* In addition to the above sexologists who authored specific sections of this chapter, the authors and general editor are grateful to other colleagues who served as special consultants: Mark O. Bigler, L.C.S.W., Ph.D., Bonnie Bullough, R.N., Ph.D.; Vein L. Bullough, R.N., Ph.D.; Sandra S. Cole, Ph.D.; Carol A. Darling, Ph.D.; J. Kenneth Davidson, Ph.D.; Clive Davis, Ph.D.: Karen Komisky-Brash, M.A.; Barbara Van Oss Marin, Ph.D.: Ted McIlvenna, Th.D, Ph.D.; John Money, Ph.D.; Gina Ogden, Ph.D.; Paul Okami, Ph.D.; Letitia Anne Peplau, Ph.D.; and Stephanie Wadell, M.A. Although these colleagues generously contributed resource materials and their expertise for sections of the chapter, the authors and general editor accept full responsibility for the final integration of the material presented in this chapter.
This extensive chapter on sexuality in the United States is unique in this multivolume International Encyclopedia of Sexuality for three reasons: (1) the vast amount of research information and data available on American sexuality, (2) the ethnic and religious complexity of the population, and (3) the number of sexologists involved in its preparation. Twenty-three specialists joined me and the chapter coeditors, Drs. Patricia Barthalow Koch and David L. Weis, in writing individual sections. An additional fifteen specialists advised individual writers on topics within their expertise.
Because the editors were very much aware of and sensitive to the diversity of our contributors and their varied and rich perspectives, we felt it was important to let each contributor speak for her or himself. In respecting this freedom and diversity, we feel a strong responsibility to comment on the consequences of this decision for the reader.
The reader should not expect to find in this chapter a single, consistent, and coherent picture of sexual attitudes and behaviors in the United States. In some sections, the reader will encounter an insider’s or emic view of a particular aspect, e.g., Ariadne Kane offers an insider’s view of cross-gender issues, and Mitchell Tepper writes about sexuality and people with physical and developmental disabilities from both his personal experience and professional perspective. Most of the other contributors write from an etic view as outside researchers or observers. To appreciate critically these various views, the reader should consider the perspective of the individual writer. Among the contributors to this chapter, the reader will encounter researchers, therapists, counselors, and educators. Each researcher, therapist, counselor, or educator will be more or less strongly influenced by her or his professional background and training as a psychologist, sociologist, biologist, health-care professional, behavioral biologist, nonverbal behaviorist, social, clinical, or evolutionary psychologist, cultural or evolutionary sociologist, anthropologist, health educator, gender specialist, or activist/advocate.
The reader will encounter research theories and statistics throughout the chapter. These data may represent the results of studies conducted by researchers who might have been constrained by popular interests, political restrictions, or the biases of funding agencies to devote their time and energy to, perhaps, interesting and useful, but trendy research. Thus, they may have had to devote their expertise to more limited, and perhaps chic or politically safe research.
The chapter presented here represents a mosaic that is not always coherent - nor could it be, given the diversity of American sexologists, the funding and support for sexology, and the ever-changing complex of American sexual attitudes, biases, and values. This chapter does, however, present a solid picture of what American sexologists do when they summarize the research and data available on topics in their own domain of interest and specialization.
In one sense, great diversity is virtually guaranteed by the sheer size of the United States. The U.S.A. is a union of fifty participating states. It is one of the larger nations in the world, with the forty-eight contiguous states spanning more than three thousand miles across the North American continent, from its eastern shores on the Atlantic Ocean to its western shores on the Pacific Ocean, and more than two thousand miles from its northern border with Canada to its southern border with Mexico and the Gulf of Mexico. In addition, the state of Alaska, itself a large landmass covering thousands of square miles in the northwest corner of North America, and the state of Hawaii, a collection of islands in the mid-Pacific Ocean, are part of the union.
The U.S.A. has a population of more than 260 million racially and ethnically heterogeneous people (Wilkinson 1987; World Almanac and Book of Facts, 1993). A majority, about 161 million or two thirds, are white descendants of immigrants from the European continent, with sizable groups from Great Britain, Ireland, Italy, Germany, and Poland. The second-largest group, roughly 29 million or 12 percent, is African-American, most of whose ancestors were brought to North America as slaves before the twentieth century. The third-largest group, 22 million or 9 percent, is comprised of Hispanic-Americans, whose ancestors emigrated from such places as Mexico, Puerto Rico, Cuba, Haiti, and the Dominican Republic, as well as other Central and South American nations. Hispanics represent the fastest-growing minority group in the U.S.A.. There are also more than two million Native Americans - Eskimos, Aleuts, and those mistakenly at one time called Indians - whose ancestors have occupied North America for thousands of years, and whose residence within the boundaries of what is now the U.S.A. predates all of the other groups mentioned.
Another group experiencing rapid growth in recent decades is Asian-Americans; there are now more than three million residents of Asian heritage. Substantial populations of Japanese and Chinese immigrants have been in the U.S.A. since the nineteenth century. More recently, there has been an increase from such nations as India, Vietnam, Korea, the Philippines, Cambodia, Indonesia, and Pakistan. Finally, there are smaller groups of immigrants from virtually every nation, with growing numbers of Moslems in recent decades. The size of the various nonwhite minority groups has been increasing in the last thirty years, both in terms of real numbers and as a percentage of the total U.S.A. population (Wilkinson 1987; World Almanac 1993).
It is fair to conclude that the U.S.A. is generally a nation of former immigrants. Moreover, one continuing feature of American history has been the successive immigration of different groups at different points in time (Wells 1985).
Approximately two thirds of the population lives within one hundred miles of one of the coastal shorelines. Most of the largest metropolitan areas lie within these coastal areas, and it is worth noting that most sexologists in the U.S.A. also reside in these same areas.
The U.S.A. is somewhat unique among the world’s economies in that it is simultaneously one of the largest agricultural producers as well as one of the largest industrialized nations, exporting manufactured goods and technology to the rest of the world. Historically, the northeast and upper midwest have been the principal industrial centers, and the southeast and the central Great Plains have been the agricultural centers.
One of the economically richest nations in the world, America, nevertheless, has an estimated 500,000 to 600,000 individuals and 125,000 to 150,000 families homeless on any night. Overall, 15 percent of Americans - 30 percent of the poor - are without health insurance. Infant-mortality rates and life-expectancy rates vary widely, depending on socioeconomic status and residence in urban, suburban, or rural settings. Fifty-two million American married couples are paralleled by 2.8 million unmarried households and close to 8 million single-parent families.
In summarizing aspects of sexuality in America, it is helpful to keep in mind that the United States of the twenty-first century will look profoundly different from the nation described in this chapter. Four major trends for the future have been detailed in Population Profile of the United States (1995), published by the U.S. Census Bureau.
There is also great diversity in religious affiliation in the U.S.A. (Marciano 1987; see Section 2A). To a considerable degree, the choice of religious denomination is directly related to the ethnic patterns previously described. The overwhelming majority of Americans represent the Judeo-Christian heritage, but that statement is potentially misleading. Within the Judeo-Christian heritage, there are substantial populations of Roman Catholics, mainstream Protestants (Lutheran, Methodist, Baptist, Episcopalian, and others), and a growing number of fundamentalist Christians. There is no great uniformity in religious practice or sexual mores shared by these various groups. In addition, there is a relatively small percentage of Americans who are Jewish and range from ultra-orthodox to conservative, reformed, and liberal. In recent decades, as immigration from Asia has increased, there has been a corresponding growth in the Moslem and Hindu faiths.
Several trends related to the practice of religion in the U.S.A. have become a source of recent social concern. These trends include: the declining attendance at the traditional Protestant and Catholic churches, in what has been labeled the growing “secularization” of American culture; the “religious revivalism” reflected by the growth of fundamentalist churches; the growth of religious cults (e.g., Hare Krishna and the Unification Church); the growing power of the conservative Christian Coalition; and the emergence of the “Electronic Church” (religious broadcasting) (Marciano 1987). Throughout the history of this nation, diversity of religious beliefs and the separation of church and state have been central elements in conflicts over sexual morality.
The subcultures and peoples of the United States are as varied, diverse, and complex as any other large nation. The unique feature of sexuality in the United States is that we have far more information and data on American sexual attitudes, values, and behaviors than is available for any other country.
A few examples will illustrate some of the issues that have been affected by this complex of influences.
Each of the above incidents serves as an intriguing indicator of the state of sexuality in the United States, and each also reveals much about the interaction of politics and sexual issues as we approach the end of the twentieth century. They demonstrate that, despite the immense social changes that have occurred during this century, a strong element of religious fundamentalism and conservatism remain active within the culture. In fact, a full explanation of sexuality in the United States requires an understanding of the diverse sexual, social, and political ideologies characterizing the culture, and the ongoing conflict between various groups over those ideologies.
In this respect, there is a rather schizophrenic character to sexuality in the United States. On the one hand, the U.S.A. is a country with a multi-billion-dollar-a-year erotica/pornography business; a mass-media system where movies, television, books, magazines, and popular music are saturated with sexually titillating content alongside serious educational material; a high rate of premarital sex (nearly 90 percent by the 1990s); one of the most active and open gay-rights movements in the world; and a continuing public fascination with unusual sexual practices, extramarital sex, and gender-orientation issues, including, most recently, bisexuality.
On the other hand, federal, state, and local governments have invested heavily in recent years in prosecuting businesses for obscenity, allowed discriminatory practices based on sexual orientation, largely failed to implement comprehensive sexuality-education programs in the schools, and refused to support accessibility to contraceptives for adolescents. The consequences of these failures include one of the highest teenage-pregnancy and abortion rates in the world and increasing incidents of gay-bashing that reflect the prevalence of homonegative and homophobic attitudes in the U.S.A.
These examples illustrate one of the major themes in this chapter: the changing nature of sexuality in the U.S.A. throughout the twentieth century. Although accounts of changing sexual norms and practices are frequently portrayed as occurring in a linear process, we would suggest that the more-typical pattern is one reflected by ongoing conflicts between competing groups over sexual ideology and practice. Each of the examples cited is an illustration of how those conflicts are currently manifested in the social and political arenas in the U.S.A.
A focus on the conflict between groups with contrasting ideologies and agendas over sexual issues will be a second theme of this chapter. This process of changing sexual attitudes, practices, and policies in an atmosphere that approaches “civil war” is a reflection of the tremendous diversity within American culture. In many respects, the widespread conflict over sexual issues is a direct outcome of the diversity of groups holding a vested interest in the outcomes of these conflicts, with some groups seeking to impose their beliefs on everyone.
The diversity of these groups will be the third major theme of the chapter. One example that will be apparent throughout this chapter is the question of gender. There is growing evidence that men and women in the U.S.A. tend to hold different sexual attitudes and ideologies, to exhibit different patterns of sexual behavior, and to pursue different sexual lifestyles - frequently at odds with each other (Oliver and Hyde 1993). In some ways, it may even be useful to view male and female perspectives as stemming from distinct gender cultures. In reviewing sexuality in the U.S.A., we will frequently attempt to assess how change occurs in a context of conflict between diverse social groups.
This overall theme of social change occurring in a process of conflict between diverse groups is woven throughout the history of the U.S.A. itself. There are at least two ways in which a study of history is important to an understanding of contemporary sexological premises and sexual patterns in the U.S.A. First, there is a specific history of sexual norms and customs changing over time. To the extent that sexual attitudes and practices are shared by the members of a social group or population in a particular time period, they can be viewed as social institutions. Unfortunately, it is exceedingly difficult to describe such sexual institutions in the U.S.A. prior to the twentieth century, because there are few reliable empirical data sets available for that period. To a large extent, we have to rely on records of what people said about their own or others’ sexual attitudes and practices, and such statements may be suspect. Still, it seems reasonable to suggest that current sexual norms and customs have been shaped, at least in part, by earlier patterns.
In addition, there is a second way in which the general social history of the U.S.A. is important to understanding changing sexual institutions. Sexuality, like other social institutions, does not operate in a vacuum. It is related to and influenced by other social institutions, such as the economy, government, marriage and the family, religion, and education, as well as social patterns such as age distributions and gender ratios. As we will discuss in Section 2, a good deal of research evidence indicates that such social institutions are often related to various sexual variables. Researchers have not consistently tested these associations, but the point is a crucial one theoretically for explaining the dynamics of sexual processes in a culture as large and diverse as the U.S.A.
In 1776, at the time of the War for American Independence, the U.S.A. became a nation of thirteen states located along the shore of the Atlantic Ocean. Most of the inhabitants of the former British colonies were of English descent, and they tended to be Protestant. Although the first Africans had been brought to America as indentured servants as early as 1620, the practice of slavery quickly evolved. By the time of independence, an active slave trade involving hundreds of thousands of Africans and Caribbeans was well established. Of course, the Africans and Caribbeans brought their own customs with them, although they were frequently prevented from practicing them. West of the thirteen original states, the remainder of the North American continent within the area now constituting the nation was inhabited by several million Native Americans representing hundreds of tribes, each with its own set of customs.
At its birth, the U.S.A. was essentially an agrarian society. More than 90 percent of the population were farmers. There were few cities with as many as 5,000 residents. Boston was the largest city with 16,000, and New York was the second largest with 13,000 (Reiss 1980). The Industrial Revolution had yet to begin. Few men, and virtually no women, were employed outside the family home. Although it has become common to think of the twentieth-century pattern of role specialization, with the man serving as the family provider and the woman as the housekeeper and child-care provider, as the traditional American pattern, it did not characterize this early-American agrarian family. Family tasks tended to be performed out of necessity, with both men and women making direct and important contributions to the economic welfare of their families. Sexual norms and practices in early America arose in this social context.
The images of early-American sexuality in folklore are those of antihedonistic Puritanism and sexually repressed Victorianism. In popular culture, these terms have come to be associated with sexual prudishness. This view is oversimplistic and potentially misleading. Recent scholars (D’Emilio and Freedman 1988; Robinson 1976; Seidman 1991) tend to agree that sexuality was valued by the eighteenth-century Puritans and nineteenth-century Victorians within the context of marriage. To the Puritans, marriage was viewed as a spiritual union, and one that tended to emphasize the duties associated with commitment to that union. Marriage involved mutual affection and respect, and the couple was viewed as a primary social unit. Spouses were expected to fulfill reciprocal duties. One of these was sexual expression. No marriage was considered complete unless it was consummated sexually. The Puritans accepted erotic pleasure, as long as it promoted the mutual comfort and affection of the conjugal pair. The reciprocal duties of marital sexuality were justified, because they were seen as preventing individuals from becoming preoccupied with carnal desires and the temptation to practice improper sex outside of marriage (Seidman 1991). Of course, one of the principal functions of marital sex was reproduction. Pleasure alone did not justify sexual union. Instead, the regulation of sexual behavior reinforced the primacy of marital reproductive sex and the need for children (D’Emilio and Freedman 1988).
Within this context, it is certainly true that the early English settlers tried to regulate nonmarital forms of sexual expression. However, even this point can be exaggerated. Reiss (1980) has noted that Americans have always had a courtship system where individuals were free to select partners of their own choice. To some extent, this may have been due to necessities imposed by immigration to frontier territories, but it also was a consequence of the freedom settlers had from the institutions of social control found in Europe. Elsewhere, Reiss (1960; 1967) has maintained that such autonomy in courtship is associated with greater premarital sexual permissiveness.
In this regard, it is interesting to note that the settlers in New England developed the practice of bundling as a form of courtship. In colonial New England, settlers faced harsh winters. They commonly faced fuel shortages, and mechanized transportation forms had yet to be developed. Single men would travel miles to visit the home of an eligible female. Typically, they would spend the night before returning home the next day. Few New England homes of the period had multiple rooms for housing a guest, and few could heat the house for an entire twenty-four-hour day. At night, the woman’s family would bundle the man and the woman separately in blankets, and they would spend the night together talking to each other as they shared the same bed. It is worth noting that the practice of bundling was restricted to winters. Reiss (1980) has argued that the implicit understanding that the couple would avoid a sexual encounter was not always honored. In fact, a study of marriages in Groton, Massachusetts, from 1761 to 1775 found that one third of the women were pregnant at the time of their weddings (cited in Reiss 1980). This system was acceptable because betrothals were rarely broken at the time and because it served to produce the marital unions the Puritans valued so highly. Eventually, bundling was replaced by visits in the sitting parlors of nineteenth-century homes and by the practice of dating outside parental supervision in the twentieth century (Reiss 1980).
Around 1800, the Industrial Revolution began changing this world, albeit gradually. In the two centuries since, virtually every aspect of American life has been transformed. The nineteenth century was marked by social turmoil, a frontier mentality open to radical change, and a resulting patchquilt of conflicting trends and values. Among the events that left their mark on American culture in the nineteenth century were the following:
Pankhurst and Houseknecht (1983) have identified five major trends that they maintain began to change and shape the modern institutions of marriage and the family in the nineteenth century and have continued to impact American culture in the twentieth century. The author of this section suggests that they have had a similar influence on sexual institutions. These trends are:
We do not have the space to explore fully the impact of each of these trends. However, relevant effects would include increased life spans, decreased maternal and infant mortality at childbirth, the development of effective contraceptives, the emergence of a consumer culture that allows families to purchase most of their goods and services, the creation of labor-saving household technologies, increased leisure time, the development of modern forms of transportation, especially automobiles and airplanes, an increasing divorce rate, the increasing entry of wives and mothers into the labor force, decreasing birthrate and family size, increasing rates of single-parent families and cohabitation, increasing percentages of adults living alone, and increasing proportions of married couples with no children currently living at home (Coontz 1992). Many of these changes have resulted in greater personal autonomy for individuals. As Reiss (1960; 1967) has argued, such autonomy may be a major factor underlying several changes in sexuality throughout American history.
