (prostatectomy ), he may be unable to obtain an erection. However, new surgical advances and new chemotherapy options may help reduce these effects.

If, during surgery, the blood supply to the penis is affected, the surgeon may take an abdominal artery and try to connect it the penis. This operation is only successful in a quarter of the patients. Penile injection therapy and vacuum devices have been used to produce erections in the absence of sufficient blood flow. Medications that produce erections are risky and may lead to the formation of scar tissue. Vacuum erection devices are safer but intrude in the lovemaking. Medical erection problems may also be treated by penile prosthesis. This is one of the best ways to treat a permanent erection problem.

Sexual problems of specific cancer treatments

Urostomy or colostomy

Before sexual activity one must ensure that the urostomy fits correctly. The appliance should be emptied to reduce the chance of a leak. A patterned pouch can be worn over it to cover it. Sexual activity with a colostomy can be performed with the same precautions. One can plan sexual activity at a time when the colostomy is not active and avoid gas-producing foods that day. Direct communication and reassurances from a loving partner can be extremely helpful.

Mastectomy

The breast symbolizes sexuality and when the treatment of breast cancer involves mastectomy , psychological counseling is helpful to regain desire and sexual enjoyment. There may be fewer problems when a lumpectomy is done. Women who feel awkward about the change after surgery may consider using a prosthesis covered with a nightgown or bra, or they may consider reconstruction either with or without implantation.

Limb amputation

Treatment mainly of primary tumors of bone often includes amputating a limb. If the partners can openly communicate they can decide whether the prosthesis needs to be worn during lovemaking. Prosthesis can help with movement and balance but the straps that attach it can get in the way. If the prosthesis is not used, pillows could be used instead for balance.

Treatment of facial cancer

Some cancers of the head and neck may be treated by partial removal of the facial bony structure. This can be psychologically very damaging as the scar is so public and affects the face, a vital part of the human personality. Following such surgery, speech may also be affected. Recent advances in facial prosthesis and plastic surgery may help regain a more natural appearance and speech.

Professional help for sexual problems

The first step is to discuss sexual problems with one's doctor. Sometimes doctors themselves may not be at ease discussing sexual issues. Cancer centers may have sexual rehabilitation centers with experts on staff comfortable dealing with these issues. Medical schools and some private practice groups run sexual dysfunction clinics that provide comprehensive care to treat sexual problems. Sex therapists can provide sexual counseling. It is important that the sex therapist be a psychiatrist, social worker or psychologist with special training in treating sexual problems. Professional societies such as American Association for Marriage and Family Therapy can give information about these specialists. It is important to avoid untrained people who provide useless and sometimes harmful therapy.

Resources

BOOKS

Bullard, David G. et al. "Becoming Sexually Active Again." Cancer Therapy, edited by Malin Dollinger M.D., Ernest H. Rosenbaum M.D., and Greg Cable. Kansas City, Missouri: Somerville House, 1994.

DeVita, Vincent T., Samuel Hellman and Steven A. Rosenberg, ed. Cancer, Principles and Practice of Oncology. Philadelphia: J.B. Lippincott Company, 1998 .

Sexuality

The full range of thoughts and actions that describe sexual motivation and behavior.

While sex is not necessary for an individual's survival, without it a species would cease to exist. The determinants of sexual motivation and behavior include an individual's physiology, learned behavior, the physical environment , and the social environment.

A person's sex is determined at conception by whether one out of the 23 chromosomes in the father's sperm is either X (female) or Y (male). All female eggs contain an X chromosome, so each fertilized egg, or embryo, has a genotype of either XX (female) or XY (male). Reproductive hormones produced by the gonads (male testes and female ovaries) determine the development of the reproductive organs and the fetal brain , especially the hypothalamus . All the human reproductive hormones are found in both sexes but in different amounts. The principal female hormones are estrogens and progesterone (of which the main ones are estradiol and progesterone); the primarily male hormones are androgens (mainly testosterone). In males, levels of testosterone remain fairly constant, regulated by a feedback loop to the brain and pituitary gland, which control hormone secretion. In females, hormone levels fluctuate within each menstrual cycle, rising at ovulation. Reproductive hormones have two types of effects on the body. Organizational effects, which occur primarily before birth , are irreversible and permanently govern an individual's response to further hormone secretion. Activational effects govern behavior temporarily while hormone levels are elevated.

Human females are born with about 400,000 immature eggs. Each one is contained in a sac called a follicle. When a girl reaches puberty , one or more eggs mature every month, stimulated by the release of a hormone from the pituitary gland. As the egg matures, it secretes the hormone estrogen, causing the uterine lining to thicken in anticipation of the implantation of a fertilized egg. This is followed by ovulation, as the follicle ruptures, releasing the mature egg which travels through the fallopian tube towards the uterus. If the egg is not fertilized by sperm, it disintegrates and the uterine lining leaves the body, a process called menstruation. Women remain fertile until menopause, which normally occurs around the age of fifty. Unlike the production of female eggs, the male production of sperm is not cyclical and men remain fertile throughout their lives, although they may produce fewer sperm as they age. A man produces several billion sperm each year, releasing 300 to 500 million sperm in an average ejaculation.

Unlike that of other species, human sexual behavior is not bound to the female reproductive cycle. Women may engage in or refrain from sexual intercourse at any time during the cycle. Some women have reported increased sexual interest at the time of ovulation, others around the time of menstruation, and still others experience no link at all between their sexual behavior and menstrual cycle. After their initial organizational effects at birth, hormone levels stay low until puberty when activational effects first begin, triggering the reproductive system and generating an interest in sexual behavior. Whether or not sexual activity actually occurs at this point, however, depends on the interaction of physical readiness, social skills, and opportunity. For adults, as for adolescents, sexuality is not governed solely by hormones but also by a repertoire of learned attitudes and behaviors. This learning begins in childhood with the development of gender roles and continues throughout the life span, and it depends on attitudes prevalent in a culture at a given time.

The laboratory research conducted by William Masters and Virginia Johnson in the 1950s and 1960s yielded important information about the human cycle of sexual response. This cycle has four phases for both men and women: initial excitement, a plateau stage, orgasm, and resolution, during which the person returns to a state of relaxation. Males experience a refractory period after orgasm during which they are temporarily insensitive to sexual stimulation.

The same combination of physical, psychological, and social factors that govern sexuality may contribute to sexual dysfunction , any condition that inhibits the desire for, or ability to have, satisfying sexual experiences. In males, the most common dysfunction is impotence, or the inability to have or maintain an erection sufficient for intercourse. While impotence can have physical origins, including fatigue, diabetes, alcoholism, and the side effects of certain medications, it is usually psychological in nature. In females, a common sexual dysfunction is the inability to reach orgasm, also called arousal disorder, which is also associated with such psychological factors as self-consciousness, lack of self-confidence, depression , and dissatisfaction with the nature of the romantic relationship itself.

Although human sexual activity is primarily heterosexual, between 5 and 10 percent of males and 2 to 6 percent of females in the United States are homosexuals, individuals in whom sexual attraction and behavior are directed at members of their own sex. (Persons whose sexual behavior is directed at members of both sexes are known as bisexuals.) Researchers have found evidence of both biological and environmental origins of homosexuality . While no significant differences have been found in the levels of hormones that circulate in the blood of homosexuals and heterosexuals, exposure to high levels of certain reproductive hormones during fetal development has been linked to homosexuality. In addition, anatomical differences have been found between the hypothalamus of heterosexual and homosexual men, and studies of twins have found distinct evidence of a hereditary component to homosexuality. Environmental influences include early family relationships and the modeling of behaviors observed in the parent of the opposite sex, as well as social learning throughout the life span.

Sexual preference—the gender to which one is attracted—is only one aspect of human sexual orientation. Also involved is gender role, a general pattern of masculine or feminine behaviors that is strongly influenced by cultural factors. Distinct from this is sex identity, referring to whether individuals consider themselves to be male or female. Transsexualism, a condition in which a person believes he or she is of the wrong sex, occurs in approximately one in 20,000 in men and one in 50,000 in women. Today, these individuals have the option of a sex change operation that allows them to live as a member of the sex with which they identify.

See also Gender Identity Disorder; Heterosexuality.

Further Reading

Fisher, Seymour. Sexual Images of the Self: The Psychology of Erotic Sensations and Illusions. Hillsdale, NJ: L. Erlbaum Associates, 1989.