It should be stressed that these changes have not necessarily been linear or consistent throughout the period of the Industrial Revolution. Many began to emerge in the nineteenth century, but accelerated and became mainstream patterns only in the twentieth century. For example, as late as 1900, a majority of Americans were still farmers. The 1920 census was the first to show a majority of the population living in towns and cities. By 1980, only 4 percent of Americans still lived on farms (Reiss 1980). Similarly, women began entering the labor force in the early nineteenth century. However, it was not until 1975 that one half of married women were employed. By 1990, 70 percent of married women between the ages of 25 and 44 were employed (Coontz 1992). Yet another example is provided by the divorce rate. It had been gradually increasing for decades. That rate doubled between 1965 and 1975, and for the first time, couples with children began divorcing in sizable numbers at that time (Coontz 1992; Reiss 1980; Seidman 1991).
Seidman (1991) has described the principal change in American sexuality during the nineteenth century as the “sexualization of love.” It could also be described as a shift to companionate marriage. Marriage came to be defined less as an institutional arrangement of reciprocal duties, and more as a personal relationship between the spouses. The modern concept of love as a form of companionship, intimacy, and sharing came to be seen as the primary justification for marriage. As this process continued, the erotic longings between the partners, and the sexual pleasures shared by them, became inseparable from the qualities that defined love and marriage. By the early part of the twentieth century, the desires and pleasures associated with sex came to be seen as a chief motivation and sustaining force in love and marriage (Seidman 1991). This view has come to be so dominant in the contemporary U.S.A. that few Americans today can envision any other basis for marriage.
D’Emilio and Freedman (1988) have argued that what they call the liberal sexual ethic described in the previous paragraph has been the attempt to promote this view of the erotic as the peak experience of marriage while limiting its expression elsewhere. However, as this view became the dominant American sexual ideology of the twentieth century, it also served to legitimate the erotic aspects of sexuality itself (Seidman 1991). Eventually, groups emerged which have sought to value sex for its inherent pleasure and expressive qualities, as well as for its value as a form of self-expression. In effect, as the view that sexual gratification was a critical part of happiness for married persons became the dominant sexual ideology of twentieth-century America, then it was only a matter of time until some groups began to question how it could be restricted only to married persons (D’Emilio and Freedman 1988).
The social turmoil and the pace of social change that marked the nineteenth century has accelerated exponentially in the present century. American culture in the twentieth century has been increasingly complicated and changed by often-unanticipated developments in technology, communications, and medicine. Among the events that have been identified as significant in twentieth-century United States are the following:
These and other events too numerous to list, let alone analyze here, both contributed to and reflect the tension between the two ideologies mentioned above - one viewing sex as legitimate only in marriage, but as a necessary component of marital happiness, and the other viewing sex as a valid and important experience in its own right. The attempt to reconcile them can be seen as an underlying dynamic for many sexual practices and changes in the twentieth century. These broad-based trends include:
Reactions to these trends, and the continuing tension between the two major ideologies we have outlined above, lie at the very heart of the ongoing conflicts over sexual issues today. Robinson (1976) has characterized this conflict as a battle between nineteenth-century romanticism and what he calls sexual modernism. Romanticism affirmed the essential worth of the erotic, but only within the context of an intense interpersonal relationship transformed by a spiritual and physical union. Modernism reaffirms this romantic ideal, but also transforms it by acknowledging the value of “an innocent physical need” (p. 194). Although the modernist is glad to be rid of Victorian repression and anticipates the promise of a greater sexual freedom, there is a concomitant fear of a future of emotional emptiness.
Reiss (1981) has characterized this as a conflict between what he calls the traditional-romantic and modern-naturalistic ideologies. He maintains that this distinction can be used to explain current conflicts over such issues as abortion, gender roles and differences, pornography, definitions of sexual exploitation, concepts of sexual normality, and even accounts of sexual history itself. This perspective is useful in interpreting mass-media claims about sexuality in the U.S.A. Thus, Lyons (1983), reporting for The New York Times, proclaimed that the “sexual revolution” was over by the 1980s and that America was experiencing a return to traditional values and lifestyles. To support his argument, he claimed that there was a recent decrease in the number of sex partners and a shift away from indiscriminate, casual sexual behavior (Lyons 1983). In contrast, Walsh (1993), writing for Utne Reader, proclaimed that the 1990s have been characterized by a renewed sexual revolution (second-wavers), with pioneering new philosophies and techniques employing technology (latex, computer imaging, computer networks, virtual reality sex, phone sex, cathode rays, and group safe sex) to achieve sensual pleasure in a safe way.
From 1970 to 1990, as these social processes continued, Americans witnessed: (1) a decrease in the marriage rate; (2) an increase in the divorce rate; (3) an increase in the birthrate for unmarried mothers (although the overall adolescent birthrate decreased); (4) an increase in single-parent families; and (5) an increase in married couples without children at home (Ahlburg and DeVita 1992). In the next section, we consider the impact of religious, ethnic, and gender factors on such changes.
Social scientists have demonstrated an association between human behavior and such social factors as religion, race, gender, social class, and education. This is as true of sexuality as of other forms of behavior. Although sexuality researchers have not always incorporated a recognition of this principle in their designs and analyses, there is still abundant evidence that sexual practices in the U.S.A. are strongly related to social factors. In this section, we examine several examples. First, we review the general influence of the Judeo-Christian heritage in the U.S.A. and describe the sexual culture of a particular religious group within this tradition, the Church of Jesus Christ of Latter-Day Saints (Mormons). Then we review the sexual customs of two of the largest minority groups in the U.S.A., African-Americans and Hispanic-Americans. Finally, we review the emergence of feminist ideology in the U.S.A., a view constructed around the concept of gender. These reviews are by no means exhaustive or complete, but should serve to illustrate both the diversity of social groups within the U.S.A. and the influence that membership in such groups exerts on sexual customs and practices.
Sexual science in America is a mid- to late-twentieth-century discipline. By contrast, Western religious thought about love, sexuality, marriage, the social and familial roles of men and women, and the emotions and behavioral patterns associated with courtship, pair bonding, conception, and birth have textual bases in the Jewish Pentatuch and other biblical writings. In pre-Christian Hellenic thought, the First great document of sexology is Plato’s Symposium (ca. 400 B.C.E.). Because Judaic and Hellenic thought have strongly influenced the sexual views of Christianity and all of Western culture, one must acknowledge that the theological, religious, and secular writings that permeate American conceptions of sexuality are embedded in this 3,500-year-old matrix that gives sexuality its place in life (and unique meanings). This section will explore the sources and character of religious values in the U.S.A. and their impact on sexual attitudes, behaviors, and policies.
Religious Groups in the U.S.A. Statistically, Americans are 61 percent Protestant - 21 percent Baptist, 12 percent Methodist, 8 percent Lutheran, 4 percent Presbyterian, 3 percent Episcopalian, and 13 percent other Protestant groups, including the Church of Latter-Day Saints (see Section 2 below for a more in-depth discussion of the sexual doctrines and practices of this religious group), Seventh-Day Adventists, Jehovah’s Witnesses, Christian Scientists, and others. Roman and Eastern-rite Catholics account for 25 percent of Americans, Jews 2 percent, 5 percent other religious groups, and 7 percent are not affiliated with any church. Therefore, the two largest denominations in the U.S.A. are the Roman Catholic Church with a membership of over 50 million and Southern Baptist Conventions with between 10 and 15 million members (Greeley 1992). There are also 2.5 million Muslims in the U.S.A.
Because Americans tend to cluster geographically according to both their religious and ethnic heritages, local communities can be much more strongly affected by a small but highly concentrated religious or ethnic tradition than the above percentages might suggest at first sight. With recent public debate focusing on sexual morality (e.g., contraception, abortion, and homosexuality), a paradoxical realignment has occurred, with liberal Roman Catholics, mainstream Protestant churches, and liberal and reformed Jews lining up on one side of these issues, and conservative (Vatican) Roman Catholics, fundamentalist Protestants, including the televangelists and Southern Baptists, Orthodox Jews, and fundamentalist Muslims on the other side.
A Basic Conflict Between Two Worldviews. American religious institutions on the national level, their local religious communities, and individual members are caught in a pervasive tension between the security of traditional unchanging values and the imperative need to adapt perennial religious and moral values to a radically new and rapidly changing environment. This tension permeates every religious group in the United States today, threatening schism and religious “civil war” (Francoeur 1994).
At one end of the spectrum are fundamentalist, evangelical, charismatic factions that accept as word-for-word truth the writings of the Bible as the word of God and advocate the establishment of the United States as a Christian nation. For them, living under God’s rule would be evidenced by the man firmly established as the head of each family in the U.S.A. and the woman in her God-given role as submissive wife and bearer of children for the Kingdom of Heaven. Similar fundamentalist strains in the United States are apparent among ultra-orthodox Jews and radical Muslims (LeHaye and LeHaye 1976; Marty and Appleby 1992, 1993, 1994; Penner and Penner 1981; Wheat and Wheat 1981). These embody an absolutist/natural law/fixed worldview.
On the conservative side, books about sexuality written by married couples dominate the market and sell millions of copies without ever being noticed by the mainstream publishing industry. Intended for Pleasure (Wheat and Wheat 1981) and The Gift of Sex (Penner and Penner 1981) - the latter couple having been trained by Masters and Johnson - provide detailed information on birth control and express deep appreciation of sex as a gift to be enjoyed in marriage. Tim and Beverly LeHaye’s The Act of Marriage celebrates marital sexual pleasure, but disapproves of homosexuality and some sexual fantasy. All books in this category stress mutual pleasuring and the importance of female enjoyment of marital sex.
At the other end of the spectrum are various mainstream Protestants, Catholics, Jews, and Muslims who accept a processual/evolutionary world-view (Fox 1983, 1988; Curran and McCormick 1993; Heyward 1989; Kosnick et al. 1977; Nelson 1978, 1983, 1992; Nelson and Longfellow 1994; Ranke-Heinemann 1990; Spong 1988; Thayer 1987; Timmerman 1986) rather than the fixed fundamentalist worldview. In this processual worldview, the sacred divinely revealed texts are respected as
the record of the response to the word of God addressed to the Church throughout centuries of changing social, historical, and cultural traditions. The Faithful responded with the realities of their particular situation, guided by the direction of previous revelation, but not captive to it. (Thayer et al. 1987)
The most creative and substantive analysis of the evolution and variations in biblical sexual ethics over time is William Countryman’s Dirt, Greed, and Sex: Sexual Ethics in the New Testament and Their Implications for Today. (For a full annotated list of sexuality texts, see Cornog and Perper 1995.)
The tension between the values and morals derived from fixed world-views and those derived from processual worldviews is evident in official church debates about sexual morality and is also experienced by church members as they struggle to find their way through the confusion resulting from these two views. But it also affects the lives of secular Americans with no connection with a church, mosque, or synagogue, because the religious debate over sexual values permeates all levels of American society, and no one can escape the impact of this debate and conflict on politics, legislation, and social policies. Table 1 is an attempt to describe in a nondefinitive way the two divergent sets of values derived from the processual and fixed worldviews. Table 2 lists some religious traditions in both the fixed and processual worldviews in the major religions around the world.
Table 1
A Cognitive and Normative Continuum of Sexual Values Derived from Two Distinct Worldviews, Fixed and Process, Within the Christian Tradition
|
|
Christian Religions Type A |
Christian Religions Type B |
|
Basic vision |
Cosmos - a finished universe |
Cosmogenesis - an evolving universe |
|
Typology |
The universe, humankind is created perfect and complete in the beginning. |
The universe, humankind is incomplete and not yet fully formed. |
|
Theological understanding of humans emphasizes Adam. |
Theological emphasis has shifted to Christ (The Adam) at the end of time. |
|
|
Origin of evil |
Evil results from primeval ’fall’ of a perfect couple who introduce moral and physical evil into a paradisical world. |
Evil is a natural part of a finite creation, growth, and the birth pains involved in our groping as imperfect humans struggling for the fullness of creation. |
|
Solution to the problem of evil |
Redemption by identification with the crucified Savior. Asceticism, mortification. |
Identification with the Adam, the resurrected but still fully human transfigured Christ. Re-creation, growth. |
|
Authority system |
Patriarchal and sexist. Male-dominated and ruled. Autocratic hierarchy controls power and all decisions; clergy vs. laity. |
Egalitarian - ’In his kingdom there is neither male nor female, freeman or slave, Jew or Roman.’ |
|
Concept of truth |
Emphasis on one true Church as sole possessor of all truth. |
Recognition that other churches and religions possess different perspectives of truth, with some elements of revelation clearer in them than in the “one true Church.” |
|
Biblical orientation |
Fundamentalist, evangelical, word-for-word, black-and-white clarity. Revelation has ended. |
Emphasizes continuing revelation and reincarnation of perennial truths and values as humans participate in the creation process. |
|
Liturgical focus |
Redemption and Good Friday, Purgatory, Supernatural. |
Easter and the creation challenge of incarnation. Epiphany of numinous cosmos. |
|
Social structure |
Gender roles clearly assigned with high definition of proper roles for men and women. |
There being neither male nor female in Christ, gender roles are flexible, including women priests and ministers. |
|
Goal |
Supernatural transcendence of nature. |
Unveiling, Revelation of divine in all. |
|
Ecological morality |
Humans are stewards of the earth, given dominion by God over all creation. |
Emphasis on personal responsibility in a continuing creation/incarnation. |
|
Self-image |
Carefully limited; isolationist, exclusive, Isaias’s ’remnant.’ Sects. |
Inclusive, ecumenical, catalytic leader among equals. |
|
Human morality |
Emphasis on laws and conformity of actions to these laws. |
Emphasis on persons and their interrelationships. We create the human of the future and the future of humanity. |
|
Sexual morality |
The ’monster in the groins’ that must be restrained. |
A positive, natural, creative energy in our being as sexual (embodied) persons “Knowing” (yadah), Communion. |
|
Justified in marriage for procreation. Genital reductionism. |
An essential element in our personality in all relationships. Diffused, degenitalized sensual embodiment. |
|
|
Heterosexual/monogamous. |
“Polymorphic perversity,” “paneroticism.” |
|
|
Noncoital sex is unnatural, disordered. |
Noncoital sex can express the incarnation of Christian love. |
|
|
Contraceptive love is unnatural and disordered. |
Contraception can be just as creative and life-serving as reproductive love. |
|
|
Monolithic - celibate or reproductive marital sexuality. |
Pluralistic - sexual persons must learn to incarnate chesed/agape with eros in all their relationships, primary and secondary, genital and non-genital, intimate, and passionate. |
|
|
Energy conception |
Competitive. |
Synergistic. |
|
Consumerist. |
Conservationist. |
|
|
Technology-driven and obsessed. |
Concerned with appropriate technologies. |
Modern America is a ferment of discourse and debate concerning relationships between sexuality and religion. This occurs on the local and personal level among church members, as well as on the administrative level among the church leadership. The vast majority of local church debates are not reported in the popular press. These debates center on the interpretations of revelation, religious truths, and the nature and place of sexuality within a particular absolutist/natural law/fixed worldview or processual/evolutionary worldview. From time to time, denominational leaders and assemblies issue authoritative statements in denominational position or workstudy papers. These formal statements are designed to answer questions of sexual morality and set church policy. However, contradictory majority and minority positions rooted in the opposing fixed and processual worldviews accomplish little beyond stirring heated debate and deferring the problem to further committee study (Francoeur 1987, 1994).
Table 2
A Spectrum of Ethical Systems with Typical Adherents in Different Religious Traditions
This table is an attempt to visualize the range of sexual moralities in different religious traditions and relate them in terms of their basic worldviews. There is often more agreement between different Jews, Protestants, and Catholics at one or the other end of the spectrum, than there is between Protestants, or Catholics, or Jews who disagree in their worldviews. Protestants in the covenant tradition, for instance, have more in common with liberal Catholics who disagree with the Vatican’s opposition to such practices as contraception, masturbation, premarital sex, abortion, divorce, and homosexuality, than they do with their fellow Protestants who are members of the fundamentalist Christian Coalition, Eagle Forum, or Focus on the Family.