Levand, Rhonda. Sexual Evolution. Berkeley, CA: Celestial Arts, 1991.

sexuality This word initially denoted organisms capable of reproducing sexually (thus plants had sexuality), and was applied to things rather than people (humans had sex, a man's spermatozoa had sexuality). Then, early in the nineteenth century, it began to be used to denote a whole nexus of concepts around sexual expression, sexual activity, and sexual powers, detached from the original connotation. In spite of this, it took some time to develop as a concept: for example, the pioneer British sexologist Havelock Ellis entitled his series of investigations Studies in the Psychology of Sex (1897–1928), rather than Studies in Sexuality, which might now seem a more appropriate title.

Freud and Foucault

It was perhaps Freud who gave it its particular modern meaning as a term describing not only the sexual drive as such but the direction which it takes in a particular individual. He distinguished the sexual instinct from the sexual object, arguing that the very numerous instances in which the instinct was not attached to something appropriate — a suitable member of the opposite sex — suggested that the instinct was initially independent of any object. The sexual instinct permitted much variation in the choice of objects it was directed towards, and often also, he pointed out, a considerable lack of discrimination — he cited bestiality as an example. These vagaries, however, were not to be confused with insanity. Sexuality was thus not coterminous with the sexual instinct. Freud was accused of making sexuality too important, allocating it a central place in human motivation and extending its ramifications into areas that many had not previously thought to be sexual. It could, conversely, be argued that he was making explicit an obsession with the importance of sex that characterized his times.

Michel Foucault has famously described sexuality, in A History of Sexuality; Volume I, Introduction (1976), as a system of discourses rather than a ‘given’, that came into existence during the nineteenth century — created, he argued, by the desire to regulate sex, and to define and prohibit certain kinds of behaviour. While Foucault's conclusions are supported by perhaps over-broad and sometimes unsubstantiated generalizations, and the establishment of elegant antitheses with which one might want to contend, he has certainly drawn our attention to the rise of a particular way of looking at and defining sexual matters. Sexuality, in the sense of a personal and idiosyncratic amalgam of drive and direction, central to a person's individuality, was generated out of a perception of sex as a problem, or a series of problems.

Foucault has also forced us to think differently about existing naïve concepts of what sexuality is and does. It is not a force of nature which was repressed during the course of the nineteenth century and then liberated through the breaching of the taboo of silence which had prevented it being spoken about. Rather, it is a nexus of concepts and relationships brought into being through a complex process of naming the forbidden, in order to control and regulate it. And through that process, forbidden desire and behaviours were given names by which they could be discussed and spoken. In fact it was a product of the great nineteenth-century urge to catalogue and classify, mediated by a sense that there was something peculiar, slippery, elusive, and dangerous about the subject. The ‘hydraulic’ view of sexuality as something that can either be dammed up, liberated, or channelled, is thus seen to be just one way of looking at the phenomenon of sex, and one which is, moreover (though Foucault does not make this point) open to the criticism of being heavily dependent upon a male model of sexual functioning.

Towards a plurality of sexualities

With this delineation of ‘sexuality’, as a particular way of looking at or talking about sex created by a particular kind of society during a particular historical epoch, often goes an assumption that previously there was no such thing as ‘sexuality’. There was the sexual instinct, there was lust, there was sin or crime or insanity, but there was not ‘sexuality’ in the sense of the individual's personal and centrally-defining blend of drive and desire. This assumption has been much contested, in particular the corollary that prior to the definition of the homosexual as an individual of innately inverted sexuality, in the late nineteenth century, there was no such thing as the ‘homosexual’ but merely individuals convicted of acts which were defined by the law as sodomy. Historians had demonstrated a strong case for the emergence of something like a ‘homosexual identity’ well before the writings of the sexologists created the category, and in fact these writers based their conclusions on contacts with individuals who already had the sense of their own difference from a norm.

With the rise of feminism and feminist analyses of sex in society, and with the contemporaneous rise of gay studies and theory, the idea of ‘sexuality’ meaning a particular association of sexual desire and its object (hetero or homo) is itself seen as too coarse a definition; it tends to conflate very different kinds of preference and behaviour. Recent feminist, gay, and ‘queer theory’ writers have preferred to talk about ‘sexualities’ rather than sexuality as such. These sexualities may be defined as constructed partly through social means (the provision of roles or scripts for sexual identity and behaviour) and partly on the basis of personal psychological factors.

It thus follows that the notion of some biological basis for ‘sexuality’ is an over-simplistic concept. While there may be (as a current example) some predisposition in biochemistry or brain structure to same-sex attraction, it will be manifested in various ways because of the ways society defines ‘sexuality’. The same predisposing factor at different times and in different cultures, and according to other elements of personal psychology, will be expressed in very different ways — a furtive (married) cottager, a drag queen, an AIDs activist. ‘Sexuality’ is a bundle or a container rather than a reified thing in itself.

Lesley A. Hall

sexuality Sexual differentiation is explained in the creation narratives as part of God's design for humanity. It is good; and it is necessary for the continuation of the race. It is expressed in OT narratives in polygamy (1 Kgs. 11: 1–3), concubinage (Gen. 16: 1–4), and Levirate marriage (Deut. 25: 5–10). Divorce was permissible (Deut. 24: 1–4); homosexual acts were not (Lev. 18: 22). The emphasis throughout was on the production of future generations and the birth of children showed the divine favour (Ps. 127: 3–5). But the Song of Songs is a witness to the worth of erotic love in itself without reference to marriage.

The NT teaching is conditioned by an expectation of the possible end of the world and the consummation of the Kingdom, which lent a negative view on human, temporal relationships which could distract from the imperatives of expectation (1 Cor. 7: 31). However, the Gnostic view that the material world is evil and the body and its passions to be denied is firmly rejected (Col. 2: 20–3; 1 Tim. 5: 23; Heb. 13: 4), but Paul is aware that passions do not have unrestricted moral licence (Rom. 1: 24–7).

585. Sexuality

1. Flowers of Evil, The thoroughly explore the possibilities of vice, depravity, and sin. [Fr. Poetry: Baudelaire The Flowers of Evil in Magill III, 399]
2. Hite Report surveys men’s sexual habits and performance. [Amer. Pop. Cult.: Misc.]
3. Ideal Marriage Van de Velde study of the physiology and technique of marital sex. [Pop. Cult.: Misc.]
4. Joy of Sex, The popular 20th-century sex manual. [Misc.: Dr. Alex Comfort The Joy of Sex in Weiss, 239]
5. Kinsey reports pioneer explorations of sexual behavior based on interviews with 100,000 men and women. [Pop. Cult.: Misc.]
6. Masters and Johnson published a study of sexual performance under laboratory conditions. [Sexology: Masters and Johnson Human Sexual Response in Weiss, 214]
7. Morel, Paul his Oedipus complex makes erotic fulfillment impossible. [Br. Lit.: D. H. Lawrence Sons and Lovers in Magill I, 913]
8. Psychology of Sex, The seven-volume Ellis work revolutionized attitudes toward sex and sexual problems. [Pop. Cult.: Misc.]

Sexuality

Human sexuality encompasses many things. The subject has personal biological implications, social implications, and moral implications. Sexuality involves how people view themselves and behave sexually as well as how their bodies function sexually.

It is important to note that sexuality is viewed differently in different cultures. Certain practices and standards vary from country to country, religion to religion, and culture to culture. Other factors affecting the perception of sexuality, and how people react to it, include age and gender.

In this chapter, sexual development for both boys and girls will be explained, as will physical attraction and the urges and actions that accompany sexual development. Other issues related to sexuality, such as pregnancy, birth control, and sexually transmitted diseases, will also be addressed.

TALKING ABOUT SEX: IS IT TABOO?

What is the difference between sex and sexuality? The word sex can refer to gender, meaning whether an individual is male or female. It can also refer to the physical act of having sexual intercourse with another person. But sexuality encompasses much more. Sexuality includes how people learn to define themselves as sexual beings in the world. It includes desires, wishes, and dreams as well as relationships with others. It is a lot more than the physical act of sex.

Sexuality is often a difficult topic for many people to discuss, and talking openly about sexual feelings or the changes one's body is going through can make some individuals uncomfortable. Sometimes, due to a lack of open communication, young adults may receive negative or confusing messages concerning sexuality. It is important to remember that sexuality, and all of the thoughts and changes that develop as a result of growing up, are all very natural, and that everyone has questions and worries about this topic. Many teens think, "I'm the only one in the entire world with zits," or "My breasts haven't started growing yet, and I feel like an outcast," or "All the other guys in gym class seem to have bigger penises than I do," or "Why do I masturbate?" The common theme among all of these questions is, "What's wrong with me? Am I normal?" The fact is, however, that most teens are normal. They are not weird for wondering, nor are these thoughts unique to any young adult.

Sexuality is an individual experience, but the fear and frustration adolescents may feel is quite common. It's all a part of the process of growing up. Parents, teachers, and older siblings experienced many of these very same feelings, and they managed to survive the growing-up process. Armed with the proper knowledge and outlook, most teens are capable of surviving, too.

PUBERTY

Puberty: Words to Know

Abstinence:

Voluntary, self-denial of sexual intercourse.

Cervix:

Narrow outer end of the uterus.

Clitoris:

Small erectile organ at anterior part of the vulva.

Conception:

Also called fertilization. The formation of a cell capable of developing into a new being, such as when a man's sperm fertilizes a woman's egg creating a human embryo.

Contraception:

A birth control tool that prevents conception.

Cowper's glands:

Two small glands on sides of the male urethra, below the prostate gland, that produce a clear, sticky fluid that is thought to coat the urethra for passage of sperm.

Cunnilingus:

Oral stimulation of the vulva or clitoris.

Date rape:

Also called acquaintance rape; forced sexual intercourse between a person and someone she or he is acquainted with, is friends with, or is dating.

Ejaculation:

Sudden discharge of fluid (from penis).

Endometrial:

Referring to mucous membrane lining the uterus.

Epididymis:

System of ducts leading from the testes that holds sperm.

Estrogen:

Hormone that stimulates female secondary sex characteristics.

Fallopian tubes:

Pair of tubes conducting the egg from the ovary to the uterus.

Fellatio:

Oral stimulation of the penis.

Hymen:

Fold of mucous membrane partly closing the orifice of the vagina.

Labia majora:

Outer fatty folds of the vulva (big lips).

Labia minora:

Inner connective folds of the vulva (little lips).

Masturbation:

Erotic stimulation of one's own genital organs.

Maturation:

Process of becoming mature; developing, growing up.

Menstruation:

Monthly discharge of blood and tissue debris from the uterus.

Oral sex:

Sexual activity involving the mouth.

Ova:

Female reproductive cells; also called eggs.

Ovaries:

Female reproductive organs that produce eggs and female sex hormones.

Ovulation:

Discharge of mature ovum from the ovary.

Penis:

Male sex organ and channel by which urine and ejaculate leave the body.

Pro-choice:

Supports a woman's choice in regard to abortion.

Prostate gland:

A muscular glandular body situated at the base of the male urethra.

Right-to-life:

Supports anti-abortion (with possible exceptions for incest and rape) movement.

Scrotum:

External pouch that contains the testes.

Sexual abuse:

All levels of sexual contact against anyone's will, including inappropriate touching, kissing, and intercourse.

Sexual harassment:

All unwanted and unsolicited sexual advances, talk, and behavior.

Sexual intercourse:

Involves genital contact between individuals.

Smegma:

Cheesy sebaceous matter that collects between the penis and the foreskin.

Sperm:

Male reproductive cell.

Testicles:

Male reproductive gland that produces sperm.

Testosterone:

Hormone produced by testes.

Urethra:

Canal that carries urine from the bladder.

Uterus:

Womb; female organ that contains and nourishes an embryo/fetus.

Vagina:

Canal that leads from the uterus to external opening of genital canal.

Vas deferens:

Spermatic duct connected to the epididymis and seminal vesicle.

Vulva:

External parts of the female genital organs.

Puberty is simply the time during which the secondary sexual characteristics, such as boys' voices deepening or girls' breasts growing, develop and a sign that the body's reproductive organs are becoming fully functional. Puberty occurs in boys roughly from ages thirteen to sixteen and in girls roughly between the ages of twelve and fifteen. However, this time certainly doesn't feel simple to those going through it. It is probably the first time in a person's life that he or she will have the opportunity to be truly aware of his or her own biological changes.

The experience of puberty will be new and different for both boys and girls. It is not something that happens overnight, though, but rather it is a process that occurs in stages and at different ages for different people. It is perfectly normal, for example, for one person to have already started developing while his or her best friend has not.

WHAT HAPPENS TO BOYS?

Pubescent boys can have a really hard time feeling like they fit in. That's because of the huge variation in the rate of development in boys. Two fourteen-year-old boys can look very different from one another physically. For instance, one fourteen-year-old boy can have lots of body hair, a deep voice, and be very tall, while his classmate might still be short, have no chest and other body hair, and still have a childlike voice. So why and how do boys change into men? The answer is in the hormones. Even in the womb, a male fetus contains small amounts of the "male" hormone—testosterone.

Male Anatomy

The male reproductive system has three parts: the testicles, scrotum, and penis. The testicles are where sperm cells are produced. At the start of puberty, the hypothalamus, pituitary, and pineal glands signal to the testicles to begin producing testosterone, the most important male hormone. Testosterone triggers male secondary sex characteristics, like the deepening of the voice, thicker body hair, facial hair, and enlargement of the genital organs. The testicles look like two small eggs in a sac. This small sac of skin that hangs under the penis is called the scrotum. It's perfectly natural for one testicle to hang lower than the other. In fact, in 70 percent of men, the left hangs lower than the right. This has a very good biological purpose: if the two testicles hung at the same length, they would both get a lot of friction from the legs.

The Journey of the Sperm

The sperm cells are created in a series of chambers in the testicles. They grow and travel through the second part of the male reproductive system, which consists of the ducts for storage and transportation of sperm. The epididymis is a long, coiled canal that lies over each testicle. The next stop for the sperm is the vas deferens, a shorter extension of the epididymis. This takes the sperm from the scrotum to the abdominal cavity, passing to the back of the bladder and joining the seminal vesicles, and forming the ejaculatory duct where sperm is stored. The prostate gland lies against the bottom of the bladder and secretes the seminal fluid. Fluids from the seminal vesicles combine with this and carry the sperm out from the body. The prostate gland gets much bigger when males reach adolescence. (Taking care of the prostate gland by eating a healthy diet starting in adolescence can help prevent prostate problems that develop in many men later in life.) There are two tiny structures on either side of the urethra, called the cowper's glands, that produce a clear, sticky fluid that is thought to coat the urethra for passage of sperm. This is not seminal fluid, but it may contain sperm.

FEMALES ALSO PRODUCE SMALL AMOUNTS OF THE MALE HORMONE TESTOSTERONE. IT IS SOMETIMES CALLED THE LIBIDO HORMONE, MEANING THAT IT STIMULATES SEXUAL DESIRE.

THE TESTICLES PRODUCE ABOUT 200 MILLION SPERM CELLS A DAY.

The third part of the male reproductive system is the penis. During arousal, the penis gets solid and erect and may eventually release the seminal fluid. The fluid is called ejaculate. This final stage of arousal is called orgasm or ejaculation. There is usually about one teaspoon full of ejaculate emitted. Not all sexual excitement ends in orgasm, though. Sometimes the penis may become flaccid (soft) without having ejaculated after arousal. This is perfectly normal.

Facts about the Penis

There is a lot of folklore and misinformation about the penis. There are racial stereotypes about penis size and often an unspoken competition between boys about the size of their penises. Many young men are very concerned about having a large penis. They are worried that when they start having sex, their penis will be too small to please a woman sexually or that they will be made fun of by other men. Size of the penis is not the most important factor in terms of pleasurable intercourse for a woman. There are many other aspects of sex, such as caring feelings between the sex partners, that play a more important role than penis size.

Penises come in all shapes, sizes, and shades. Some boys have birthmarks on their penises, just like people have on other parts of their body. (If there is any mark on the penis that wasn't previously noticed or some mark has changed in size, color or texture, a physician should be consulted.) Some penises, while erect, point over to the left or right, and some point up.

The penis is actually made up of spongy tissue and large blood vessels. When males become sexually excited, the blood vessels expand and more blood flows to the penis, making it erect. Although the penis is hard at this time, the skin around it stays loose to allow for expansion during erection.