While Eastern religions may, in some cases, fit in with this dualism of worldviews, the ascetic traditions of the East are positive traditions and lack the negativism towards sexuality that permeates the history of Christian asceticism and celibacy. Eastern asceticism is seen as a positive balance to the Eastern’s embrace of sexuality as both a natural pleasure to be greatly enjoyed and a path to the divine union. Also, the relationship with the dichotomous weltanschauungs evident in Western traditions needs to be explored and explicated.
|
Tradition Source |
A Spectrum or Continuum |
|
|
Fixed Philosophy of Nature |
Process Philosophy of Nature |
|
|
Roman Catholic tradition |
Act-oriented natural law/divine law order ethics expressed in formal Vatican pronouncements |
A person-oriented, evolving ethics expressed by many contemporary theologians and the 1977 Catholic Theological Society of America study of human sexuality. |
|
Protestant nominalism |
Fundamentalism based on a literal interpretation of the Bible, as endorsed by the Moral Majority and the religious New Right: Seventh-Day Adventists, Jehovah’s Witnesses, and Church of Latter-Day Saints |
An ethic based on the covenant announced between Jesus and humans - examples in the 1970 United Presbyterian workstudy document on Sexuality and the Human Community, Unitarian/Universalists, and the Society of Friends (Quakers) |
|
Humanism |
Stoicism and epicurean asceticism |
Situation ethics, e.g., the 1976 American Humanist Association’s “A New Bill of Sexual Rights and Responsibilities” |
|
Judaism |
Orthodox and Hasidic concern for strict observation of the Torah and Talmudic prescriptions |
Liberal and reformed application of moral principles to today’s situations |
|
Islam |
Orthodox; observance of female seclusion (purdah) and wearing of the veil (chador); ritual purifications associated with sexual activities |
Secular; more or less adoption of Western gender equality; flexible/lax observance of sex-associated purification rituals |
|
Hinduism |
Ascetic tradition of monks with world-denying sexual abstinence; Yoga; ritual taboos and purification rites associated with sexual activities |
Sacramental view of sex with worship of male lingam and female yoni; the Kama Sutra |
|
Buddhism |
Ascetic tradition of monks with sexual abstinence |
Tantric traditions in which sexual relations are a path to divine union |
However, there is often a great difference between official church doctrine and worldview and the views and practices of its members. For example, the most erotophilic religion in America may be grassroots Roman Catholicism as expressed and lived by the laity. Many rank-and-file American Catholics express great and amused doubt and scorn for the sexual pronouncements of the Vatican (Greeley 1995). Peter Gardella (1985) has made a strong case for the thesis that Christianity has, in fact, given America an ethic of sexual pleasure.
The Conservative Christian Coalition. Among the major forces in the American religious scene that affect public sexual mores is the conservative Christian Coalition. Among the fundamentalist Christians, one finds an extraordinary heterogeneity. There exists a large and virtually unstudied mixture of Pentecostal, fundamentalist, and evangelical/charismatic churches whose preachers expound on sexuality, marriage, family, and morality. Their opinions are diverse, and poorly known or understood by those outside their domain, especially sexologists. Two examples illustrate this: A religious pamphlet published by the Rose of Sharon Press in Tennessee, the buckle of the so-called Bible Belt in the U.S.A., extols the clitoris as the “cradle of love,” and the Reverend Timothy LeHaye reminds his followers that God indeed created the delights of oral sex for married couples (only) to enjoy. No statistical data exist concerning these groups, and we know nothing about sexual behavior among individuals within these churches.
The current strength of the power of the American religious right is evident in the wide-reaching branches of Pat Robertson’s political machine, the Christian Coalition, and the “electronic churches,” including Robert-son’s cable television Christian Broadcasting Network (CBN), with annual revenues of $140 million (Roberts and Cohen 1995). A parallel conservative culture is James Dobson’s multimedia empire, Focus on the Family, which includes ten radio shows, eleven magazines (including speciality publications for doctors, teachers, and single parents), best-selling books, film strips, and videos of all kinds, curriculum guides, church-bulletin fillers, and sermon outlines faxed to thousands of pastors every week. The popularity of Dobson’s first book, Dare to Discipline - more than 2 million copies sold in 1977 - inspired his formation of Focus on the Family, which now has an annual budget of $100 million and a staff of 1,300 workers who answer more than 250,000 telephone calls and letters a month (Roberts and Cohen 1995).
In the late 1980s, Protestant fundamentalist televangelists from the South were reaching millions of listeners. Their influence was weakened by several major sex scandals, but they continue to play a major role in the anti-abortion movement and are part of the Christian Coalition. In the same era, the National Conference of Catholic Bishops tried to establish a cable television network to bring the Catholic faith to the masses. Where they failed, a determined Catholic fundamentalist-charismatic, Mother Angelica, from Mobile, Alabama, succeeded with the Eternal Word Network, which brings ultraconservative interpretations of Catholic sexual and social morality to devoted listeners twenty-four hours a day.
In the southern states, on the east and west coasts, and in the populous midwest states are several hundred “mega-churches,” which draw upwards of 5,000 to 20,000 faithful every week to each church. Congregations seated in upholstered theater seats are inspired by the style of a professional theater with a large choir, orchestra, large screens displaying hymn verses for congregational singing, interpretive dance, bible lessons with soft-rock concerts, and morality plays that rival anything on music television (MTV). These mega-churches are usually huge glass and steel shopping-mall-like complexes with large theater-stage sanctuaries, scores of meeting and classrooms for a variety of activities, including aerobics, multimedia Bible classes, counseling centers, and even bowling alleys, accompanied by acres of parking space. Sermons delivered by skilled “teaching pastors” include such topics as: how to find joy in a violent world, create a “happy day” each week, find rhythm between work and rest, handle teenage children, and discipline one’s mind to a biblical perspective. Youth, in particular, are attracted to the instant intimacy of this large-group, Disney-World environment. Weekly contributions from 15,000 members at one mega-church averaged $228,000, giving the church an annual budget of almost $12 million (Roberts and Cohen 1995). With the mainstream small local churches suffering a steady decline in attendance and contributions, many of the more-traditional pastors are turning to the mega-churches for pastoral retraining. Thus, the mega-churches are establishing smaller, local congregations. It appears that the way these churches deal with sexual issues may have a major impact on American sexuality because of the large memberships they are attracting.
Emergence of a Sex-Positive Individual-Based Value System. Diotima of Mantinea, Socrates’ instructress in the art of love in the Symposium, explained that the god Eros provides an avenue or way by which human beings reach upward to the Divine - a view modern classical scholars chauvinistically attribute to Socrates and call the “Erotic Ascent.” Historically, Diotima’s argument became the basis of the later Christian idea that God is Love. In Eurocentric Christianity, the first great flowering of Eros came between 1050 C.E. and 1200 C.E., when Ovid’s The Art of Love reached Europe from Arab-Spanish sources. The synthesis of sexuality and spirituality quickly assumed major status as a popular doctrine expressed in the music of the troubadours of “courtly love.”
Its most ardent opponents were the faculty of the medieval universities led by Thomas Aquinas, who developed a full and coherent alternative to the theology of the Platonic Erotic Ascent in the thirteenth century. The Thomistic synthesis, with its denunciation of the Erotic Ascent and analysis of the essence and goals of human sexuality in terms of a “natural law,” became the official Catholic view. This synthesis is the basis on which the modern magisterium and hierarchy of the Roman Catholic Church grounds its absolute condemnation of contraception, abortion, and the practice of homosexuality. By contrast, Protestantism has been much more accepting of sexuality and sexual pleasure, and more flexible with and accommodating to such issues as divorce, contraception, abortion, masturbation, premarital sex, and even homosexuality.
However, it was not the theory of Thomistic Aristotleanism that ultimately superseded late medieval and Renaissance beliefs in Eros. These dwindled as Europe, staggered under waves of the Black Death, which ultimately killed one quarter of Europe’s population; the Crusades, during which 22,000 people were killed in the Provençal city of Bezier alone; endless local wars among nobles, kings, and petty brigands where the peasants were invariably victimized; Turkish invasions; the epidemic of syphilis in 1493; peasant uprisings in Germany and England in the 1300s and 1400s; and the Inquisition, that specifically targeted women as its victims.
Protestant reformers from Luther through Calvin, Knox, and Zwingli, not only rejected the “natural law” approach to sexual morality; but extended, strengthened, and normalized the nuclear family and the blessing of marital sex. This type of marriage was a valuable social institution for assuring the distribution of new wealth from father to son. For example, in northern European merchant families, it replaced the older, southern European models of inheritance by name, and social status by membership in a “house” (e.g., the “house of the Medici”), with this type of lineage system.
An important characteristic of the Renaissance was appreciation and acceptance of individual control of one’s own life. Thus, the late 1500s and early 1600s saw a new struggle of the young to wrest control over their love affairs and marriages from their parents and families. Shakespeare’s Romeo and Juliet epitomizes what was to become the central issue of the modern-American religious debate about sexuality and spirituality. Who is to control the sexuality of the young? Older and more powerful individuals, who have vested interests in the outcome of youthful sexuality, ... celibate church leaders still convinced of the unchangeable patriarchal sexual values expressed in the Genesis story of creation, ... or young people, who claim for themselves the right to find the right mates and express their erotic passion in a way that, for them, brings sexuality and transcendence together?
Of growing significance in the 1990s in the U.S.A. is the question of the sacred nature of Eros. Among the liberal religious best-sellers pioneering a new synthesis of sexuality and spirituality are: Human Sexuality: New Directions in American Catholic Thought (Kosnick et al. 1977), which was sponsored by the Catholic Theological Society of America, but was condemned by the Vatican; Original Blessing (1983) and The Coming of the Cosmic Christ (1988) by the Dominican Matthew Fox (censured and expelled from his community by the Vatican); sociologist and erotic-novel author Father Andrew Greeley’s Sex, The Catholic Experience (1995); lesbian theologian Carter Heyward’s 1989 Touching Our Strength: The Erotic as Power and the Love of God; Presbyterian seminary professor James Nelson’s books Embodiment (1978), Between Two Gardens: Reflections on Sexuality and Religious Experience (1983), and Body Theology (1992); James Nelson and Sandra Longfellow’s anthology on Sexuality and the Sacred (1994); William Phipps’ Recovering Biblical Sensuousness (1975); Catholic feminist theologian Joan Timmerman’s The Mardi Gras Syndrome: Rethinking Christian Sexuality (1986); and Episcopalian Bishop John Shelly Spong’s 1988 Living in Sin? A Bishop Rethinks Human Sexuality. In addition, some Christians have turned to Eastern religions, particularly in the Tantric and Taoist traditions, to seek the nexus between sexuality and spirituality (Francoeur 1992).
Current and Future Religious Debate. During the 1980s, the most virulently debated issue was abortion. In 1994, between U.S. Supreme Court decisions and violence and murder by extreme anti-abortionists, support for anti-abortion stands stalled. For the majority of Americans, abortion appeared to fade as the central moral dilemma and joined the list of unresolved moral issues that includes war, drugs, crime, capital punishment, discrimination, and related social ills. Certain far-right religious leaders, who still have a devoted and vocal following and claim to speak for Christ, even conceded reluctantly that they could not win their war against abortion, and seemed to refocus their crusade on homosexuality and “the danger of homosexual rights” as their mobilizing issue.
However, with the mid-1995 success of the Republicans’ conservative hundred-day Contract with America, the Christian Coalition announced its own Contract with the American Family. Two-dozen legislative proposals were introduced into Congress, including an unprecedented attempt to ban and criminalize some now-legal abortions. A bill to reinstate a ban on abortions at American military hospitals overseas was passed. Other proposed bills would ban family planning programs from including abortion counseling for low-income women and adolescents; refuse funding to institutions that favor requiring obstetric/gynecology programs to provide training in abortion procedures; overturn an executive order lifting a ban against using foreign-aid money for abortion counseling or referrals; end or restrict support for agencies, including the United Nations, that offer family planning programs with abortions funded by private money; limit federal Medicaid money for abortions to situations where the woman’s life is threatened and ban it in cases of incest or rape; ban fetal-tissue research; ban clinical testing of RU-486; restore a ban on counseling women about abortion at clinics that receive any federal money; and prohibit the federal employee’s health benefit plan from covering abortion. The ultimate goal is to make all abortions under all circumstances a crime.
The list of controversial sexual issues that are religiously debated with little hope of being resolved in the near future includes:
The American religious, and consequent social and political, debates over each of these issues are not likely to be resolved in the near future. The dichotomy of the two worldviews is too deeply embedded in the American culture to allow for a quick resolution. The more likely prognosis is for continued, tension-filled confrontations within the churches, denominations, and political/legislative arenas throughout the United States.
The Religious Right’s social and political agenda deeply divides American society. Although 40 percent of Americans express concern about the Democrats’ ties to radical liberal groups, 39 percent are worried by Republican ties to conservative special-interest groups like the Religious Right, the Family Research Council, Focus on the Family, Eagle Forum, and the Christian Coalition (Roberts and Cohen 1995). These results reflect the continuing diversity of worldviews within the Judeo-Christian tradition. They also indicate that these religious differences not only result in contrasting sexual ideologies, but also have an important impact on political processes in the U.S.A. more broadly. As such, religion continues to be a major American social influence.
* Additional comments by Mark O. Bigler, Ph.D., a lifelong member of the Church of Latter-Day Saints, a graduate of New York University’s doctoral program in sexuality, and director of community education programs at the Utah AIDS Foundation, are enclosed in brackets with his name [... (Bigler)].
Mormon Origins and Polygyny. One example of a particular religious group within the general Judeo-Christian heritage is provided by the Church of Jesus Christ of Latter-Day Saints (LDS), which is the fastest-growing religion in the world today. The over seven million members are known colloquially as the Mormons. They base their belief system on the Bible and additional scriptures, most significantly the Book of Mormon, which is understood to be a record of God’s dealings with an ancient population of the American continent. The Mormons believe this book came from gold plates revealed to the church founder, Joseph Smith, in Ontario County, New York, in 1823. The church was officially organized in 1829.
The early Mormons were persecuted because their founder claimed the Bible had not been translated properly, that all other religions were false, that religious leaders did not have God’s authority - the priesthood - to act in God’s name, and finally that the practice of polygyny was a part of the divine plan. There was also the political reality that the tight-knit Mormon communities exercised considerable local power. Interestingly, the term “polygamy” as used in LDS church history and old doctrine means the “condition or practice of having more than one spouse.” A more-accurate definition of the Mormon practice of that century lies in the word “polygyny,” meaning having more than one wife at one time. The role of polygyny in the church is a source of some embarrassment to mainstream modern-day Mormons, who may discuss the practice somewhat wryly as a revelation designed to build the church population at a time when they literally had to forge new communities under hardship. After several attempts to settle in an area and build a sectarian community, the Mormon pioneers ultimately settled in the Salt Lake City area of Utah, where the church is now headquartered.
Modern Mormon doctrine does not include the practice of polygyny. Church prophet and leader, Wilfred Woodruff, officially eliminated polygyny from doctrine in the Manifesto of 1890 (Ludlow 1992). This proclamation against plural marriage ended a decade of hardship and persecution against the church members, particularly by the Republican Party that had as part of its platform elimination of the “immoral practice of multiple wives.” While mainstream Mormons are not held accountable for not practicing plural marriage, they still must “suffer the curse of monogamy.” Today, small fundamentalist splinter groups still practice polygyny, despite state laws against it and lack of official church acknowledgment. Even before the church abandoned its practice of plural marriage, only a small fraction of Mormon men, between 3 and 15 percent, had more than one wife (Murstein 1974, 350-364).
Perhaps the persecution faced by the early members of the LDS regarding their marital patterns has contributed to a unique and paradoxical tension around sexuality. On one hand, there is nothing more sacred than sex within the bounds of church-sanctioned marriage. On the other hand, rarely is there found a modern-American subculture more prohibitive and repressive about sexuality.
Salvation and Sex. To further understand this tension, one needs a basic understanding of the Mormon Plan of Salvation. Before birth, the Mormons believe, the soul is alive as an intelligence in a spirit world. During this preexistence, a variety of situations are possible, including acts of valor that would allow the soul to be born into a family of Mormons where opportunities for service abound. At birth, the soul passes through a veil of forgetfulness where all memory of the preexistence is lost (Church of Jesus Christ of Latter-Day Saints, 1989 (Moses 3:5, p. 7; Abraham 3:21-23, pp. 35, 38; Talmage 1977)).
During life on this earth, individuals face choices throughout the course of their lives that determine in which of three kingdoms they will spend eternity. The highest kingdom, the Celestial Kingdom, is reserved for those Latter-Day Saints who meet all the requirements of doctrine, one of the most important of which is marriage to another Saint in special temple rites. The exaltation and eternal life in the highest degree of the Celestial Kingdom are achieved only by faithful Mormons through the achievement and building of an eternal marriage, discussed later. Other good people can only hope to reach the Terrestrial Kingdom, a kind of heaven on earth, while unrepented adulterers, practicing homosexuals, murderers, and other sinners are limited to the Telestial Kingdom, which some describe as a Mormon version of the Christian hell.
[According to Mormon tradition, “hell” is not a place, but rather a state of mind. Those who do not achieve the highest degree of glory (the Celestial Kingdom) will recognize the reward they might have had and live out their eternities with the knowledge of this lost potential. However, the Telestial Kingdom, though typically described in less-than-positive terms, is not generally thought of as the fire and brimstone of the traditional Christian hell. In fact, one prominent Mormon Church leader described the Telestial Kingdom as follows: “... all who receive any one of these orders of glory are at last saved, and upon them Satan will finally have no claim. Even the telestial glory ’surpasses all understanding; And no man knows it except him to whom God has revealed it’” (Talmage, 1977, 92-93). (Bigler)]
In Mormon belief, one’s marital status is decisive for the life hereafter. Without marriage one can only become a servant angel ministering to those who are far more worthy of glory, the truly married. But most of those who have married on earth are married for time only (until death), and not truly married unless they have their marriage sealed in the temple. In heaven, those who are married only for this life will be single, no better than bachelors and spinsters. (In the Mormon view of heaven, one can enjoy all the pleasures of sex, food, and other sensual delights.) Those who are married by a prophet in the temple are sealed to each other and married for time and eternity. Couples in a sealed marriage will remain married for eternity, and enjoy reigning in separate kingdoms. It is also possible to marry for eternity and not for time. Thus a kindly man may marry a spinster for eternity but not for time, leaving her to her celibate lifestyle here, but destined for all the delights of the Celestial Kingdom as his mate in eternity (Murstein 1974, 350-362).