ERECTIONS. Males have erections all through their lives. Even babies can have erections. Erections can also accompany the urge to urinate, and are quite common upon waking from a night's sleep. In fact, erections can seem to happen for no reason at all. However, they also occur with sexual stimulation, or when a person is sexually aroused.

NOCTURNAL EMISSIONS. Sometimes males will wake up after having ejaculated during their sleep. This is called a nocturnal emission, or the slang term "wet dream," and it is a natural occurrence. Wet dreams usually start during puberty and can happen throughout a man's life. While having a wet dream may cause a boy to feel embarrassment, it is a normal occurrence and happens to most males at some time or another.

The Stages of Development: Boys

As stated earlier, all boys have different rates of maturation. Puberty can start as early as age eight and end as late as fifteen. Boys should not be nervous if their friends start changing before they do, or if they themselves are the first to start changing. There is no rhyme or reason to development; the body develops as it is genetically programmed to do so. What, then, happens to the male body at puberty? According to The New Teenage Body Book, British physician Dr. J. M. Tanner identified the stages of puberty for boys as follows:

• Stage One: (approximately between ages nine and twelve)

No visible signs of development occur, but, internally, male hormones become a lot more active. Sometimes a growth spurt will begin at this time.

• Stage Two: (approximately between ages nine to fifteen)

Height will increase and the shape of the body will change. Muscle tissue and fat are developing at this time. The aureole, the dark skin around the nipple, will darken and increase in size. The testicles and scrotum will grow, but the penis probably won't. A little bit of pubic hair will begin to grow at the base of the penis.

• Stage Three: (approximately between ages eleven and sixteen)

The penis will finally start to grow during this stage. It will tend to grow in length rather than width. Pubic hair is getting darker and coarser and spreading to where the legs meet the torso. Also, boys will continue to grow in height, and even their faces will begin to appear more mature looking. The shoulders will broaden, making the hips look smaller. Muscle tissue increases and the voice will start to change and deepen. (This is because the larynx is enlarging.) Finally, facial hair will begin to develop on the upper lip.

• Stage Four: (approximately eleven to seventeen)

At this time, the penis starts to grow in width, too. The testicles and scrotum are also continuing to grow. Boys shouldn't be alarmed if hair begins to grow on the anus; this is perfectly normal. The texture of the penis is beginning to look more adult. Underarm and facial hair increases as well. Skin will get oilier, and the voice will continue to deepen.

• Stage Five: (approximately fourteen to eighteen)

Boys will be reaching their full adult height. Pubic hair and the genitals will look like an adult man's would. At this point, too, shaving may become a necessity. Some young men continue to grow past this point, even into their twenties.

Most important to remember in understanding the stages of development is that everyone has their own, individual pace. Age may vary from the approximate ages in each stage. There's no reason to worry. Inevitably, virtually everyone develops into an adult in due time.

WHAT HAPPENS TO GIRLS?

Girls usually start and finish puberty before boys. However, since their bodies are changing, too, girls have a lot of the same concerns as boys. Many girls are confused and scared of the changes they are experiencing emotionally, as well as physically. Girls often wonder if their friends and classmates are developing faster than they are. Some might be concerned because they are developing breasts faster or slower than their peers. Still others might feel uncomfortable because they are the tallest in their class. All of these feelings and changes are normal for pubescent females.

THE HYMEN

The hymen, a fold of membrane at the vaginal opening, is not always visible, nor is it the main determinant of virginity (being a virgin, or one that has not had sexual intercourse). The hymen can break when girls play sports, or sometimes even with use of tampons. If the hymen is broken but one still hasn't had sexual intercourse, one is still a virgin. And some girls who have had sex may have hymens that are still intact.

Female Anatomy

The vulva is the proper word for the entire area between a girl or woman's legs. (A common misconception is that this area is called the vagina. The vagina is actually just one part of the vulva.) There are two sets of vaginal lips. The first is the labia majora, or "big lips." This area is covered with hair in the more advanced stages of development. The outer lips protect the rest of the vagina. Under-neath the labia majora are the labia minora, or "small lips" (although they aren't always small). The labia minora can vary distinctly in color, size and shape. They may be pink or brown, wrinkled or smooth. The labia minora don't have fat or padding. Instead they have blood vessels, oil glands, and scent glands. At the point where the labia minora connect lies the clitoris. The clitoris is very small but quite sensitive. It is a very important part of the experience of sexual arousal in girls and women but it may be hard to find because it is hooded with skin. Below the clitoris is the urethra (the urinary opening). Below that is the vaginal opening. The hymen, a fold of membrane at the vaginal opening, may cover it.

The vaginal opening connects the inner and outer genitalia. It is possible to feel inside the long, moist canal beyond the vaginal opening. This is the actual vagina. It is even possible to feel all the way to the back of the vagina to touch the cervix. The cervix is dimple-shaped and might feel like the tip of one's nose. Beyond this dimple is the opening of the cervix, called the os. During menstruation, the flow passes through the uterus and out of the os into the vaginal canal and then out the vaginal opening.

The uterus is small and shaped like a pear. It is comprised mostly of muscle tissue, and can expand tremendously during pregnancy. Right above the uterus are the fallopian tubes. They are passages from the uterus to the ovaries, where egg cells are found. During every cycle (about a month), an egg cell is released from one of the two ovaries. This is called ovulation. During ovulation, it is possible to become pregnant if one of the eggs is fertilized by a sperm cell. This is called conception. The window for ovulation is twenty-four to seventy-two hours. This is a female's most fertile time. Sexually active women should always use protection at this time to avoid pregnancy. Women who are trying to get pregnant often chart their cycles so they know the best times to have sex. Usually during ovulation the egg that is released is unfertilized and disintegrates. The menstrual flow is made up of this tissue and the endometrial tissue that has been building up in anticipation of a new life to nourish.

The Stages of Development: Girls

Every girl matures in her own, individual way. Each person's "biological clock" is unique. Just because one person's development begins before another's has started doesn't mean that either one is abnormal. Just as it is for boys, sexual development for girls really begins in the womb. Baby girls are born with thousands of immature ova (eggs) in their ovaries. When a girl hits the age of eight, behind-the-scenes hormonal changes start to take place. Estrogen, the most important female hormone, begins to be produced by the ovaries. This starts when the brain tells the pituitary gland to begin to produce follicle-stimulating hormone (FSH). This FSH stimulates the ovaries to make estrogen. This initiates the process of puberty for females. According to The New Teenage Body Book, British physician Dr. J. M. Tanner identified the stages of puberty for girls as follows:

• Stage One: (approximately between the ages of eight and eleven)

The ovaries are enlarging and hormone production is starting, but external development is not yet visible.

• Stage Two: (approximately between the ages of eight and fourteen)

The first external sign of puberty is usually breast development. At first breast buds develop. The nipples will be tender and elevated. The area around the nipple (the aureole) will increase in size. The first stage of pubic hair may also be present at this time. It may be coarse and curly or fine and straight. Height and weight increase at this time. The body will get rounder and curvier.

• Stage Three: (approximately between the ages of nine and fifteen)

Breast growth continues and pubic hair gets coarser and darker. During this stage, whitish discharge from the vagina may be present, signaling that the vagina is self-cleansing. For some girls, this is the time that the first menstrual period begins.

• Stage Four: (approximately from ages ten to sixteen)

Some girls will notice that their aureoles get even darker and separate into a little mound rising above the rest of the breast. (Some girls never get this.) Pubic hair may begin to look more like the adult triangular pattern of growth. If it didn't happen in Stage Three, menarche (first menstruation) should start now. Ovulation might start now, too. But it won't necessarily occur on a regular basis. (It is possible to have regular periods even if ovulation is not occurring every month.)

• Stage Five: (approximately between ages twelve and nineteen)

This is the final stage of development. Full height should be reached by now, and young women should be ovulating regularly. Pubic hair should be filled in, and the breasts should have developed fully for the body.

Menstruation

Menstruation, or "getting your period," is the monthly shedding of blood and uterine lining that occurs when the female egg cell is not fertilized. Menstruation normally begins during the onset of puberty in females; however, as with everything else, "normal" is different for everyone. In general, a menstrual cycle is 28 to 30 days in duration (in other words, a girl can expect her period every 28 to 30 days). A period can last from 3 to 7 days. Healthy menstrual periods should at least:

• Come regularly. It's normal to skip one or two periods when first menstruating. But for girls who've been regular for a few years and suddenly start missing periods, a gynecologist should be consulted.
• Have a normal flow—not too heavy. Girls bleeding through a tampon in less than an hour are probably bleeding too much. This can make a girl overly tired from iron loss. Again, if this happens, one's doctor should be told.
• Have a normal flow—not too light. When a girl first starts to menstruate, light periods are common. But those experiencing consistently light or brief periods should not assume everything is okay. A gynecologist can help determine if this is a symptom of a more serious problem.

Premenstrual-Syndrome (PMS)

PMS is a common complaint of young and older women alike. For years, PMS was thought of as something that women "made up" to explain their feelings—physical and emotional—around the time of their menstrual cycles. Today, PMS is accepted in the medical community as a real phenomenon that may or may not affect some women. That means girls and women can have a whole list of symptoms, or just one, or none. Some girls suffer to such an extreme that they seem to experience all the pain and symptoms of PMS. Others do not exhibit any symptoms of PMS.

PMS includes headaches or migraines; abdominal, leg, and lower-back cramps; acne; depression; anxiety; bloating; fatigue; heart palpitations; confusion; breast swelling and pain; cravings; and even proneness to accidents. Most PMS sets in at ovulation. That means up to two weeks of every month can be filled with the above symptoms.

HEALING PMS. Girls can start to come to grips with PMS by writing all of their feelings about menstruation in a journal. They can record and reflect on all the symptoms they have, and try to figure out if the symptoms happen at the same time each month. This is the first step to healing.

The next step is addressing the symptoms themselves. One of the major causes of PMS is poor diet. What are the worst culprits? Processed foods, caffeine, sugar, dairy and meat. Sometimes simply eliminating or cutting back on these foods will cure the symptoms, but that is easier said than done. Girls seeking to beat PMS should think about eating a healthy diet based on whole foods: fruits, vegetables, soy products and whole grains.

Pharmacies also sell over-the-counter products that may help with some of the symptoms of PMS, such as reducing bloating and providing mild pain relief.

Cramps (Dysmenorrhea)

Dysmenorrhea, commonly known as cramps, may be experienced by some females during menstruation. Over-the-counter painkillers can offer a quick fix for cramps, while some women prefer to use painkillers specially formulated to also reduce bloating. (Another dietary way to prevent bloating is to reduce salt intake and drink lots of water.) Chamomile tea is a great natural muscle relaxant. However, to prevent cramps from starting in the first place, eliminating unhealthy foods from one's diet is a good thing to keep in mind. Another approach is exercise. Regular exercise will keep hormones flowing properly through the body and regulate periods, and often eliminate cramps. Doing yoga is a good way to eliminate cramps (and other symptoms of PMS as well). There are even some yoga poses that can be done which will ease the pain of cramps immediately.

THE NOBILITY POSE

Practicing yoga is a good way to eliminate cramps (and other symptoms of PMS as well). Yoga is a form of exercise comprised of many different poses that gently stretch and work out the muscles. One great pose for easing menstrual cramps is called the Bhadrasana or Nobility Pose. This is how to do it:

Sit on the floor and bring soles of the feet together. Close the eyes. Clasp the hands around the feet, and pull the heels as close in to the body as possible. Inhale slowly and try to keep the head, spine, and neck in a straight line. Push the knees to the floor. Hold the breath in at a comfortable level for five counts. Exhale.

If cramps and/or PMS are incapacitating, a physician should be consulted. Getting rid of cramps and PMS doesn't happen overnight. It will definitely be a process of trial and error. So if someone has PMS or even a mom, best friend, sister, or girlfriend has it, let the P stand for patience. Boys need to understand PMS too, so they are kind and compassionate to the girls and women they know who go through it.

KISSING, DATING AND PHYSICAL ATTRACTION

Crushes

Everyone gets crushes on other people at some point in their lives. The truth is adults and even little kids can get crushes. But due to the rush of hormones that seem to "take over" young adults, crushes get really intense at the start of puberty. A crush is simply the feeling of really admiring, being attracted to, or liking someone. Both boys and girls have crushes; crushes are a fun and safe way for young people to explore their emerging sexuality, even though it doesn't always feel fun when feelings for another person are not returned. That's why they are called "crushes." The crushee can feel crushed if his or her feelings don't lead to a real romantic relationship.

There are a lot of different kinds of crushes. People get crushes on their teachers, movie stars, or people in older grades at school. People get crushes on friends of their older brothers or sisters. What do all of these kinds of crushes have in common? The objects of the crush are unattainable. That means that they are out of bounds, or aren't actual possibilities for dating because of a significant age difference or, in the case of movie stars, someone the crushee might never meet. Crushes on unattainable people are healthy

and normal. As long as a crush doesn't become an obsession (thoughts that occupy the mind continually), people should enjoy their secret feelings.

Dating

Dating is when two people take a romantic interest in one another and spend time together going to movies, or to dances, or any number of places. Some kids and teens, and even some adults don't always like to use the term "dating" because it sounds too formal. Instead of dating, it may be referred to as people just kind of "hanging out" with each other. A girl might like a boy and then find out that he likes her, too. Then, she might spend time or talk on the phone with him and get to know him better. Over time, they might become boyfriend and girlfriend. If they go somewhere together, like to the movies or to dinner, they might consider that a date, but the whole process usually isn't treated as formally as it was in the past.

Kissing

Kissing is fun and, as with many things, can be perfected with practice. Lots of teens are terrified that they will end up being bad kissers, but by relaxing and doing what comes naturally most teens find that there is no such thing as a "bad" kisser. French kissing is kissing with an opened mouth and exploring one's partner's mouth with the tongue. Kissing is a great way for two people to show their feelings toward one another without going too far. In fact, some people feel kissing can often be more intimate than the act of sexual intercourse.

Petting

Petting is another term for "fooling around" or "hooking up." This is what happens when couples go beyond kissing. Petting is touching one's partner's body but not having intercourse. Clothes may be kept on during petting. However, heavy petting can advance to the stage when clothing is removed. Such petting can include oral sex and touching of the genital area and the breasts. It can arouse very strong sexual responses, including orgasm. As always, consent (permission or agreement) between the two people is really important. If one person has any reservations about progressing, something should be said. It's better to say Stop than to regret going too far.

Intimacy

Intimacy, or closeness, can be shared with someone without sharing a physical relationship. Really liking someone doesn't necessarily mean that a physical relationship is possible or even necessary. Emotional intimacy—being able to share personal feelings and thoughts—should go hand-in-hand with sharing physical intimacy. Anyone who is uncertain about taking a relationship to a physical level shouldn't do so. Often, people can share a deeper connection and more true intimacy by keeping their clothes on and finding out about a person through communication.

Homosexuality

Homosexuality, or being gay, is when a person has sexual feelings for someone of the same sex (heterosexuality is the term used for those who have sexual feelings for people of the opposite sex). It is perfectly normal to have a crush on someone of the same sex, particularly in the teen years. Many people have feelings for people of the same sex. Boy or girl, it's normal to feel deep affection for friends. For example, many females are very affectionate with one another. Does this mean that they are gay? Not necessarily. Many teenagers have anxiety about being gay. This is probably because homosexuality is often viewed negatively in American society. It's common to have sexual feelings or sexual dreams about people of the same sex. Many young people panic when this happens and wonder if they are gay. Consistent sexual feelings about people of the same sex and attraction can indicate homosexuality. These are normal feelings, too.

Bisexuality

Bisexuality is defined as attraction to and/or engaging in sexual relations with people of both sexes. Many people experiment sexually with people of both sexes. Experimenting or the temptation to do so does not necessarily make a person bisexual or homosexual. Rather, this is merely an indication of curiosity.

Some people think that those who define themselves as bisexual are just extremely open-minded and sexually free. But many bisexuals themselves often disagree. They say that they are bisexual not by choice, but because of their biology. Bisexuality is often harder to figure out, at least for young people, than homosexuality. Any teen who has such concerns should talk openly with a trusted friend, relative, or counselor to help them sort out their feelings.