Gender Roles. As with all societies, gender roles among Mormons are scripted very early in life. The LDS church plays a distinct role in gender definition and scripting. Church activities segregate children at around the age of 12: boys are guided into vigorous endeavors, such as scouting and outdoor gamesmanship, whereas girls learn household activities and crafts.
[To clarify Forrest’s comment above, it is important to note that Mormon adolescents frequently participate in mixed-gender activities. Although young men and young women generally meet separately as a part of the official church youth program (known variously as Mutual Improvement Association (M.I.A.), Mutual, and Young Men’s/Young Women’s Program), males and females come together for Sunday School and the Mormon worship service known as Sacrament Meeting. In addition, LDS seminaries - religious study programs for high-school-age teens (grades 9 through 12) that operate in virtually every location around the world where congregations of Mormons are found - are always conducted with male and female students meeting together. Furthermore, Mormon youth regularly attend church-sponsored dances and participate together in community activities, including school proms, holiday celebrations, and cultural events. Young Mormon women and men are encouraged to interact, though care is usually taken to provide chaperons or to direct young people into activities where the possibility of sexual contact is limited (e.g., Mormon youths are strongly encouraged by their church leaders and parents to date in groups, and establish curfews that will not keep them out past midnight). (Bigler)]
It is not unusual for a preadolescent girl to have an LDS-designed poster on her bedroom wall urging her to remain “temple worthy,” or reminding her of gospel precepts that will keep her safe from worldly situations. For example, one poster is of a young girl looking into a mirror in whose reflection is a vision of herself as a young woman in a bridal scene with a handsome man. The caption says, “looking forward to a temple marriage.” Young men are also urged to bridle their carnal urges. Masturbation is expressly forbidden, and moral cleanliness, a requirement for any temple ceremony, essentially equates to abstaining from sexual activity before marriage.
[In Mormon practice, “moral cleanliness” at its most basic level is understood as abstaining from sexual activity before marriage and remaining faithful to one’s spouse. It is not at all equated with celibacy, as the author has implied. A pamphlet for youth, recently published by the church, makes this position clear: “Our Heavenly Father has counseled that sexual intimacy should be reserved for his children within the bonds of marriage.... Because sexual intimacy is so sacred, the Lord requires self-control and purity before marriage as well as full Fidelity after marriage” (Church of Jesus Christ of Latter-Day Saints, 1990, 14-15). (Bigler)]
Gender roles become even more firmly established during transitions into adulthood. Church officials clearly define the position, duties, and destiny of women in the divine plan. Women are to be “copartners with God in bringing his spirit children into the world” (Tanner 1973); this is generally understood metaphorically without any sexual connotation. Rather than focus on the erotic element of this distinction (having babies does require first having sexual intercourse), the LDS leaders instead urge women to stay home in order to love and care for children to ensure a generation of Mormons who learn about their “duty as citizens and what they must do to return to their Heavenly Father.” Women are regarded as sacred vessels, with important roles not only in childbearing, but also as positive influences on men’s lives. A “general authority” in the church, Hugh B. Brown, suggests that “women are more willing to make sacrifices than are men, more patient in suffering, and more earnest in prayer” (Relief Society 1965). Women in the Mormon community are indeed known for their good works. The Relief Society is the oldest women’s group in the United States and is remarkably active with community support of all kinds.
[Most Mormons, female and male alike, continue to hold traditional views concerning gender and gender roles. In general, Mormon women today still view motherhood and caregiving as fundamental traits of a “righteous” woman. However, it is also fair to say that the beliefs of church officials and the broader membership regarding gender roles have liberalized somewhat since President Hugh B. Brown’s statement in 1965. For example, in a recent general conference of the church, Chieko N. Okazaki, First Counselor in the Relief Society General Presidency, urged LDS women to obtain an education and career training:
[Each year it becomes increasingly important for women to improve their abilities to take care of themselves and their children economically, if circumstances should require.... If anything, [the counsel of Elder Howard W. Hunter] has become even more relevant in the almost twenty years that have passed as the national economy has made it increasingly difficult for one wage to support a family, as more mothers are left alone to raise their children, and as more women spend lengthy portions of their lives single. He is telling all of us to use the oar of study to prepare ourselves professionally for worthy and rewarding activities, including paid employment. (Okazaki, 1994) (Bigler)]
LDS men have a clearly defined role as well. Men bear the responsibility and the privilege of the Priesthood, which is a spiritual calling and connection to God specifically not given to women. An exception to this is found in LDS mission work, where young women on evangelical missions for the church have a type of “priesthood calling” on a temporary basis, lasting only for the duration of the mission.
[Throughout the church’s history, Mormon women have served missions for the church. Today, young women (typically in their early 20s) are embarking on proselyting and church service missions in ever-increasing numbers. Although Mormon men are encouraged much more strongly than are women to go on missions, teaching and preaching are not restricted to priesthood holders (males) in the church today. In fact, the priesthood is not a prerequisite for participation in most church positions, all of which are filled by lay members. Nevertheless, church leadership at its highest levels, both locally and generally, remains a function of the priesthood (male members). (Bigler)]
Through the priesthood, God governs all things. Priesthood power is considered a vital source of eternal strength and energy; a responsibility delegated to men for the well-being of mankind. Holding the priesthood means having authority to act as God’s authorized agent, which includes some church organizational duties. The right of worthy priesthood holders is to preside over their descendants through all ages, achieving its highest function in the family. As the presiding priesthood holder in the home, decisions relating to discipline often fall to the man, and the role of providing for the household is ultimately his, in spite of the presence of more employed Mormon women. Giving righteous advice, loving family members, and the laying-on-of-hands for healing purposes are all rights of the man of the house.
[In the ideal Mormon household, discipline, family decisions, and the day-to-day management of the home are seen as a shared responsibility between a unified husband and wife. Although Mormon fathers have been designated the presiding authority in the family (once again a function of the priesthood), it is the mother who is typically responsible for managing the home and children. However, male church members are counseled against the misuse of their designation as leader in the home, and men have been encouraged by the prophet and president of the church himself to share in parenting and home management:
[A man who holds the priesthood accepts his wife as a partner in the leadership of the home and family with full knowledge of and full participation in all decisions relating thereto.... You share, as a loving partner, the care of the children. Help her to manage and keep up your home. Help teach, train, and discipline your children. (Hunter, 1994, 5-7) (Bigler)]Body Theology. The Mormon doctrine about the body is worth noting since it creates another element of sexual tension. In many Christian religions, the body is considered simply a vessel housing the spirit/soul for the duration of life. For the Mormons, the body itself is highly revered and serves an eternal function. At the point of resurrection, the body of an individual is returned to “perfection,” ridding it of all the faults and defects of this life. A Mormon friend of mine often queries, “Just whose version of perfection will I get in Eternity? I have a list of modifications right here.”
One indication of the importance of the body is manifested by the wearing of “garments.” During the Temple marriage, a couple is given special “garments” to wear. This special underwear (manufactured by the Mormon church) is designed to serve as a reminder of the sanctity of the covenants made in the temple and to protect the body from harm. A quiet Mormon joke about the garments refers to them as “Mormon contraceptives,” since they must be worn next to the skin at all times and are notoriously unsexy in appearance. Women wear their foundation garments, such as brassieres and slips, over the Mormon garments. Because of the design of the garments, only modest clothing can be worn. However, the modern garments are much more relaxed and functional than traditional ones. The old versions are still available, with the tops extending just below the elbows and the bottoms below the knee, but most younger Mormon women opt for the cap sleeve and midthigh cotton versions for comfort and more choice in clothing.
[Mormon garments (which are worn by both women and men) serve as a constant reminder of sacred covenants made in temple ceremonies. Mormons also believe that these undergarments help protect the wearer against physical and spiritual harm. In addition, the design of the underclothing encourages the wearing of modest clothing. Although temple garments are to be worn day and night under normal circumstances, church members are not required by either doctrine or dictum to keep their underclothing on during activities such as bathing or while participating in sporting events. Nor are faithful Mormons required to wear their garments during sexual activity. (Bigler)]
Adolescent Dating. Adolescent dating rituals are very similar to those of other conservative American cultural groups. As LDS children grow older, the church plays more of a role in their lives, interweaving doctrinal and social activities. The transitions through church steps for adolescents are made in tandem with all their church peers. For instance, at 8 years old, children reach the “age of understanding” and are baptized into the church. Many of their peers are also taking this step, which takes on social significance in the form of family gatherings and informal parties. Later, dating is encouraged in group settings around church activities, since this context is most likely to encourage an interfaith marriage. Teens are often told, “if you don’t date outside, you won’t fall in love outside, and you won’t marry outside the faith.”
[Dating among Mormon teens is not restricted solely to church activities, although local congregations do often sponsor teen-oriented events, such as dances, firesides (discussions of religious topics especially relevant to teens), and cultural activities (plays, concerts, art exhibits, etc.). While dating outside of the church is not strictly forbidden, it is, as the author states, discouraged by church leaders and parents in an effort to reduce the chances that a member will marry outside of the church. Families of particularly staunch members are likely to view the marriage of a child to someone from outside of the church as a lamentable and perhaps even shameful event. Although Mormons who are married to nonmembers are not excluded from church activity or normal religious practice, one’s relationship to the church is undoubtedly affected by the “part-member” status of the family. (Bigler)]
At Brigham Young University, a Mormon-owned and operated institution in Provo, Utah, approximately 45 miles south of Salt Lake City, a subculture of dating reigns. Known to be an ideal place for Mormon youth to find a same-faith marriage partner, it is also a hotbed of sexual exploration. Mormon coeds fine-tune their “NCMOS,” (pronounced “nick-moes”), which is an acronym for “noncommittal make-out sessions.” These sexual forays include “everything but intercourse”: extensive kissing, petting, and “dry humping” (rubbing bodies) is common, but touching of the genitals is typically off-bounds, as is penetration of any kind.
[Brigham Young University, the oldest private university west of the Mississippi River, boasts a student body of more than 30,000, comprised almost entirely of young Mormons who come from every state in the country and many nations outside of the United States. The amount and types of sexual activities that the author reports occur among BYU students are not all that atypical of young college students in general. However, given the strict code of sexual conduct that Mormons have for themselves, even nongenital sex play and sexual activity short of intercourse give BYU the appearance of a “hotbed of sexual exploration.” At the same time, such activity also suggests that young Mormons have healthy sexual appetites, and perhaps are not as peculiar as it may first appear when compared to their peers on other American campuses. (Bigler)]
Marriage, Sex, and the Celestial Kingdom. In order to access the Celestial Kingdom, a couple must marry in the temple. These temple rites seal the two partners together not just for life, but for all eternity. When a couple is in the Celestial Kingdom together, they can enjoy the full experience of their resurrected and eternally perfect bodies. The purpose of the sealed marriage is primarily to ensure the eternal connection between partners, allowing them to procreate and populate their own worlds (eternal procreation). An essential precept, “As man is, so God once was; as God is, so man can become,” guides heterosexual couples through life with the promise that they, as the God they worship has done, will become creators of their own world (Murstein 1974).
Although not formally prohibited, birth control is regarded with clear reservation by church members, since large families are viewed favorably. Women who leave the Mormon church often refer, “with tongue in cheek,” to their loss of opportunity to bear children during the afterlife. One woman commented, “At least I know I won’t be barefoot and pregnant through time and eternity.”
[While birth control is regarded with reservation by many church members and authorities, various forms of contraception are commonly practiced, even by active, faithful members. Today, the decision to use birth control is left to the discretion of the couple. (Bigler)]
The gender roles established early in the life of the couple are metaphorically established again during the marriage ceremony. The order of the Plan of Salvation is clearly outlined during the ceremony, as is the order of the household that symbolically supports the Divine Order when it is in accord with the Plan of Salvation. An interesting element of the temple marriage is the giving of a name to the bride, known only to her husband. This name is for the use of the husband in calling his wife to him in the afterlife. She does not have access to his secret name - the calling of partners in eternity is purely a masculine prerogative. The giving of the name to the bride is kept secret from outsiders, as is much of the rest of the ceremony, which is closed to all those without special church endowments. Mormon church weddings are different from typical American weddings in that only worthy LDS family members and friends are allowed into the temple to observe the ceremony itself. If a family member is an inactive church member or a nonmember, they will be excluded from the wedding ceremony, joining the party outside the temple or at the reception.
In the face of the lack of sexuality education, the first act of sexual intercourse for a good Mormon is likely to be ill-informed. One contemporary of mine recalls her first sexual experience, which took place after an LDS temple marriage: “We were both virgins, and it literally took us several weeks to consummate the marriage by having intercourse. We had been raised to believe sex was a sacred thing, so we just sat in bed, prayerfully, kissing gently and waiting for something to happen. Obviously, something finally did, but I was dreadfully disappointed. It not only didn’t feel sacred, it didn’t even feel good.” This particular couple did not seek therapy for support or education, relying instead on the Holy Spirit, a decision common among LDS couples.
Because the church operates with a lay ministry, the local bishop has an enormous influence on how issues of sexuality are handled. In most instances in which married couples face difficulty with sexual relations or general marital dissatisfaction, the bishop is the first and most likely source of comfort and counsel. Often the bishop is just a kindly intentioned neighbor with limited or no training. Many times, his response is based on his own experience, attitudes, aversions, and parental training. Some extremely compassionate bishops give forgiving responses to an individual who has erred sexually. Some bishops advise specifically against such behaviors as oral or anal sex. Others, repulsed by the vulgarity of even discussing the topic of sexuality, take refuge in esoteric spiritual or academic language or avoid the topic altogether. Still others may be open-minded and suggest that either the lay ministry has an extremely limited role in the bedroom of other folks or advise liberal measures, such as doing whatever works best for the couple involved. If marriage counseling is clearly needed, a referral may be made by the bishop to the LDS Social Services or to an LDS therapist, who can give professional advice with an empathy for the doctrinal requirements. In sharp contrast, other bishops respond with an injunction to leave the fellowship if someone has premarital intercourse, commits adultery, or engages in homosexual relations, all of which are forbidden by church doctrine.
[Problems that result from limited sexuality education coupled with well intentioned but poorly trained lay clergy are compounded for Mormons by a dearth of LDS therapists and other mental-health professionals who have specific training and experience in the area of sexuality. (Bigler)]
Divorce is discouraged, but not uncommon. The divorce rate in the state of Utah, in spite of a predominantly LDS population, matches those of many states. Even marriages sealed in the temple are now relatively easy to unseal. Remarriage from a doctrinal standpoint is difficult to comprehend in light of the eternal marriage concept, but temple divorces will officially separate the couple for the purposes of the Celestial Kingdom.
[If a temple divorce has been granted, a second marriage can be sealed in a Mormon temple. Marriages that take place outside of the temple are officially recognized by the church as legal and valid, with the understanding that these unions will not carry on into the eternities. (Bigler)]
The Mormon Family. An ideal Mormon family works together, putting the sense of “family” first, honoring the doctrine that families will endure throughout eternity. It is a rare LDS home that lacks some visible reminder of this doctrine in an embroidered or otherwise handcrafted item proclaiming, “Families are Forever.” The cultural value placed on family as a priority distinctly impacts those who choose not to have children, making those couples at least the object of social curiosity, if not censure.
Utah, the Mormon Mecca, is culturally oriented toward family because of the LDS church influence. Exemplifying this is Enid Waldholtz, the Republican congresswoman elected to office in 1994 from Utah, who is only the second member of Congress to bear a child while in office. This choice on the part of LDS Congresswoman Waldholtz clearly cemented her popularity among her Mormon constituents. She made a clear statement about her support for family life by meeting one of the most basic expectations of a Mormon couple with this childbirth.
Sex Education. Children are taught about sexuality more by implicit measures than direct and overt messages. Sexual exploration at a very early age is treated with quiet but firm repression. Mormon adults often describe their sense of guilt at their developing sexuality, often beginning at a very early age. These ideas are often disseminated by parents during “morality lessons,” which might include the suggestion of singing hymns if “impure thoughts” enter one’s mind, or using affirmative reminders that one’s primary objective is to reach the Celestial Kingdom, which demands the purity of the body temple. “Impure thoughts” are usually not specifically defined, but are so pervasively assumed to be sexually related that many Mormon adults still claim to equate words such as “purity” and “morality” with specific sexual connotations.
In spite of the importance placed on having babies in a married state, very little formal education is done regarding sexuality and pregnancy. Countless times after I have made a simple junior- or high-school presentation on HIV prevention, students have lined up to ask me other “related” questions, often regarding basic body functioning, for example, “I haven’t started my period.... How do I know if I’m pregnant?... Can I get pregnant from kissing?”