SEX

Times have changed a great deal since a few decades ago. People are experimenting with sex at younger and younger ages. American culture is saturated with sexual imagery; however, sex is often presented in a taboo (forbidden) light. Often times young adults are drawn to engaging in activities that are considered taboo to them. On the other hand, abstinence, a conscious choice to abstain from sex, is gaining favor with young people. More and more teens are choosing to remain virgins until marriage. This includes boys and girls. Ideally, sex should be based on loving and tender feelings for a partner. Many people have sex based on lust rather than love. There is nothing wrong with this, if both partners consent to and enjoy the sex, but it's usually even more fulfilling if it's based on a loving union.

TALK TO SOMEONE

Teens are often the worst offenders in terms of perpetuating prejudice about homosexuality, perhaps due to pressures in society to "be normal" at all costs. As a result, people who suspect they may be gay can feel desperately lonely and depressed. Many teens who attempt suicide do so because they are gay and feel they have no one to turn to.

Teens who think they might be gay or lesbian should talk to a counselor. Counselors will help a person work through his or her feelings. If it isn't possible to talk with someone at school or with another adult, the Gay and Lesbian National Hotline can be reached at 1-888-843-4564. Hotline representatives can answer all questions and make referrals to local area agencies. The Hetrick-Martin Institute in New York is a resource center for gay teens, and it can be reached at 212-674-2400.

Intercourse

Sexual intercourse can occur when a man is sexually aroused and his penis is erect. He slides his penis into the vagina of a consenting partner. The aroused female will produce vaginal secretions that will make it easier for the man's penis to enter her. He will move his penis in and out of her vagina in a rhythmic fashion until he ejaculates (reaches orgasm, the highest point, or climax, of sexual excitement).

Women often have orgasms during sex as well. Women usually have clitoral orgasms, but they can have vaginal orgasms, too. (For many women, it takes practice to learn to orgasm from sexual intercourse.) It is important that there is open communication between the partners so that each can share desires with the other. It's hard for both women and men to orgasm if they are tense and nervous.

Choosing to enter into a full-fledged sexual relationship that includes intercourse should never be done lightly. Both the man and woman should be mature enough and responsible enough to discuss birth control and protection from sexually transmitted diseases (see sections below) before taking that step. It is also essential to discuss one's expectations as well as how a pregnancy will be handled (see section on pregnancy) if one occurs.

Oral Sex

Oral sex is often practiced as an alternative to intercourse. Oral sex includes fellatio (pronounced fell-AY-shee-o) and cunnilingus. Fellatio is the stimulation of a man's genitals with the mouth of a partner. Cunnilingus is the stimulation of a woman's genitals with the mouth of a partner. Oral sex does not carry with it the risk of an unplanned pregnancy, as sexual intercourse does. However, it does not protect against sexually-transmitted diseases (STDs), including AIDS, because there is contact with a person's bodily fluids. When engaging in either form of oral sex, both partners should take precautions to protect themselves from STDs by using either a condom (for men) or a dental dam (a rubber shield that dentists use to isolate a specific tooth when doing work on it; used to practice safe oral sex on women).

Masturbation

Masturbation is the safest kind of sex. It is pleasuring oneself, or solo sex. It is totally natural and healthy. Most people do it, but they don't like to admit it because of the negative portrayal put upon it by society. Girls can masturbate by stimulating their clitoris or putting their fingers inside of their vaginas. Boys can masturbate by stroking or rubbing their penis. Some people believe that masturbating too often is dangerous. This is a myth. As long as something feels good, is carried out in private, and doesn't involve hurting anyone or anything, masturbation is a healthy way to explore and indulge sexual fantasies and impulses without the risk of unwanted pregnancy or STDs.

BIRTH CONTROL

Birth control has had a dual purpose in recent times, specifically where condoms are concerned. Preventing an unwanted pregnancy goes hand in hand with preventing the spread of sexually transmitted diseases, including HIV. There are many forms of birth control, or contraception, available but none offer 100 percent protection against STDs, including condoms. Ideally, both partners should be tested for HIV and STDs before engaging in a sexual relationship so that their options for birth control widen and are not limited to the condom.

Condoms

A condom is a sheath that fits snugly over the penis. The reservoir at the tip of the condom collects the semen that is ejaculated, thus preventing it from entering the vagina. Condoms are the easiest, safest, and most commonly used form of birth control. Latex condoms that are spermicidally lubricated are the most effective. Spermicidal lubricant, such as Nonoxynol-9, kills any sperm that might leak out of a condom. Some people have latex allergies; for those individuals, condoms are available in other compositions; however, they are not as effective in preventing pregnancy or the transmission of STDs as latex condoms.

Condoms are widely available, at drug and convenience stores and even supermarkets. Both sexes can purchase them; this helps both partners share responsibility for birth control. Condoms are a good way to ensure that one is always prepared (in terms of birth control) for a sexual encounter.

It is a myth that condoms lessen sexual pleasure. If one or both partners are uncomfortable using condoms, each should be tested for STDs, including HIV, and then discuss other birthcontrol options with a counselor or physician.

The female condom, which is similar to traditional condoms, is also available. It is placed inside a woman and it lines her vagina and blocks her cervix.

The Pill

Another common form of contraception is the birth-control pill. There are several types of birth-control pills, available by a physician's prescription only. Most common is the combination pill (which employs a combination of different

hormones). This type of birth-control pill works by inhibiting the development of the egg in a woman's ovary. In other words, the ovaries remain somewhat inactive, which is similar to how a woman's body behaves when she is pregnant.

Birth-control pills are the most effective form of birth control (aside from abstinence) and are used by millions and millions of women throughout the world. However, the pill does not offer protection against sexually transmitted diseases (STDs), which leaves many women at risk for HIV and other diseases like herpes. Furthermore, the dangers of taking the pill (such as heart attack, stroke, or embolism—a sudden obstruction in a blood vessel) can be intensified by family and personal health histories and lifestyle. (It is advised that smokers over the age of thirty-five should not take the pill.) Always discuss possible side effects with a doctor. Most experts agree, however, that the possible dangers involved with an actual pregnancy and delivery outweigh the possible dangers presented by the pill. For most people, in consultation with a doctor, the pill is considered safe.

Some women have other issues with the pill, including nausea from the increased hormones, weight gain, irritability, migraines, depression, and a reduced sexual desire. These side effects usually decrease after a few monthly cycles of taking the pill. As with any prescription product, some have a great deal of difficulty with the pill while others experience no difficulty at all.

There are many pros and cons to taking birth-control pills, and these should be weighed carefully against a woman's lifestyle and health before deciding to use them.

Diaphragm

A diaphragm is a soft, round, rubber cup that fits over the cervix. It works by keeping the sperm out of the uterus. A doctor must measure a woman's cervix and prescribe the proper size diaphragm for her.

Diaphragms are used in conjunction with spermicidal jelly and are inserted thirty minutes prior to intercourse. The diaphragm must be left in place for several hours afterward. Many women enjoy diaphragms as they offer the freedom that is similar to pill usage. However, some women find diaphragms to be messy (because of the spermicide) and difficult to insert. Furthermore, the effectiveness rate is not as high as that of the pill and, unlike the condom, diaphragms offer no protection against STDs and HIV.

Cervical Cap

A cervical cap looks like a thimble with a rim. It fits over the cervix just like a thimble fits over a finger. It comes in four different sizes, and must be fitted to the user by a doctor. The cervical cap works as a diaphragm does, blocking the cervix.

Drawbacks to the cap are that it does not allow free flow of cervical fluid, which can lead to odor and infection in certain wearers. Also, like the diaphragm, the cervical cap can be difficult to insert and remove and it offers no protection against STDs, including HIV.

Intrauterine Device

Intrauterine devices (IUDs) are small devices placed in the uterus to prevent pregnancy. Though it is not known how IUDs work precisely, it is believed that they prevent fertilization. Usually comprised of plastic (copper IUDs are no longer common), most contain a synthetic hormone, often progesterone, that helps prevent pregnancy if the IUD exists in the body at a constant rate throughout a woman's entire cycle. IUDs are decreasing in popularity and are controversial as they have been known to affect fertility (the ability to become pregnant) and cause other health problems, such as rejection of the device by the body and damage to the uterus. Another drawback to IUDs is that they must be implanted and removed by a physician. Furthermore, IUDs offer no protection against STDs and HIV.

Norplant

Norplant is a contraceptive device that involves a set of thin, match-size capsules containing hormones that are implanted just under the skin of a woman's upper arm. Effective for approximately five years, Norplant has a high success rate in preventing pregnancy. Since it is implanted in the woman's arm, the woman is protected twenty-four hours a day and there is no chance of forgetting birth control (as with the pill, condoms, or the diaphragm). However, it offers no protection against HIV and other STDs; further, Norplant has many risks associated with its use, including irregular menstruation, headaches, weight gain or loss, benign (noncancerous) ovarian cysts, depression, and acne. Smokers or women with a history of certain health problems should not use it. Finally, Norplant is a very costly method of birth control (it can cost hundreds of dollars for insertion and removal is also expensive).

PREGNANCY

A planned pregnancy between two mature adults can be a beautiful experience. Ideally a pregnancy occurs between loving partners who will share the responsibility of the pregnancy. A healthy pregnancy should be free of stress. If a woman is even a little bit unsure about whether having a baby is right for her, it can affect the course of her pregnancy.

Unplanned Pregnancy

An unplanned pregnancy can be terrifying for anyone, but especially for a teenager. It can make a person feel totally out of control, especially if the parents are not emotionally connected to one another. (This is why it's so essential to practice safe sex; see box on page 81). If a girl is sexually active and using protection but misses a period, she should not assume that she isn't pregnant. There is no single form of birth control that is 100 percent effective.

For girls who are sexually active and menstruate on a relatively regular basis, if a period is late (that is, beyond the usual 28- to 30-day cycle) by even a week or two, it is best to take a pregnancy test. Pregnancy tests are administered at local clinics, such as Planned Parenthood, or at a physician's office. Home pregnancy tests are available at most pharmacies and even many supermarkets. Home pregnancy tests have drawbacks, however. First, they are not 100 percent accurate. Second, clinics and physicians provide more than just accurate results; they are qualified to discuss what options there are for dealing with a pregnancy.

A good approach to this situation is to share concerns with a trusted adult or friend, who may offer advice and comfort and ease feelings of isolation.

Choices

Going to a clinic or a physician comes with the added benefit of having all options for addressing an unexpected pregnancy explained by qualified individuals. A couple or a woman alone may choose to carry the pregnancy to term and raise the child. Adoption is also another alternative. Finally, the pregnancy may also be terminated through abortion.

ABORTION. Abortion remains a very controversial issue, and the choice to proceed with one depends on personal belief as much as the legalities of abortion in a particular state. While abortion was made legal in the United States through the Roe v. Wade Supreme Court case in the 1970s, many states have legislation in place requiring parental notification, something that makes abortion an undesirable or impossible choice for many minors.

Abortion is the termination of a pregnancy before the embryo or fetus is capable of surviving outside of the womb. Someone desiring to terminate her pregnancy can usually find help through a local Planned Parenthood clinic. Planned Parenthood will be familiar with area clinics and physicians that offer abortion services. The organization is also familiar with any restrictions that exist in a particular state concerning abortion.

THE RIGHT TO CHOOSE

Prior to 1973 abortion was illegal in the United States. On January 22, 1973, the US Supreme Court declared that "the right of privacy…founded in the fourteenth amendment's concept of personal liberty…is broad enough to encompass a woman's decision whether or not to terminate her pregnancy." The court held that a woman and her doctor had the right to make a private decision about first trimester abortions. Prior to that decision, women who wanted to terminate a pregnancy had few choices. Many put their lives in danger by having "back-alley" abortions (abortions performed by laypersons that often involved unsanitary conditions and the abortionists' inability to deal with emergency situations, such as hemorrhaging). Sadly, many women lost their lives in this manner. In response to these medical mishaps and the Roe v. Wade ruling, the Pro-Choice movement has been working for women's rights ever since. Conversely, the Right-to-Life movement believes abortion is morally wrong as a fetus is a human being with inherent rights.

Most abortions are performed in the first trimester (first three months) and early second trimester of the pregnancy. Having a procedure in a clinic or a hospital is an ambulatory procedure (meaning that patients are sent home the very same day). After undergoing an abortion, most women are issued antibiotics to prevent infection and given birth-control counseling. Follow-up visits to a physician are required and recipients must also abstain from sexual intercourse and wearing tampons for several weeks. Discomfort, cramps, and bleeding are common in the days following an abortion, as is emotional pain.

Some women may not be emotionally affected at all by an abortion, while others may address feelings of regret or sadness years later. Choosing abortion is not simple or easy; in fact, it can be terrifying and traumatic. However, for many women, young and older, it is still the best choice for them personally.

ADOPTION. Some young women who find themselves pregnant are opposed to abortion for moral or religious reasons. Yet for any number of reasons,

they feel they are not able to raise a child on their own. For such people, carrying a child to term (until it is born) but placing the baby for adoption after the birth is a viable solution.

Adoption can be a very complicated legal process, but put very simply, when a woman or couple decide to place their baby up for adoption, they legally give up parental rights to the child so that another person or couple can legally become the child's parents. The biological parents, or birth parents, are the people who conceived and gave birth to the child. The adoptive parents have legal custody of the child and are the people who care for and raise the child as their own.

Giving up a child for adoption is never easy. Many women that have experienced pregnancy bond with the baby inside them on a very deep level. It's not easy to let go after nine months of closeness. Often, a birth mother or birth father will wonder about that child for the rest of their lives. Stories, positive and negative, about birth parents reconnecting with children they've given up for adoption years earlier are prevalent in the media. People considering adoption must make careful choices and be certain that they are willing to face the likelihood that they will never see their birth child again. People need to be honest with themselves when considering adoption and all parties should consult with attorneys experienced in such matters. However, for many people, adoption is the best choice for them personally.

SEXUALLY TRANSMITTED DISEASES

Sexually transmitted diseases (STDs) include an array of diseases, some treatable and some not, that are transmitted primarily through sexual activity. The best way to almost completely reduce the risk of catching a STD is to abstain from sexual activity. Another method to reduce the odds of becoming infected is getting tested, along with one's planned sexual partner, for STDs, including and especially for HIV.

HIV/AIDS

Human Immunodeficiency Virus (HIV) infection is an immune system disorder (the immune system helps the body resist infection by diseases) that can be contracted through sexual activity as well as other types of contact. HIV is often labelled as an STD because of the high number of cases that emerge as a result of sexual activity, but it is important to note that HIV is not always contracted through sexual activity.

HIV can lead to the development of full-blown Acquired Immunodeficiency Syndrome (AIDS), which is also an immune system disorder. People catch HIV through sexual contact or by exposure to contaminated blood (such as through sharing dirty needles or a blood transfusion). People cannot contract HIV from sharing a meal, swimming in a pool, hugging, casual kissing, holding hands, or even sharing a toothbrush. Furthermore, there are no documented cases of transmission of HIV through French kissing. HIV can remain in the systems of the body for many years without leading to the development of AIDS; however, HIV can easily be detected with a blood test.

Many myths about AIDS have circulated since it was first discovered in the early 1980s. The first, and most fatal myth to women and heterosexual men, is that AIDS is only a "gay person's disease" or a syndrome limited to intravenous drug abusers who share needles with other users. The disease did devastate the gay community in the 1980s, but gay communities around the United States quickly took up a campaign of awareness and activism that led to a sharp decline in HIV-infection rates in that population. (These numbers, however, are going up again and are a big concern in the gay and lesbian community.) The strongest growing populations currently being infected with HIV include heterosexual women and teens. Specifically, young black heterosexual females are the fastest growing group of new cases.

Anyone who has sex is at risk for catching and/or spreading HIV. This is why practicing safe sex is imperative to everyone's health.

Chlamydia

Chlamydia is the most common sexually transmitted disease. It is caused by a virus and is spread during sexual intercourse with an infected person. Girls often have no symptoms. Males are more likely to have symptoms, including irritation or burning during urination and a milky discharge from the penis in the morning. For females, the only indication of being infected with chlamydia may be vague, lower abdominal pain. As a result, women's reproductive organs may be damaged by Pelvic Inflammatory Disease if chlamydia is not treated in a timely way. Therefore, it is really important to get tested if one has had unprotected sex. The virus can be treated with antibiotics.