[Mormon families are counseled by their leaders to hold a weekly Family Home Evening each Monday night. This is a specially designated time during the week for the family to join together to study religious topics, enjoy activities outside of the home, or address important family issues. Family Home Evening, as it has been outlined, provides LDS families with a perfect opportunity to provide sexuality education in the home within the framework of the family’s own value system. After observing this practice among Mormon families, Dr. Ruth Westheimer and her colleague Louis Lieberman noted:
[In particular, we have been impressed by the manner in which the Church of Jesus Christ of Latter-day Saints (the Mormons) has approached the difficult task of teaching moral and ethical precepts in the area of sexuality. If Jews, Italians, Chinese, and Japanese, among other groups, may be said to be child-centered societies, the Mormons must be said to be family-centered, par excellence. There appears to be a structured, systematic, integrated and total approach to morality through the family. Thus, sexual morality is taught as part of a system and way of life that focuses on the goal of eternal or celestial marriage. The church readies out to the family through many media: songs, family meetings, family resource books, television, videos, etc., to provide the Mormon perspective on all aspects of sexuality for all family members. (Westheimer & Lieberman 1988, 109)
[Unfortunately, all too often, Mormon families fail to take advantage of this valuable resource, and miss an obvious opportunity to educate their children about matter related to human sexuality. (Bigler)]
Many couples marry with limited information even about the act of intercourse. If they have been properly parented in the faith, they will have been protected from exposure to sexual or “perverted” images. A Mormon church leader, Dallin Oakes, in a speech at Brigham Young University, said “We are surrounded by the promotional literature of illicit sexual relations on the printed page and on the screen. For your own good, avoid it.” He added, “Pornographic or erotic stories and pictures are worse than filthy or polluted food. The body has defenses to rid itself of unwholesome food, but the brain won’t vomit back filth.”
Biological information about menstruation is disseminated clinically. Some women recall this clinical information as imbued with a sense of shame, in which menstruation is described as a sickness or something one does not discuss in polite company. For example, I dated a Mormon man who was so unfamiliar with menstrual issues and women’s bodies - in spite of having several sisters - that he did not know what the purpose of a tampon was or how it functioned.
Abortion. Abortion is considered a most venal sin. Since Mormon doctrine regards the bearing of children as an opportunity to bring “spirit” children into an earthly form, abortion is not only considered murder, but in addition, a denial of a body for a predestined soul.
Gay Culture. Both the San Francisco and New York gay cultures take special note of the Brigham Young University gay underground, famous for its size and covert scope. Many of the returning missionaries come back to BYU to find a mate and resolve the same-sex desires often stirred on the two-year LDS mission strongly encouraged by the Church with strictly enforced male-only companionship.* Sometimes that resolution does not come easily. Support groups for Mormon homosexuals in the Provo and Salt Lake area around BYU give voice to the pain of these men. Lesbians face the same dilemma, since they are surrounded by the cultural pressure to marry and have families.
[* A note on LDS missionary services. Mormon men are strongly encouraged (not required) to serve a two-year mission at the age of 19. Formal sanctions are not imposed on those males who choose not to go on a mission. However, in a strong Mormon family or LDS community, social sanctions can be quite severe. The status of “Returned Missionary” is a valuable asset to a young man’s marriage potential. In contrast, the decision not to serve a mission - or worse yet, leaving on a mission and returning home early - often brings shame to both the young man and his family. Mormon women, on the other hand, can choose to go on an 18-month mission at the age of 21. However, the expectation of service is not nearly as great for females as it is for males, and the decision not to go, particularly if a young woman opts to get married instead, results in few, if any, negative repercussions. (Bigler)]
The divine mandate of heterosexual marriage regards homosexuality as a repudiation of the gift and giver of life. Thus, homosexuality is regarded as a direct violation of God’s plan, which is that men should cleave to women. Sexual relations between any nonmarried persons is considered sinful and homosexuality falls into tins category. According to Dallin Oaks, one of the church apostles, “Eternal laws that pertain to chastity before marriage and personal purity within marriage apply to all sexual behavior. However, marriage is not doctrinal therapy for homosexual relationships” (Ludlow 1992). Since so much of the restored gospel hinges upon the legally and temple-wedded heterosexual couple, practicing homosexuals are excommunicated.
Often the feelings of a gay person meet responses of incredulity on the part of parents and church leaders. One parent counseled his son not to act on his “supposed” same-gender feelings, “to date young women seriously, to wait and see” (Schow et al. 1991). Because homosexual couples cannot reproduce, this parent urged his son to “choose otherwise.” The church offers “counseling to those who are troubled by homosexual thoughts and actions” in order that they might become acceptable to God. Repentance is offered in these circumstances. “Homosexuality and like practices are deep sins; they can be cured; they can be forgiven” (Church News 1978). In order to remain a Mormon in good standing, homosexuals must remain celibate and refrain from all same-gender eroticism. Acceptance is not advocated at any level.
[The current Mormon position on homosexuality can be described as one of limited tolerance. Because sexual activity is reserved for marriage, and same-sex relationships are not recognized by most legal bodies or by the church, homosexual activity is therefore forbidden. As the author correctly notes, to continue to be a Mormon in good standing, homosexual men and women must remain celibate and refrain from all same-sex sexual activity. The church’s position officially allows for individuals who are sexually attracted to members of the same gender to remain fully involved in church activities, so long as there is no sexual activity. This stance, though still extremely restrictive, is quite a departure from past policy and practice when virtually any indication of same-sex attraction could be used as grounds for excommunication. However, despite the apparent shift in thinking toward greater acceptance, it remains difficult, if not impossible, for members who feel a same-sex attraction to continue to actively practice Mormonism. Unfortunately, homophobia is often a more-powerful emotion for many church members than the New Testament challenge to “Love thy neighbor as thyself.” Frequently, this homophobia is internalized and, despite Ludlow’s declaration that “marriage is not doctrinal therapy for homosexual relationships,” many gay, lesbian, and bisexual Mormons follow the traditional course that has been set for them by getting married and starting a family. Some carry on with a heterosexual life and take the secret of homosexuality to the grave. Others Find their true sexual feelings too powerful to deny and may have clandestine same-sex relationships or seek out friendly advice, often from a bishop or other church authority. For those who acknowledge same-sex attraction, reparative or reorientation therapy is a common recommendation. These programs have demonstrated little lasting success in changing sexual orientation. Participation in reparative or reorientation therapy is often experienced as the ultimate failure, since the promise of change is directly linked to the sincerity and worthiness of one’s efforts.
[Change-orientated therapy, therefore, is commonly the final step for many gay, lesbian, and bisexual Mormons before leaving the church or being asked to leave. In the end, homosexual Mormons are often left with a choice between their church and their sexuality. Because the two are diametrically opposed, there is little room for compromise. (Bigler)]
Summary. The Mormon culture is distinct in many ways. Known for hard work, loyal families, and abstinence from alcohol and tobacco, the Mormons are steadfast in their maintenance of traditional family values. Sexually conservative and repressive, Mormon doctrines may be the ideal for people disillusioned with or anxious about the liberalization of sexual attitudes and practices occurring in the United States in recent decades. According to the 1995 United States census, Utah - with a 70 percent Mormon population - ranks first in fertility and last in teen pregnancy. The Mormons, long considered remarkable for their nearly anachronistic traditional values, may actually be on the cutting edge of the Christian Right’s abstinence- and morality-based vision of American family life.
In addition to the religious factor, two other social factors continue to exert considerable influence on American sexual ideologies and practices, race/ethnicity and gender. In this section, we examine the sexual customs of two of the largest racial and ethnic minority groups in the U.S.A., African-Americans and Latino-Americans, and the effects of feminism and feminist perspectives on sexuality in America and sexological research.
The term African-American is widely and often carelessly used to suggest or imply that the more than 30 million African-Americans constitute some kind of homogeneous community or culture. This is both contrary to reality and dangerous, as the term properly includes a rich diversity of very different, and often distinct, subcultures, each with its own set of sexual values, attitudes, and behavioral patterns. Included under the rainbow umbrella of African-Americans are urban African-Americans in the northeast, ranging from Boston south to Washington, D.C., African-Americans in Los Angeles on the West Coast, and African-Americans in urban centers in the southern states. Rural African-Americans are often quite different from urban African-Americans, even in nearby metropolitan centers. Socioeconomic and educational differences add to the diversity of African-American subcultures. This perspective is essential to avoid overgeneralizations about the observations provided here.
Historical Perspective. A review of the past record reveals that many white Americans have regarded the majority of African-Americans as representing the sexual instinct in its raw state. This belief that African-American sexual behavior is somehow more sordid and crude than the sexual behavior of white Americans is by no means a new concept. Reports dating from the mid-sixteenth century depict the sexual behavior of Africans as bestial. The same descriptions were later applied to the Africans brought to the New World by the slave trade.
Moreover, the folk view of the sexuality of blacks is often hard to distinguish from what appears in the scientific literature. In the guise of science, some investigators have presented such conclusions as: (1) African-American men and women are guided by “bestial instinct” (DeRachewiltz 1964; Jacobus 1937; Purchas 1905); (2) the black man is more animalistic in bed (DeRachewiltz 1964; Jacobus 1937; Purchas 1905); (3) the black man’s penis is larger than the penis of the white man (DeRachewiltz 1964; Edwardes and Masters 1963; Jacobus 1937); (4) the black man is a sexual superman whose potency and virility is greater than the white man’s (DeRachewiltz 1964; Jacobus 1937; Jefferson 1954); (5) the black man’s reproductive capacity is colossal (Jacobus 1937); (6) black men are obsessed with the idea of having sex with white women (Edwardes and Masters 1963; Fanon 1967); (7) all black women want to sleep with anyone who comes along (DeRachewiltz 1964; Jacobus 1937; Rogers 1967); and (8) black women respond instantly and enthusiastically to all sexual advances (DeRachewiltz 1964; Jacobus 1937). Blacks have also been characterized as holding more-permissive attitudes regarding extramarital affairs (Bell 1968; Christensen and Johnson 1978; Houston 1981; Reiss 1964, 1967; Roebuck and McGee 1977; and Staples 1978). This simplistic notion may well misrepresent the complexity of African-American sexual values. According to Robert Staples (1986, 258),
Blacks have traditionally had a more naturalistic attitude toward human sexuality, seeing it as the normal expression of sexual attraction between men and women. Even in African societies, sexual conduct was not the result of some divine guidance by God or other deities. It was secularly regulated and encompassed the tolerance of a wide range of sexual attitudes and behaviors. Sexual deviance, where so defined, was not an act against God’s will but a violation of community standards.
Gender, Gender Role, Sex, Lave, and Marriage. Gender and gender roles are culturally defined constructs that determine the boundaries of acceptable and unacceptable behavior for men and women. These notions are often based on stereotypes - a fixed, oversimplified, and extremely distorted idea about a group of people. In the general American culture, the traditional stereotyped female is gentle, kind, dependent, passive, and submissive. The traditional stereotyped male is tough, brutal, independent, aggressive, and intractable. Any deviation from one’s expected gender role may be met with skepticism about one’s psychological health. For example, the traditional view of the black male - as it relates to gender-role identification - is that he has been emasculated by the experience of slavery and is suffering from gender-identity problems because of absent or inadequate male role models. Moreover, because of these two problems, he has a more-feminine gender identity than white males (Grier and Cobbs 1968; Glazer and Moynihan 1964; Pettigrew 1964; Wilkinson and Taylor 1977). Grier and Cobbs (1968, 59) suggest that:
For the black man in this country, it is not so much a matter of acquiring manhood as it is a struggle to feel it his own. Whereas the white man regards his manhood as an ordained right, the black man is engaged in a never ending battle for its possession. For the black man, attaining any portion of manhood is an active process. He must penetrate barriers and overcome opposition in order to assume a masculine posture. For the innermost psychological obstacles to manhood are never so formidable as the impediments woven into American society.
Pettigrew (1964) supported the notion that black males are more feminine than white males because of certain responses to items in the masculinity-femininity scale on the Minnesota Multiphasic Personality Inventory (MMPI). Two items that Pettigrew noted were the statements, “I would like to be a singer” and “I think I feel more intensely than most people do.” Black males responded more positively to these statements than did white males. This pattern was interpreted to mean that black males are more feminine than white males. Pettigrew based his conclusion regarding the black male’s gender identity on two studies. One study included a sample of Alabama convicts; the other was a group of veterans with tuberculosis! As Pleck (1981) notes, these are hardly representative samples.
In contrast to the emasculated, feminine, black-male hypothesis, Hershey (1978) argues that black males have a stronger masculine identity than white males. In her study of sex-role identities and sex-role stereotyping, the black men’s mean masculinity score was significantly higher than the mean masculinity score of the white men in her sample.
To the extent that African-American males have been emasculated by gender-role stereotyping, African-American females have been de-feminized by gender-role stereotyping. The so-called black matriarchy has been historically blamed for the deterioration of the black family, because black women have greater participation in family decision making in a society where male control is the “normal rule.” Because white stereotyped norms are violated, African-American women are seen as being domineering. By virtue of the historical legacy of slavery and discrimination against African-American men, African-American women were in the labor market, received education, and supported their families.
According to Staples,
Sex relations have a different nature and meaning to black people. Their sexual expression derives from the emphasis in the black culture on feeling, of releasing the natural functions of the body without artificiality or mechanical movements. In some circles this is called “soul” and may be found among peoples of African descent through the world. (Cited by Francoeur 1991, 90-92)
In a practical sense, this means that black men do not moderate their enthusiasm for sex relations as white men do. They do not have a history of suppressing the sexual expression of the majority of their women while singling out a segment of the female population for premarital and extramarital adventures (Staples 1977, 141-42).
The major problem with such studies is that few have questioned the stereotyped assumptions regarding gender-role socialization upon which their conclusions are based.
Views and Practices of Sex Education. Black males and females are socialized very early into heterosexual relations by their culture and extended-family system. The less-stringent age and gender-role orientations that are evident in the black community exposes children at an early age to a more permissive sexual ethos. Many African-Americans perceive sex as a natural function; thus, children are not hidden from discussions of a sexual nature.
Academically, many sexuality- or family-life-education programs employ the Health Belief Model, not only as a way to predict sexual behavior, but to facilitate behavior change. This model has certain assumptions that are based on Euro-American social norms. These norms may not be consistent with the beliefs and values of many African-Americans. Mavs and Cochran bated at all in the past year. However, black men were almost twice as likely to report that they had not masturbated at all during the past year, and about 68 percent of black women reported that they did not masturbate the past year. However, those African-Americans who do masturbate demonstrate the same childhood, adolescent, and adult patterns as their white counterparts. Blacks may not acknowledge that they masturbate as readily as whites, because of the belief that admitting that one masturbates means one is unable to find a sex partner.
Children and Sex. African-American children, according to Staples (1972), are socialized very early into heterosexual relations by their culture and extended-family system. This socialization pattern exposes them at an early age to a more permissive sexual ethos. Thus, African-American children may have a knowledge of sexual intercourse, masturbation, condom usage, and other sexual practices at a younger age.
Adolescents and Sex. Compared to white teenagers, African-American teenagers begin coitus about two years earlier, on the average, and are more likely to progress directly from light petting to sexual intercourse (Brooks-Gunn and Furstenburg 1989). Consequently, African-American females may be at greater risk of pregnancy.
Black men start dating earlier, are more likely to have a romantic involvement in high school, have the most liberal sexual attitudes, and are most inclined to have nonmarital sex without commitment (Broderick 1965; Larson et al. 1976; Johnson and Johnson 1978). (See Section 5B for additional data comparing black and white adolescent sexual patterns).
Adults. In the aftermath of the Civil War, blacks married in record numbers because, under the inhumane institution of slavery, legal marriage had been denied to them. Three out of four black adults were living in intact nuclear families by the early part of the twentieth century, and the overwhelming majority of black children were born to parents who were legally married. Today, an African-American child has but a one-in-five chance of being raised by two parents (Chideya et al. 1993). Out-of-wedlock births have risen since the 1960s, particularly among African-Americans. Two out of three first births to African-American women under the age of 35 are now out of wedlock.
Traditionally, women in American society have tended to marry men in their own social class or to “marry up” to a higher socioeconomic group. This pattern has been substantially disrupted among African-Americans, largely because of a distorted gender ratio among blacks. This imbalance in the proportion of males and females of marriageable age has been present for several decades, but has become exacerbated in recent years. By the 1990s, there were roughly fifty adult African-American women for every forty-two African-American men, largely because of abnormally high rates of black-male mortality and incarceration (Staples and Johnson, 1993). Because the proportion of African-American women who attend college and earn degrees is much higher than the rate for men, this problem is even more severe for higher-status women. As a result, increasing numbers of black women are remaining single or marrying partners from lower-status groups (i.e., less education and/or income). There is no evidence that large groups of black women are choosing to marry outside their race (Staples and Johnson, 1993)
Joseph Scott (1976) has argued that these social conditions arc largely responsible for the emergence of a pattern he calls “mansharing.” Man-sharing is a lifestyle where a number of African-American women, each of whom typically maintains her own separate residence, “share” a man for intimate relationships. Typically, he splits time living with each of the women. Scott (1976) argued that mansharing represented the appearance of a new, polygamous family form in the African-American community. However, we want to stress that this does not mean that black women like or prefer this lifestyle. Cazenave (1979) has noted that lifestyles can sometimes be imposed by external social constraints. There is some evidence (Allen and Agbasegbe 1980) that most black women do not approve of mansharing as a lifestyle, but feel they have reduced options in an environment with few eligible male partners. Scott concluded that:
Until there is some way to correct the sex ratio imbalance and until blacks control the economic and welfare institutions in such a way to stop the breaking up of black monogamous relationships we cannot be too harsh on black men and women who find some satisfactory adjustments in sharing themselves and their economic resources in a new, at least for this society, family form which meets their most basic needs. (Scott 1976, 80)
Homosexuality and Bisexuality. Attitudes within the African-American community reflect those in the majority culture. According to Staples (1981), homosexuality may be tolerated in the black community but will not be approved openly. Bell and Weinberg (1978), in their study of homosexuality, found that black male homosexuals tended to be younger than their white counterparts, had less education, and were employed at a lower occupational level. Moreover, black male gays more often expressed the belief that their homosexuality and homosexual contacts had helped more than hurt their careers.
Compared to black gay males, black lesbians had fewer transient sexual partners. Most reported that the majority of their sexual encounters were with women for whom they cared emotionally.
Coercive Sex and Pornography. The incidence of rape among African-Americans has been subject to some controversy. According to the Department of Health and Human Services, 683,000 adult women were raped in 1990. By contrast, the National Victim Center estimated that there were 130,236 rapes in 1990 and 207,610 in 1991. Although earlier reports indicated that African-American women were more likely to be sexually assaulted than white women, newer studies do not find any statistically significant difference between African-American and white samples. The historical notion that most rapists are black men is totally without merit; indeed most rapists and their victims are members of the same race or ethnic group.
There is an important difference between the attitudes of those whites who support the antipornography movement in the United States and the lack of interest this issue stirs among African-Americans. For African-Americans, as Robert Staples (1986, 258) argues, issues of poverty, education, job opportunities, and teenage pregnancy are far more pressing concerns than the crusade against pornography.
Rather than seeing the depiction of heterosexual intercourse or nudity as an inherent debasement of women as a fringe group as [white religious conservatives and] feminists claim, the black community would see women as having equal rights to the enjoyment of sexual stimuli. It is nothing more than a continuation of the white male’s traditional double standard and paternalism to regard erotica as existing only for male pleasure and women only as sexual objects. Since that double standard has never attracted many American blacks, the claim that women are exploited by exhibiting their nude bodies or engaging in heterosexual intercourse lacks credibility. After all, it was the white missionaries who forced African women to regard their quasi-nude bodies as sinful and placed them in clothes. This probably accounts for the rather conspicuous absence of black women in the feminist fight against porn.Contraception and Abortion. Since the early 1970s, many in the African-American community have viewed contraceptive use as a form of genocide advocated by whites. Thus, control over reproduction has had political and social implications.
The majority of women having abortions are white. Although 12 percent of the population is of African-American ancestry, black women constitute approximately 31 percent of the women who seek abortions. There is a history of forced sterilization against African-Americans, which many perceive as a form of genocide similar to contraception.
STDs and HIV/AIDS. In 1932, the United States Public Health Service recruited 600 African-American men from Tuskegee, Alabama, to participate in an experiment involving untreated syphilis. The aim of this study was to determine if there were any racial differences in the development of syphilis. The Tuskegee participants were never informed that they had syphilis. This wanton disregard for human life allowed the disease to spread to the sexual partners of these men, as well as their offspring. This experiment continued until 1972! The repercussions from the “Tuskegee Experiment” still resonate strongly through African-American communities, and negatively impact on HIV/AIDS prevention programs.
HIV was the eighth-leading cause of death for all Americans in 1990, but it was the sixth-leading cause of death for African-Americans. It is the leading cause of death for African-American men between the ages of 35 and 44, and the second-leading cause of death for black men and women between 25 and 35. Again this raises the specter of genocide among many members of the African-American community, in that many believe that the virus was man-made!
Sexual Dysfunction. The stereotyped notions about the sexual experiences of African-Americans not only influence the attitudes that whites may have about African-Americans, but also affect the way in which African-Americans perceive themselves. For example, the willingness of an African-American male who is experiencing difficulty in maintaining an erection or ejaculatory control to seek help may be dependent on how closely he identifies with the myth of the “super potent” black man. Any man may feel embarrassment about a sexual problem, but for the African-American male, the embarrassment that he may feel is compounded by the images of the myth.
For clinicians, an awareness of this historical legacy is essential to the treatment process. A key component in the treatment of many sexual problems is the use of self-pleasuring exercises. These exercises are an effective method for a person to learn more about his or her own sex responses. Many African-Americans have negative feelings about masturbation that may infringe on the treatment process. First, changing these negative feelings may take more time than is typical for other clients. Second, African-Americans who do masturbate may be more reluctant to discuss this issue because, for many, admitting that they masturbate indicates that they cannot find a sexual partner.
Latinos, like most other ethnic/racial groups residing in the United States, exist in a distinct social environment, have developed a unique culture, and are often disfranchised from mainstream society. The terms “Latino” and “Hispanic” are used interchangeably in this section to describe a heterogeneous group of people representing a kaleidoscope of experiences, educational attainment, acculturation levels, and citizenship status. The term “Latina” pertains specifically to Hispanic women. The heterogeneity of the Latino population residing in the United States of America can be observed in each group’s unique culture, beliefs, language, socio-economic background, family name, racial ascription, and culinary preferences (Castex 1994; Neale 1989; Williams 1989). Although Latinos can be found in almost every state, more than half of them live in Texas and California (National Council of La Raza 1992).
Latinos are one of, if not the fastest-growing population groups in the United States. According to census data, in the last decade, the United States Latino population increased by 54 percent, a rate of increase more than twice that of the general population (U.S. Bureau of the Census [USBC] 1993). Currently, almost nine percent of the U.S. population is classified as being of Hispanic or Latino descent; this figure is expected to increase to 21 percent by the year 2050. High fertility rates, high levels of immigration to the United States, and the relatively young population, are often cited as reasons for this increase (Brindis 1992). Among Latinos, persons of Mexican origin form the largest population group, with a population total of approximately 13.5 million people; Puerto Ricans place at a distant second with over 2.7 million (USBC 1993).
Overall, U.S. Latinos are a relatively young population with a median age of 26 years compared to 34 years for non-Latinos; conversely, less than 5 percent of Latinos are aged 65 or older compared to 13 percent for non-Latinos (USBC 1993). Among U.S. ethnic groups, only Native Americans have a younger population. Further differences among Latinos can be observed in the age distribution of different Latino groups. Census data show that Mexican-Americans have the youngest population, with a mean age of 24 years, and Cuban-Americans have the oldest population - mean age 40 years (Claude 1993).
The following material describes relevant sexological concepts among United States Latinos. Although it does not seek to report all sexual-related knowledge, it will highlight relevant sexological issues and hopefully dispel some of the stereotypes related to Latino sexuality. Comparisons presented here represent general data for Latinos, thus the reader needs to understand that there are differences between Latino subpopulation groups. The truth is that the variety of sexual practices and patterns among Latinos in the United States, and for that matter in Latin America, are only surpassed by the limits of human imagination.
Family Issues. Several authors (de la Vega 1990; Lifshitz 1990; Fennelly 1988) have emphasized the importance of recognizing the differences in family and cultural expectations regarding sexual behavior for females and males in the Latino culture. The acknowledgment of these differences allows for the understanding of the complexity of sexuality-related issues within this population group. Traditionally, Latinos have placed a high value on the family, the entity which shapes their earlier views on sexuality (Brindis 1997). Latinos frequently place family over an individual’s needs. It is, therefore, not uncommon for Latinos to reside in multigenerational households with members of their extended families (Alberda and Tilly 1992; Garcia 1993). This arrangement permits the division of labor, sharing of economic and domestic responsibilities, and most importantly, allows extended-family members to participate in the rearing of children (Kutsche 1983; Leaper-Campbell 1996).
Latino culture has been described as being patriarchal in nature. However, although men are traditionally the family’s representative before society, women are the primary caregivers at home; in fact, women in the Latino culture are seen as the base of the family structure. Latinas, according to de la Vega (1990), have an important non-public and non-verbal authority within the family. Females are expected to maintain the equilibrium and smoothness of family relationships. In this role, Latinas traditionally tend to pay more attention to the family’s needs than their own. This expectation is most often noted in young women taking care of older relatives, while their male counterparts seek to forge their own future, albeit not too far from the family unit.
Along with family orientation, Latinos often show the closely related concept of simpatía. The latter refers to Latinos’ willingness to go along with items which may not be understood or that they may disagree with. Szapocznik (1995) has suggested that familism and simpatía may now be liabilities for Latinos in the United States, particularly for gay men who attempt to conceal their true HIV-status from their families and friends.
Sexological Concepts: Acculturation and Sexual Practices. Until the advent of the AIDS epidemic, few researchers had systematically documented sexual practices and knowledge among Latinos. Inappropriate application of methodological issues, language difficulties, and cultural insensitivity have all been identified as barriers to data collection among U.S. Latinos (Ford and Norris 1991).
Sexuality is an important life element among Latinos. However, Latino sexuality is not limited or circumscribed to coital activity, but it is rather expressed through a variety of life attitudes which reinforce male and female sexual identities. In the United States, sexual patterns are not only affected by culture, but also by the individual’s degree of acculturation and assimilation (Spector 1991).
Acculturation and education also play a pivotal role in the acceptance of new expressions of sexuality. In a 1990 study, Marín, Marín, and Juárez found that Latinas with higher levels of acculturation reported more multiple sexual partners than those with lower acculturation levels. The same study found that less-acculturated males were more likely to carry condoms and report fewer sexual partners. A follow-up study found that less-acculturated Latinas were less likely to carry condoms and experienced higher levels of sexual discomfort (Marín, Gomez, and Hearst 1993). More-acculturated and educated Latinas are also more likely to adopt a leading role during heterosexual activities.
Acculturation notwithstanding, sexuality continues to be a taboo topic for many Latinos, particularly for older, Spanish-speaking Latinos.
Sexual Stereotypes. It is perhaps significant that general knowledge of Latino sexuality is denoted more by stereotypes than factual information. De la Vega (1990) concluded that numerous myths and stereotypes are found among Latinos, as within any group of individuals. It is important that these subtle cultural forms of differentiation not be missed by North American service providers, as they may be the nuances that allow for the development of educational strategies that will effectively reach the Latino “population.”
Perhaps the most widely accepted stereotype for Latino males is that of the proverbially promiscuous “Don Juan.” This eternally charming individual is known for his ability to sexually conquer and satisfy a large number of females. A second stereotype deals with the erotic nature of some Latino groups as contrasted with more-conservative norms found among more-educated Latinos. Finally, the submissive and passive female stereotype continues to overshadow realities of contemporary Latinas.
Gender and Gender Roles. Worth and Rodriguez (1987) reported that despite the fact some Latinos in the United States have non-traditional lifestyles, they continue to adhere to traditional gender roles. Fennelly (1992) reported on cultural double standards and suggested that, whereas males are encouraged to develop strong self-reliant identities and explore their sexuality, females are taught the value of etiqueta, or proper and expected forms of feminine sexual behavior. These, sometimes-conflicting cultural norms contribute to what has been called the “cult of virginity” (Garcia 1980). This “cult of virginity” has its roots in the Catholic Church’s teachings and is seen as a sign of purity for women. The basic premise of virginity until marriage has been found to decrease a number of sexual health problems, such as unplanned pregnancies, and to decrease the number of STDs. The primary problem with this concept, at least as practiced among Latinos, is that it is not applied equally to both genders. The literature suggests that these double standards result in either females postponing sexual activities, underreporting of sexual contacts (Taggart 1992), and in some cases, denial of other sexual behaviors, such as anal sex, in order to preserve the “cult of virginity” basic premises. This, however, does not prevent sexual innuendo from taking place.
Coquetería is a term used to describe a group of female behaviors aimed at reinforcing sexual attraction. Some of these behaviors include the use of sexually appealing clothing, the adoption of manners that stimulate sexual attraction, and the use of verbiage that indicate sexual interest. Latinas are not the only ones to discreetly express their sexual or personal interests. Piropos are statements generally expressed by men that include a sexual connotation within the context of respect and value for females. Cultural sexual standards are also denoted in language which arbitrarily classifies females as either suitable for marriage, novias, or those who can be pursued for sexual conquests, amantes (Alexander 1992; Carballo-Diéguez 1989). This dichotomy of sexual and gender roles may explain the reason sexual discussions seldom take place among spouses, since esposas (wives) are expected to possess little knowledge about their own sexuality, and even less about their spouse’s. It has been suggested that, in some cases, the only Latinas totally in charge of their own sexuality are commercial sex workers, as they can be less constricted to express and fully explore their sexuality.
De la Vega (1990) suggested that sexual double standards are based on the erroneous belief that males are less able than females to control themselves sexually. It is believed that women exercise greater control over their sexual impulses while males appear to be guided by their instincts. In this context, male infidelity is more easily tolerated than female infidelity. Research indicates that Latinos who have poor sexual communication skills engage in extramarital affairs more often then those who have fewer difficulties communicating with their sexual partners. A 1994 study found that infidelity rates were higher among those who attended church infrequently than regular church attenders (Choi, Catalnia, and Docini 1994).
Machismo and Marianismo. Machismo has been described as a strong force in most Latino communities, which encourages males to be sexually dominant and the primary providers for their families; it stresses male physical aggression, high risk-taking, breaking rules, and casual, uninvolved sexual relations (de la Vega, 1990). In contrast, Marianismo refers to Latino cultural expectations that include the spiritual and moral superiority of women, and encourage Latinas to be virginal, seductive, privately wise, publicly humble, fragile, and yet, provide the glue that holds the family together. It has been argued that while these standards lead to womanizing, they also foster the tenet among males that they are responsible for their family’s welfare.
Sexual Education. The AIDS epidemic has spearheaded an emphasis on the need to investigate sexuality education and communication patterns among Latinos in the United States. Family bonds, moral values, machismo, Marianismo, etiqueta, as well as profound religious beliefs, combine to prevent U.S. Latinos from openly discussing sexuality with family members. In some cases, just saying sexual words in front of family members may be difficult for some Latinos (Medina 1987).
The secrecy surrounding sexuality prevents Latinos from receiving adequate, if any, information about sexuality, contraceptives, and HIV/AIDS and other STDs (Amaro 1991; Carrier and Bolton 1991; Mays and Cochran 1988). In 1992, only 67 percent of Latinos said they had communicated with their children about AIDS, as compared to 77 percent of European-Americans and 74 percent of African-Americans (Schoenborn, Marsh, and Hardy 1994).
In traditional Latino families, sexuality education may come from extended-family members rather than nuclear-family members. Aunts, uncles, and grandparents may assume the role of sexuality educators for younger generations. For instance, Marín, Marín, and Juárez (1990) reported that Latinos were more willing than non-Hispanics to discuss certain sexual topics (i.e., drug use and sex) with an older family member. Similarly, data from the National Health Interview Survey found that less than two thirds (59 percent) of Latino parents had discussed AIDS with their children aged 10-17, compared to 72 percent of African-American and 68 percent of European-American parents (Dawson 1990).
In a study of first-generation immigrant adolescents employed in agriculture, Pérez (in press) found that Latino parents failed to adequately educate their children about sexuality-related matters. However, not all Latino parents hesitate to address sexuality-related issues with their offspring. Some researchers have found that 57 percent of Latino parents do communicate with their children about sexuality. In those cases, home-based sexuality education is the primary responsibility of the mother (Biddlecom and Hardy 1991; Dawson and Hardy 1989).
Supporting our earlier assertion that not all Latinos are created equal, Durant (1990) reported that Mexican-American females where less likely than non-Latinas to have communicated with their parents about contraception, sex, and pregnancy. Dawson (1990) found that Mexican-Americans were less likely to broach these topics with their children (50 percent) than were Puerto Ricans (74 percent) and other Latinos (64 percent). In those instances where parents educate their children about sexuality, the responsibility most often lies with the mother. The data suggest that some Latino parents rely on the schools and, in some cases, mass media to educate their children about sexuality-related issues. In a 1994 study, Schoenborn, Marsh, and Hardy found that 46 percent of Latinos had received AIDS information through radio public service announcements (PSAs), compared to 36 percent of European-Americans and 44 percent of African-Americans. An additional 14 percent of Latinos said they had received information through store displays or brochures, compared to 7 percent of European-Americans and 12 percent of African-Americans. Marín, Marín, and Juárez (1990) concluded that this lack of sexual education may contribute to higher rates of childbearing among Latinos. This is among the greatest paradoxes encountered among Latinos, since research suggests that home-based sexuality education plays a key role in decreasing pregnancy rates among Latino adolescents (Brindis 1997) and increasing condom use (Moran and Corley 1991).
Contraception. Throughout Latin America, the number of children in a household assists in establishing a male’s role in the community. A large number of children, especially among low-income populations, are sometimes necessary for economic survival; the more hands available for work, the greater the family’s income. It is, therefore, not surprising that contraceptive methods are skeptically viewed by some Latinos. This is further compounded by the fact that contraception among Latinos is primarily the responsibility of the woman.
Research indicates that contraceptive use among Latinos is dependent on a number of factors. Attitudes toward contraceptives, religion, condom use during first sexual experience (Marín, Marín, and Juárez, 1990), sexual orientation (Rotheram-Borus et al. 1994), education, and income (Fennelly 1992) have all been identified as being involved with attitudes and likelihood of using contraceptives. Other studies have found that Latino males are less likely to use condoms with their spouses or other primary partners than with other sexual partners (Pérez in press; Sandoval et al. 1995).
In a survey of urban adolescents, Sonestein, Pleck, and Ku (1989) found that Latino males have more-negative attitudes towards condom use than their non-Hispanic counterparts. Although 42 percent of Latina females reported they had used condoms during their first intercourse, Marín, Marín, and Juárez (1990) reported that males still exert a great deal of influence on the decision to use contraceptives. The researchers found that males’ attitudes towards condom use determined the likelihood of using them. Latina women whose sexual partners opposed condom use were less likely than those whose partners did not oppose them or voiced no opinion. In a study of 131 bisexual youth in New York City, Rotheram-Borus and colleagues (1994) found that males were more likely to use condoms with a male than with a female sexual partner. The data indicate that more and more Latino men tend to share the decision on whether or not to use contraceptives with their sexual partners. The couple’s acculturation and assimilation level, their adherence to Catholic Church doctrine, and their desire for large or small families also play a key in their decision to use contraceptives (Marín, Marín, and Juárez 1990). Furthermore, the data indicate that the proportion of European-Americans who use contraceptive methods at first intercourse is higher than that of Latinos (69 percent and 54 percent, respectively) and that the decision to use condoms during intercourse will be affected by male attitudes towards prophylactics (Forrest and Sing 1990).
Adolescents and Sexuality. One of the pivotal stages in a Latina woman’s life is the quinceañera celebration - an event that is analogous to the traditional “sweet sixteen” observed in North America. The quinceañera party marks a woman’s ability to seek a spouse and announces her ability to bear children. During this joyous time, the female is formally introduced to society and is recognized as having achieved full womanhood.
Studies investigating sexual behaviors among Latino adolescents have yielded mixed results. Brindis (1992) found that coital activity rates for Latino youth fall somewhere between that of African-Americans and European-Americans. In contrast to self-reports of lower sexual-activity levels among Latino youth, a national survey found no differences among the proportion of Latino and non-Latino Anglo-American young men who engaged in sexual activities before age 13 (4 percent and 3 percent, respectively) (Sonestein, Pleck, and Ku 1991). Similarly, Forrest and Sing (1990) found that among never-married females 15-19, 49 percent of Latinas reported being sexually active compared to 52 percent of European-Americans and 61 percent of African-Americans.
Differences, however, have been found based on attitudes towards premarital sex (Ginson and Kempf 1990; Padilla and Baird 1991). The data suggest that among adolescents, Latino males tend to engage in sexual intercourse at an earlier age than do females (13 and 15 years of age, respectively). In cross-cultural comparisons, Latino adolescents have been found to have higher sexual risk-taking behaviors (i.e., unprotected sex) than their non-Latino counterparts (Brindis, Wolfe, McCater, Ball, et al. 1995). Brindis (1997) concluded that “acculturation is a key variable influencing adolescent attitudes, behavior, and knowledge about reproduction and contraception” (p. 8).
Latino youths in the United States balance conflicting messages from two cultures regarding their sexuality (Brindis 1992). While the dominant culture appears to promote high levels of non-marital sexual activities, Latino youths, particularly females, must also deal with the more-conservative Latino cultural norms towards sexuality and the “cult of virginity.” Some very conservative families see teenage pregnancy, and in some cases pregnancy before marriage, as a “failure.” These views are expressed in the often used phrase fracazó la muchacha. It is important to clarify that this “failure” does not represent a rejection of the newborn, but rather the woman’s limitation to pursue educational goals, employment opportunities, and her possibilities for marriage. Educational level and formal instruction play a role in parental willingness to discuss and educate their adolescent offspring about sexuality. Those with more education have been found to be more willing to educate their children about sexuality-related issues.
Adults and Sexuality. To date, we lack reliable data on the frequency and sexual preferences, masturbatory frequency and techniques, use of pornography, and sexual dysfunctions among Latinos in the United States. Although dialogs about sexual issues are often avoided, Latinos have other more socially acceptable forms to express their sensuality and sexual desire. Some of these mediums include music, dance, art, and poetry. Research indicates that Latino males learn about their sexuality through practical experience rather than through sexual education. Anecdotes suggest that it is not uncommon for young Latinos to lose their virginity through an experience with a sex-industry worker; usually encouraged by older relatives in what could be termed a “sexual rite of passage.” Sexual discussions among Latino men tend to occur within same-gender groups while they are under the influence of alcohol, with sex-industry workers, and in the context of jokes (Carrier and Magaña 1991; de la Vega, 1990; Hu and Keller 1989).
In a national survey of sexual behaviors, Billy, Tanfer, Grady, and Klepinger (1992) found that Latino men reported a median of 6.1 sexual partners over a lifetime as compared to 8.0 for African-Americans and 6.4 for non-Latino white males. The same study found that Latinos were more likely than non-Latinos to report four or more sexual partners in the last eighteen months. In a survey of over 1,500 Latinos, Marín, Gomez, and Hearst (1993) found that 60 percent of single Latino males reported multiple sexual partners in the previous 12 months.
Pregnancy. Researchers have identified acculturation level, parental communication, low education, language, and country of origin as a determinant for pregnancy among Latino women (Durant 1990). Given the cultural significance of motherhood, it is not surprising that in the United States Latinas experience more per-capita births than their non-Latina counterparts. In 1990, the average number of children per Latino family was 3.76 compared to 3.43 for African-Americans and 3.11 for European-Americans (USDC 1991). Brindis (1997) has suggested that the higher number of children among Latinas may be a residual effect of an intrinsic belief that developed among immigrants based on economic needs and high mortality rates in their countries of origin.
Garcia (1980) suggested that motherhood serves to secure an identity for the Latino woman. In a 1991 survey, Segura found that the meaning of motherhood among Latinas differed, depending on their country of birth. In his study, Segura surveyed Mexican-born women and American-born Chicanas; the findings indicate that while Mexican-born women viewed motherhood as all-encompassing, Chicanas gave greater meaning to child rearing. Among Latinas, Puerto Rican females have the highest rate of pregnancies. Among Mexican women, those born in Mexico experience more pregnancies than those born in the U.S. (Aneshensel, Becerra, Fiedler, and Schuler 1990). Darabi and Ortiz (1987) concluded that “one plausible explanation of these findings could be that Mexican-origin women marry at very early ages” (p. 27). Further differences were reported by Fennelly (1992), who found birth rates among Latino adolescent females ranging from a high of 21 percent among Mexican-Americans to a low of 6 percent among Cuban mothers. Fennelly-Darabi and Ortiz (1987) reported that Latino women were more likely than non-Latino women to have a second birth shortly after the first, and were less likely to have positive attitudes towards abortions.
Despite higher birth rates than other ethnic groups, lower socioeconomic backgrounds, and fewer prenatal visits to physicians, Latinas as a group have fewer low-birthweight babies. This finding has confused experts who would expect the opposite to be true based on socioeconomic factors. Several explanations have been offered, such as better nutrition in the form of complete proteins, less use of alcohol and other psychoactive drugs during pregnancy, and increased family support during the months preceding childbirth. Other researchers have attempted to link higher birth-weights with religiosity and spirituality of Latinas in the United States (Magaña and Clark 1995).
Marriage. Marriage is highly valued among Latino groups; however, in some cases, no difference is made between legal unions and long-term cohabitation. Fennelly-Darabi, Kandiah, and Ortiz (1989) reported that it is not possible to determine the number of couples in informal unions. In a later study, Landale and Fennelly (1992), reported that while the number of non-marital unions has decreased on the island of Puerto Rico, they have greatly increased among Puerto Ricans living on the U.S. mainland.
According to the Census Bureau, in the U.S., Latino marriage rates (62.3 percent) are almost the same for non-Latino whites (64 percent) and are higher than that of African-Americans (46.3 percent). On the other hand, National Council of la Raza data indicate that “The number of Hispanic single parents has increased at a faster rate than Black or White female-headed families” (1993, p.12). According to the U.S. Census Bureau, in 1991, 60 percent of Latino families with a female head-of-household with children under 18 lived under the poverty line (USBC, 1993).
Fennelly, Kandiah, and Ortiz (1989) argued that “A woman’s marital status at the time she bears a child is important because of the implications for her later fertility, and for her own and her children’s economic and social status” (p. 96). The social and legal implications of out-of-wedlock births have then been used to explain the reasons why there are more premarital pregnancies than premarital births in the Latino culture. It has been a time-honored tradition among some Latinos to marry while the woman is pregnant, in order to provide a stable and legal union for the newborn.
Rape. Few studies have been conducted to investigate sexual activities among Latinos in the United States; however, research findings seem to suggest that acculturation and gender, not culture, are key determinants of attitudes towards forcible sexual activities. In a study of attitudes towards date rape among college students, Fischer (1987) found that Latino students held more-traditional gender roles and had a more-positive attitude towards forcible intercourse under certain circumstances. These included spending a lot of money on the woman, the length of time they had dated, the female “leading” the man on, and the perceived female’s previous sexual history.
Acculturation and gender was also found to play a role in the views of college students towards forcible sexual encounters. According to Fischer (1987), “Bicultural and bilingual Hispanic women are less rejecting of forcible rape than assimilated Hispanic and majority women are, while Hispanic males, regardless of degree of acculturation, are less rejecting of forcible date rape than are majority males” (p. 99). Lefley and colleagues (1993) reported that Latinos not only had different definitions of sexual coercion, but also were more likely to blame the victim than were their Anglo-American counterparts. A review of the literature did not support the notion of espousal rape. Males under the influence of alcohol may force their spouses to engage in sexual activities. Forcible sexual intercourse may not be perceived as a violation of a female’s body if it happens within the context of marriage. As a result, espousal-rape reports among Latinos in the U.S. are more likely to occur among the acculturated, assimilated second generation, and those with higher educational levels.
Same-Gender Sexual Activities. In a study of African-American, Latino, Asian/Eurasian, and Caucasian gay adolescent males, Newman and Muzzonigro (1993) found that traditional families were less accepting of homosexuality than low-traditional families. Bonilla and Porter (1990) found that Latinos did not differ significantly from their African-American and white counterparts on attitudes toward homosexuality; however, they were less tolerant in their perceptions of civil liberties. This lack of acceptance may force males to hide their sexual orientation or to pursue heterosexual lifestyles (i.e., marriage) while secretly engaging in same-gender sexual activities.
Family acceptance is only part of the equation explaining Latino views toward same-gender sexual activities. Same-gender sex has different meanings and connotations for Latinos than for the non-Latino population in the United States. As a general rule, same-gender relationships are heavily stigmatized among Latinos, even among highly acculturated groups (Fischer, 1987). Homosexuality is not a topic easily discussed among males (Pérez and Fennelly 1996).
Magaña and Carrier (1991) suggested that it is not totally uncommon for Latino males to turn to “effeminate” males to satisfy their sexual needs under certain conditions. They identified lack of a female sexual partner and/or lack the economic resources to visit a sex worker as an acceptable reason for male-male sexual activities. Same-gender sexual behaviors are also more likely to appear while under the influence of alcohol. Same-gender sexual activity perceptions are also affected by Latino cultural norms. Latinos do not necessarily classify the penile inserter during male-male anal sex as homosexual (Amaro 1991; Carrier 1976). As a result, Latino males engaging in same-gender sexual activities may not perceive themselves, or be perceived as, “homosexual” or “bisexual,” as long as they play the appropriate dominant sexual role - a role which tends to mirror that of the male in a heterosexual couple (CDC 1993). Carrier (1976) reported that unlike their American “gay” counterparts, Mexican males engaging in same-gender sex prefer anal intercourse over fellatio or other forms of sexual gratification. Also, in contrast to their Anglo-American counterparts, Latino males are more likely to assume only the passive or receptive role during same-gender encounters. Ross, Paulsen, and Stalstrom (1988) concluded that it is not the sexual act itself, but rather the cross-gender behavior which gets labeled and heavily stigmatized among Latinos.
The lack of identification with the homosexual community may explain the inability of Latino men who engage in sex with other men to identify or respond to educational programs targeting homosexuals. But, most importantly, it emphasizes the need for researchers to concentrate more on behaviors than labels when studying sexual interactions (Alcalay et al. 1990; Carrier and Magaña 1991). The labeling-versus-behavior distinction is important in light of the fact that 45 percent of AIDS cases among Latinos are the result of same-gender sex, and that an additional 7 percent of AIDS cases are related to same-gender sex with intravenous drug users (CDC 1994).
Bisexuality. De la Vega (1990) discussed three bisexual patterns among Latino men in the United States. The first type he labeled the closeted, self-identified, homosexual Latino. He described this type as a male with homosexual tendencies, but who lives a heterosexual lifestyle. The second type discussed by de la Vega, is the closeted, latent-homosexual Latino; this type is characterized by a male who describes himself as a heterosexual, but who engages in same-gender sex while under the influence of mind-altering substances, primarily alcohol. Finally, de la Vega described the “super-macho” heterosexual Latino. This man allows himself to have sexual contacts with other males since he considers them to be “pseudo-females.” This last type of male will not admit, even to himself, that he may express homosexual tendencies.
HIV/AIDS. Keeling (1993) described the minority experience with AIDS in the United States as follows:
The factors of social and economic class, poverty, and urban despair... will continue to result in an increasingly disproportionate impact of the epidemic on African-American and Hispanic people during the second decade of HIV; it is worth emphasizing as strongly as possible that these disproportions occur not because of biologic reality of race, but because race is a “front” for class, socioeconomic status, and poverty in this context. (p. 264)
This fact could not be of greater truth among Latinos in the United States of America.
The Latino community in the United States has been disproportionately affected by HIV infection. In 1996, Latinos accounted for 17.3 percent of all male AIDS cases in the United States, some 78,926 cases among this population group (CDC 1996). Intravenous drug use (IVDU) is second only to same-gender sex as a transmission mode among Latino males. Latina women account for 20.5 percent of all AIDS cases, a cumulative total of 11,909 Latinas (CDC 1996). Among Latinas, 45 percent contracted AIDS through heterosexual contact, whereas 44 percent of AIDS cases are contracted from IVDU (CDC 1996). Weeks and colleagues (1995) concluded that, although the number of heterosexual cases are increasing among Latinas, the number of AIDS-prevention programs geared towards them continues to be inadequate.
Among Latinos, Puerto Ricans have the highest incidence of HIV infection. Puerto Ricans also have the fourth-highest rate in the nation (NCLR, 1992). According to the Centers for Disease Control and Prevention (1993), up to 70 percent of AIDS cases are related to IVDU in Puerto Rico.
Latino awareness of the disease does not vary greatly from other ethnic groups. Dawson (1990) reported that 41 percent of Latinos said they had some knowledge about AIDS, compared to 39 percent for African-Americans and 48 percent for European-Americans. However, less than half (48 percent) of Latinos understood the connection between HIV and AIDS, compared to 69 percent among European-Americans. These figures did not vary greatly two years later, when Schoenborn, Marsh, and Hardy (1994) reported that 40 percent of Latinos, 47 percent of European-Americans, and 39 percent of African-Americans had “some” knowledge about AIDS.
Latinos are less likely than other ethnic groups to accurately identify HIV-transmission modes. Alcalay, Sniderman, Mitchell, and Griffin (1990) found that Latinos were more likely (36 percent) than European-Americans (15 percent) to believe they could get AIDS from blood donations. The same study found that Latinos were more likely than non-Latinos to believe that HIV transmission could occur through casual contact (e.g., hugging or from water fountains). Dawson (1990) found that 7 percent of Latinos believed it was “very likely” they could become infected with HIV by eating at a restaurant where the cook had AIDS, compared to 5 percent of European-American respondents. The researchers also found that 19 percent of Latinos believed they could catch AIDS from an unclean public toilet, whereas only 8 percent of the European-American respondents and 10 percent of African-Americans believed this to be an exposure category.
Knowledge about AIDS seems to be related to language preference among some Latinos. Research indicates that Spanish-speaking Latinos are more likely than bilingual Latinos to believe AIDS is spread through casual contact (Hu and Keller 1989). Another survey found that 24.1 percent of Spanish-speaking Latinos answered positively to the question, “Do you believe that one can catch AIDS from shaking hands with someone who has AIDS?” in comparison to 1.7 percent of English-speaking Latinos (Alcalay, Sniderman, Mitchell, and Griffin 1990).
Dawson and Hardy (1989) found that Mexican-Americans tended to be less knowledgeable about HIV/AIDS than other Latino groups. Only 50 percent of Mexican-American respondents in their study indicated it is “definitely true” that “AIDS is an infectious disease caused by a virus” compared to 62 percent of other Latinos. Only 46 percent of Mexican-American respondents said they knew that blood transfusions are routinely tested for HIV antibodies, compared to 55 percent of other Latinos, 72 percent of European-Americans, and 53 percent of African-American respondents.
Hu and Keller (1989) found that, despite their lesser knowledge about AIDS, Spanish-speaking Latinos reported a higher interest in learning about AIDS (88 percent) than English-speaking groups (83 percent). Pérez and Fennelly (1996) found that Latino farmworkers are willing to learn about AIDS, even though their reluctance to discuss sex has not decreased. One might expect that lower levels of knowledge about HIV/AIDS among Latinos in the United States would lead to more discrimination towards persons with AIDS. Instead, Alcalay et al. (1990) found no differences between Latinos and non-Hispanics in their likelihood to support AIDS victims’ rights.
Summary. Latinos in the United States represent a wide range of educational attainment, socioeconomic levels, and skin color. Sexual practices and knowledge among this population have been found to be heavily influenced by strict cultural norms largely shaped by the Catholic Church. However, the data suggest that Latino sexual norms and behaviors are as varied as the heterogeneous group they represent. Further research is needed to properly investigate sexual attitudes and behaviors among the individual groups.
A Brief History of the Feminist Movements. Earlier in this section, we discussed groups that illustrate ways in which religion and race or ethnicity operate as social factors defining subcultures within the U.S.A. and influence sexuality. Gender can be regarded in a similar manner. Here, we now consider feminist perspectives as reflections of a distinct social group or subculture.
Feminism is defined and implemented in various ways by different people. In its broadest interpretation, feminism represents advocacy for women’s interests; in a stricter definition, it is the “theory of the political, social, and economic equality of the sexes” (LeGates 1995, 494). Although the terms “feminism” and “feminist” are only about a hundred years old, advocates for women’s interests have been active for centuries throughout the world. As Robin Morgan (1984, 5) wrote in Sisterhood Is Global, “An indigenous feminism has been present in every culture in the world and in every period of history since the suppression of women began.” Throughout history, women have protested, individually and collectively, against a range of injustices - often as part of other social movements in which gender equality was not the focus of the activity and women were not organized to take action on behalf of their gender.
However, stress on the ideologies of liberty, equality, and emancipation of men in the eighteenth-century political revolutions in Britain, France, and the United States laid the groundwork for these ideologies to be championed in women’s lives also. In addition, the Industrial Revolution of the nineteenth century provided educational and economic opportunities supportive of a feminist movement in many societies.
Actual women’s movements, or organized and sustained activities for gender equality supported by a relatively large number of people over a period of years, have occurred since the mid-1800s in many countries throughout the world. The United States, as well as most European societies, experienced extensive women’s movements in the closing decades of the nineteenth century, with another wave of feminism occurring in the 1960s.
The beginning of an organized women’s movement in the United States has been traced to the Seneca Falls Convention of 1848 where a Declaration of Principles called for gender equality (Chefetz and Dworkin 1986). Issues addressed included women’s legal rights to property, children, and to their own earnings; equal educational and employment opportunities; the changing of negative feminine stereotypes; and increased opportunities for women to improve their physical fitness and health. These early feminists also addressed more-explicit sexual issues, including the abolition of the sexual double standard of expecting men to be “promiscuous” and women to be “pure”; equality between sexual partners; and the right of married women to refuse sexual activity with their husbands. Yet, although feminist ideology was well developed during these pre-Civil War years, the progressive feminist leaders had few followers. “In the nineteenth and early twentieth centuries the United States was not ready for a mass movement which questioned the entire gender role and sex stratification systems” (Chefetz and Dworkin 1986:112).
Only when the issues were narrowed to focus upon women’s right to vote did the movement gain mass following. By 1917, about two million women were members of the National American Woman Suffrage Association, and millions more were supporters of the women’s suffrage campaign (Kraditor 1965). The reasons for supporting a woman’s right to vote, however, were varied. For some, it was an issue of basic human rights and gender equality. Many others, who believed in gender-role differentiation, supported suffrage on the basis that women would bring higher moral standards into governmental decisions. This more-conservative perspective dominated the movement. After achieving the right to vote in 1920 with the passage of the Nineteenth Amendment to the U.S. Constitution, this first wave of feminism dissipated.
A second wave of feminism developed within the United States, as well as worldwide, in the 1960s. At this time, many women were finding that, while their participation in educational institutions and the labor force was increasing, their political, legal, economic, and social status was not improving. This American feminist movement came on the heels of the black civil rights movement, which had already focused attention on the immorality of discrimination and legitimized mass protest and activism as methods for achieving equality (Freeman 1995). The contemporary women’s movement was organized around many interrelated issues, including: legal equality; control over one’s own body, including abortion rights; elimination of discrimination based on gender, race, ethnicity, and sexual orientation; securing more political power; and the ending of institutional and social roadblocks to professional and personal achievement. By the mid-1970s, this issue became a mass movement, with over half of American women supporting many of its principles and demands (Chefetz and Dworkin 1986).
The second women’s movement had two origins, from two different strata of society, with different styles, values, and forms of organization (Freeman 1995). Although the members of both branches were predominantly white, middle-class, and college-educated, there was a generation gap between them. The younger branch was comprised of a vast array of local, decentralized, grassroots groups that concentrated on a small number or only one issue, rather than the entire movement. Members tended to adjure hierarchical structure and the traditional political system. Some of the activities in which they engaged included: running consciousness-raising groups; providing educational conferences and literature; establishing woman-supporting services (bookstores, health clinics, rape-crisis centers, and battered-women shelters); and organizing public-awareness campaigns and marches. This branch was responsible for infusing the movement with new issues, strategies, and techniques for social change. Many of its projects became institutionalized within American society (e.g., rape-crisis centers) through government funding and entrepreneurship.
These feminists also took their particular perspectives into other arenas, including the prochoice, environmental, and antinuclear movements. They also impacted academia, establishing women’s centers and women’s studies departments, programs, and courses on campuses throughout the country. By the early 1980s, there were over 300 women’s studies programs and 30,000 courses in colleges and universities, and a national professional association, the National Women’s Studies Association (Boxer 1982). Many periodicals devoted exclusively to scholarship on women or gender were begun; Searing (1987) listed ninety-four such journals.
The second branch of the women’s movement was the older, more-traditional division that formed top-down national organizations with officers and boards of directors, and often paid staffs and memberships. Most of these organizations sought support through contributions, foundations, or government contracts to conduct research and services. Some of these feminist organizations included: the Women’s Legal Defense Fund, the Center for Women’s Policy Studies, the Feminist Majority Foundation, and the National Coalition Against Domestic Violence; with other previously established groups taking on a more-feminist agenda, such as the National Federation of Business and Professional Women and the American Association of University Women.
The National Organization for Women (NOW), an action organization devoted to women’s rights, was the primary feminist group to develop a mass membership. NOW focused its attention at the national level to become politically powerful. One of its major campaigns was the passage of an Equal Rights Amendment (ERA) to the U.S. Constitution guaranteeing legal equality for women. The ERA was endorsed by the U.S. Congress and sent to the states for ratification in 1972. In 1978, over one hundred thousand people marched in Washington D.C. in support of the Equal Rights Amendment. But the ERA and feminism were to meet with strong opposition from well-organized conservative and right-wing political and religious groups that depicted feminist goals as “an attack on the family and the American way of life” (Freeman 1995, 525). Stop-ERA campaigns were adeptly organized by these politically savvy groups and, by 1982, the ERA had failed to pass within the allotted timeframe by seven votes in three states.
Yet, it cannot be said that the feminist movement failed. Many states passed equal rights amendments of their own, and many discriminatory federal, state, and local laws were changed with the Supreme Court unanimously ruling in favor of interpreting constitutional law to provide equal opportunity for women. In addition, a powerful women’s health movement had been spawned, and efforts for reproductive freedom, including abortion rights, would be continued to combat anti-abortion groups throughout the 1980s and 1990s. As Freeman (1995, 528) concluded: “The real revolution of the contemporary women’s movement is that the vast majority of the [United States] public no longer questions the right of any woman, married or unmarried, with or without children to work for wages to achieve her fullest potential.”
Although feminists agree there are still many strides to be made in achieving the goals of legal, economic, political, and social equality for women in the United States, they are often divided over philosophy, goals, and strategies for achieving equality in these areas. Feminism is not a monolithic ideology. There is “not a single interpretation on what feminism means but a variety of feminisms representing diverse ideas and perspectives radiating out from a core set of assumptions regarding the elimination of women’s secondary status in society” (Pollis 1988, 86-87).
Feminism and Sexuality. Sexuality has always been a critical issue to feminists, because they see the norms regarding “proper” and “normal” sexual behavior as functioning to socialize and suppress women’s expression and behavior in an effort to control female fertility as socioeconomic and political assets (Tiefer 1995). “The personal is political,” the feminist rallying cry, applies particularly to sexuality, which is often the most personal, hidden, suppressed, and guilt-ridden aspect of women’s lives. MacKinnon (1982:515) captures this essence well in the analogy that: “Sexuality is to feminism what work is to Marxism: that which is most one’s own, yet most taken away.”
Although women are now being seen as sexual beings in their own right, not simply as reproducers or sexual property, Tiefer (1995, 115) describes how women’s sexual equality is still constrained by many factors, including:
Persistent socioeconomic inequality that makes women dependent on men and therefore sexually subordinate; unequal laws such as those regarding age of sexual consent and rights in same-sex relationships; lack of secure reproductive rights; poor self-image or a narrow window of confidence because of ideals of female attractiveness; ignorance of woman-centered erotic techniques, social norms about partner choice; and traumatic scars from sexual abuse.
In general, feminists believe that both women’s and men’s sexuality is socially constructed and must be examined within its social context (McCormick 1994). Gender-role socialization is viewed as a very powerful process creating unequal power relationships and stereotypic expectations for appropriate sexual feelings and behaviors of women and men. Male gender-role socialization based on male political, social, and economic dominance is likely to result in male sexual control, aggression, and difficulties with intimacy. On the other hand, female gender-role socialization based on political, social, and economic oppression of women is likely to result in disinterest and dissatisfaction with sex, as well as passivity and victimization. Feminists question the assumption of a binary gender system and challenge traditional concepts of masculinity and femininity (Irvine 1990). They politicize sexuality by examining the impact that power inequalities between men and women have on sexual expression.
Although most feminists may agree upon the relevance of socialization and context in the creation of male and female sexuality, they may vehemently disagree about the nature of sexual oppression and the strategies for its elimination (McCormick 1994). This has resulted in the emergence of two major feminist camps: radical feminists and liberal feminists.
As described by McCormick (1994, 211), radical feminists have polarized male and female sexuality - often demonizing men and idealizing women in this process. They view women as victims who must be protected. They use evidence showing girls and women as the predominant victims and boys and men as the perpetrators of rape, sexual harassment, prostitution, domestic violence, and childhood sexual abuse to support their views.
Radical feminists are vehemently opposed to pornography, “likening erotic images and literature to an instruction manual by which men are taught how to bind, batter, torture, and humiliate women” (McCormick 1994, 211). They have spearheaded many efforts to censor pornographic/erotic materials, often joining with right-wing organizations in these efforts. Another goal of radical feminists is the elimination of prostitution, which they view as trafficking in women’s bodies. They believe that all women in the sex trades are being victimized.
Because of these beliefs, radical feminists are criticized as treating women as children who are incapable of giving true consent to their choice of sexual activities. In response, these feminists argue that it is our sociopolitical system that treats women as second class and has robbed them of the equality needed for consensual sexual expression. Until this system is changed, true consent from women is not possible. In fact, orthodox radical feminists do not recognize the possibility of consensual heterosexuality, finding little difference between conventional heterosexual intercourse and rape, viewing both acts as representing male supremacy (McCormick 1994, 211). Radical feminists are accused of advocating “politically correct sex” by idealizing monogamous, egalitarian, lesbian sex and celibacy, and rejecting any other forms of consensual relationships or activity.
On the other hand, liberal feminists defend women’s rights to sexual pleasure and autonomy. They believe that, if women are viewed only as victims, they are stripped of their adult autonomy and their potential to secure joyous and empowering sexual pleasure and relationships on their own behalf (McCormick 1994, 211). These feminists do not view all erotic material as harmful and believe in women’s right to create their own erotic material. They differentiate between the depictions of forced sex in pornography and actual violence against women. Although not always pleased with all types of pornographic material, they believe in the right of free speech and choice, and acknowledge that censorship efforts could never eliminate all pornographic material anyway. In addition, who is to decide what is pornographic and what is erotic? Regarding prostitution, they view sex work as a legitimate occupational choice for some, and acknowledge the tremendous range of experience with sex work primarily based on social class.
Liberal feminism dominated the first phase of the women’s movement of the 1960s. The emphasis was on women’s empowerment to achieve professional and personal, including sexual, potentials. The expansion of sexual possibilities was explored, with pleasure being emphasized. The strategies of consciousness-raising, education, and female-centered care were used to help eliminate sexual shame and passivity, with women being encouraged to discover and develop new sexual realities for themselves (Tiefer 1995, 115). However, beginning in the 1970s, the pendulum began to swing away from an emphasis on the power of self-definition towards the agendas of the radical feminists who emphasized issues of sexual violence against women, including rape, incest, battery, and harassment. Thus, during this current feminist movement, much more time and emphasis has been devoted to women’s sexual victimization, danger, and repression than to women’s sexual equality, pleasure, and relationship enhancement.
Today, many in the general public, professionals, and even sexologists fail to distinguish between differences within feminism. They are most aware of and react primarily to the radical-feminist ideologies and strategies. Thus, feminism has become stereotyped by the extreme positions of the radicals and seems to have lost much of its overt mass support, with many trying to distance themselves from these extreme positions. For example, it is not unusual to hear someone today say, “I believe in women’s rights but I’m not a feminist.”
Feminist Critiques of and Contributions to Sexology. Feminist sexology is the scholarly study of sexuality that is of, by, and for women’s interests. Employing diverse epistemologies, methods, and sources of data, feminist scholars examine women’s sexual experiences and the cultural frame that constructs sexuality. They challenge the assumptions that sexuality is an eternal essence, arguing “that a kiss is not a kiss and a sigh is not a sigh and a heterosexual is not a heterosexual and an orgasm is not an orgasm in any transhistorical, transcultural way” (Tiefer 1995, 597). These theories and approaches have resulted in an enormous body of work during the last two decades reexamining theories, methods, and paradigms of gender and sexuality, and contributing to social change (Vance and Pollis 1990).
During this time, feminists and others have challenged the preeminence and validity of traditional science, particularly as it has been applied to human beings and their behaviors. They have argued that traditional science, rather than being objective and value-free, takes place in a particular cultural context (one that is often sexist and heterosexist), which thus becomes incorporated into research, education, or therapy (McCormick 1994). For example, research on unintended and adolescent pregnancy is focused almost exclusively on females, reflecting a double standard requiring women to be the sexual gatekeepers while relieving men of such responsibilities.
Another example comes from therapy. Numerous studies have determined that relationship factors, including intimacy, nongenital stimulation, affection, and communication, are better predictors of women’s sexual satisfaction than frequency of intercourse or orgasm. Nevertheless, the dominant therapeutic paradigm, as enforced by the Diagnostic and Statistical Manual of Mental Disorders, uses physiologically based genital performance during heterosexual intercourse as the standard for determining women’s sexual dysfunctions (Tiefer 1995).
Feminist scholarship uses the following principles in overcoming the deficits in understanding of women’s experiences, gender and gender asymmetry, and sexuality:
Sexology has been criticized for being reticent to integrate feminist perspectives and scholarship into its establishment for fear of being perceived as unscientific and radical (Irvine 1990). However, in recent years feminist perspectives have become more visible in the scholarly journals, conferences, and among the membership and leadership of professional sexological organizations. Future goals for feminist sexologists include more attention to understanding the intersections of race, class, and culture within gender, and making the results of their work more usable.
This discussion of social factors influencing sexuality in the U.S.A. has selectively focused on religion, race/ethnicity, and gender. Essentially, we have taken the view that such social variables exert influence largely through membership in corresponding social groups. Our review examined the general tradition of the Judeo-Christian heritage of the U.S.A., membership in the Mormon church, African-American, and Latino minority groups, and identification with feminist perspectives as specific examples.
We recognize that this approach omits other important social factors such as education, social class, and size of city of residence. Our purpose has not been to provide an exhaustive review of all pertinent social groups within the U.S.A. Rather, we wished to demonstrate the abundant evidence that a full understanding of sexuality in American culture eventually will require a recognition of the diverse social groups that reside in this nation. As we proceed to examine what sexuality researchers have learned about specific forms of sexual attitudes and behavior, the authors will report, where possible, the results of research which documents an association between sexuality and social variables.
Unfortunately, a recognition of these associations has not always been incorporated into investigations of sexual practices. For example, much of the existing research has been conducted with predominantly white, middle-class, college-educated populations. Researchers have frequently failed to adequately describe the demographic characteristics of their samples, and they have often failed to test possible correlations with social variables. One consequence is that American sexual scientists have yet to develop a full understanding of the very diversity of social groups we have tried to describe. Closing such gaps in our knowledge remains one of the principle tasks of sexual science in the U.S.A.
According to the National Coalition to Support Sexuality Education,
Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs, and values about identity, relationships, and intimacy. It encompasses sexual development, reproductive health, interpersonal relationships, affection, intimacy, body image, and gender roles [among other topics]. Sexuality education seeks to assist children [people] in understanding a positive view of sexuality, provide them with information and skills about taking care of their sexual health, and help them to acquire skills to make decisions now and in the future. (SIECUS 1992)
Sexuality education in the United States has always been marked by tension between maintaining the status quo of the “acceptable” expression of individual sexuality, and change as precipitated by the economic, social, and political events of the time. The major loci for sexuality education have shifted from the family and the community (in earlier times