Gonorrhea

Gonorrhea is a STD caused by bacteria. It can occur in the cervix, penis, throat and rectum. Symptoms usually appear only in the male, similar to chlamydia. Two to nine days after infection, males will experience painful urination and a thick, yellow discharge from the penis. Boys experiencing these symptoms must inform any and all sexual partners so that those individuals can get tested and receive treatment. Gonorrhea can render women sterile (unable to have children) without treatment. It is treated with highdose antibiotics.

Herpes

Herpes is another very common STD. Genital herpes affects 10 to 40 million Americans. The Herpes Simplex 2 virus causes it; this is the same virus that causes cold sores in and around the mouth. The herpes virus can be spread from the mouth to the genitals during oral sex. Two to twenty days after exposure, symptoms appear. Small, painful, pus-filled blisters appear on the labia, around the vagina, on the penis, and around the anus in both sexes. Swollen lymph glands, aching muscles and fever are some other symptoms. The symptoms subside after a few weeks, but the virus stays dormant in the body and can flare up regularly. It can also never flare up again. Even if there aren't any symptoms present, a person can still transmit the disease to another.

Compromised immunity and emotional stress can trigger symptoms. Sexually active individuals should be tested for herpes and all STDs even if no symptoms are present. At this time, there is no cure for genital or oral herpes. Treatment includes acyclovir, which can reduce symptoms and is available in topical and oral forms. A healthy diet and avoiding stress also are important.

SAFE SEX

There are three ways to practice 100 percent safe sex. They are abstinence, waiting until marriage to have sex (as long as one's marriage partner has done the same), and solo masturbation. If you choose to be sexually active, however, there are guidelines to safer sex. The first is to be informed. Know your body and know the risks. Know your sex partner and keep lines of communication wide open. Know their history, who they have had sex with, and if they have ever been diagnosed with a STD. People in monogamous (having only one partner at a time) relationships are at a lower risk for STDs.

Very safe sex includes: kissing with closed lips, rubbing against each other with clothes on (grinding), and sharing fantasies with a partner verbally.

The guidelines for reasonably safe sex are as follows: sexual intercourse using a condom and spermicidal jelly, French kissing, oral sex with a latex barrier like the "dental dam," and mutual masturbation. Unsafe sex includes the following: sexual intercourse without a condom, oral sex without a barrier, and mutual masturbation using sex toys that are shared.

The most important thing to remember about safe sex is that it is protecting one's very life if it is practiced. It is essential to insist that a potential partner agree to safe sex; this expresses the value one places on health and well-being and one's own high level of self-esteem. No one should be afraid to talk about it. If potential partners don't want to practice or even talk about safe sex, they are bad news. That means they don't value their own life, so it's highly doubtful they value anyone else's. There are many ways to give and receive pleasure without putting one's life in danger.

Syphilis

Syphilis is a STD caused by a very small, corkscrew-shaped spirochete (bacterium). It is spread by sexual contact and can be transmitted from a sex organ to an open cut on the skin of another person. Ten to ninety days after infection, a small, painless sore can appear on the genitals. After it goes away, weeks or months later a rash can appear all over the body, and swollen glands accompanied by flu-like symptoms may occur. Untreated syphilis does not go away. The disease can remain dormant for years and reappear when it is too late. The third stage of the disease may include nervous, brain, and circulatory system damage, and possibly death. Once detected, syphilis can be treated with penicillin.

Genital Warts, or Human Papilloma Virus

Genital warts (also known as Human Papilloma Virus) is the third most common STD. The warts are extremely contagious, and can appear on the vagina, cervix, penis, and rectum or in the urethra in the male. They are white-colored and cauliflower-shaped growths. They appear a few months after exposure. A physician can remove them with podophyllin, a medication, or by nitrogen freezing or laser treatment.

Crabs, or Pubic Lice

Crabs or pubic lice are spread by sexual contact with an infected partner or even by sharing of bedding, clothing, towels and toilet seats. Crabs cause intense itching and sometimes pain where the parasites have burrowed under the skin. A prescription drug called Kwell is the most effective treatment. Over-the-counter medications are also available. Washing bedding and clothing in hot water is essential follow-up for someone infected with crabs.

SEXUAL HARASSMENT AND ABUSE

Sexual harassment and abuse have always been in existence, but have gotten a lot of exposure especially over the past few years. Sexual harassment includes almost all unwanted and unsolicited sexual advances, talk, and behavior. Sexual abuse includes all levels of sexual contact against anyone's will. Sexual abuse may include, but is not limited to, inappropriate touching or kissing, incest (sexual relations between closely related people), rape, and date rape. A perpetrator's motives for victimizing another are usually based around issues of power; the power is derived by having another person at his or her mercy, sexually or verbally. Sexual abuse and harassment can happen anywhere and at almost anyone's hands, from peers to a trusted adult to a total stranger.

ROHYPNOL: THE "DATE RAPE DRUG"

Date rape, or acquaintance rape, is forced sexual intercourse between a person and someone she or he is acquainted with, is friends with, or is dating. That is, it occurs with someone the person knows, not a complete stranger. Often times, date rapes go unreported because it is hard for people to think that someone they know—or are even dating—would intentionally hurt them, even if they have not given consent to have sex. Rape, whether committed by an acquaintance or stranger, is a crime and should be reported to the police regardless of how well the two parties know one another.

Sometimes a date rape might occur but the victim has no memory of it. She may know that something has happened to her, or feel violated in some way, but not have a clear memory of the events. In these instances, Rohypnol, the socalled "date rape drug," may have been given to the person without her knowledge.

Rohypnol (pronounced row-hip-nole) is a powerful tranquilizer that is illegal in United States. (Outside of the United States, Rohypnol is prescribed for the treatment of sleep disorders.) The drug produces sedative (calming, tranquilizing) effects such as amnesia (loss of memory) and muscle relaxation, and the effects can last up to eight hours. Rohypnol, nicknamed "roofies" or "ruffies," has gotten the reputation as a date rape drug in recent years because of its reported use among victims of date rape who were rendered helpless—and thus not able to consent to sexual relations—under its effects.

Not all uses of Rohypnol are without the user's consent, however. According to the Teen Challenge World Wide Network, "Rohypnol use appears to be spreading in the United States among high school and college youth" to enhance the feeling of drunkenness when mixed with beer or alcohol. Whether taken intentionally, or having it "slipped" to someone without his or her knowledge, Rohypnol is a dangerous, illegal drug that renders one out of control of one's own body.

Many people that are being harassed or abused are sometimes afraid to admit it. There are a lot of reasons for this. Sometimes the person harassing another threatens the victim, forcing him or her to promise not to tell anyone else, or threatens to harm the victim's family or that the victim might lose a job or favor with the perpetrator. Sometimes people are afraid that they are responsible for what has happened to them, so they want to keep it a secret. Young people are often manipulated into thinking that they will get into trouble if they tell an adult about the situation.

If anyone, an adult or another teen or child, touches anyone else inappropriately or threatens another person sexually, one should immediately tell a trusted adult or law-enforcement professional. Sometimes, the abuser or perpetrator is someone that, in normal situations, should be trusted. In this case, it is often hard to speak up, especially if that person is a classmate, a boss, or even a family member. If a victim is scared that he or she won't be believed, a neutral party should be consulted (a guidance counselor, a neighbor, a friend's mother or father) so that they can act on the victim's behalf.

The only way to stop abuse and harassment is to expose it.

FOR MORE INFORMATION

Books

Ditson, Mary, Caesar Pacifici and Lee White. The Teenage Human Body Operator's Manual. Ore.: Northwest Media Inc., 1998.

Harris, Robie H. It's Perfectly Normal: Changing Bodies, Growing Up, Sex & Sexual Health. New York: Candlewick Press, 1996.

Jukes, Mavis. It's A Girl Thing: How To Stay Healthy, Safe and In Charge. New York: Alfred A. Knopf, 1996.

McCoy, Kathy and Charles Wibbelsman. The New Teenage Body Book. New York: The Body Press/Perigee Books, 1992.

Web sites

The American Foundation for AIDS Research. [Online] http://amfar.org (Accessed October 25, 1999)

Centers for Disease Control and Prevention. [Online] http://www.cdc.gov (Accessed October 25, 1999)

Planned Parenthood. [Online] http://www.plannedparenthood.org (Accessed October 25, 1999)

Teen Challenge World Wide Network. [Online] http://www.teenchallenge.com (Accessed October 25, 1999)

SEXUALITY.

This entry includes three subentries: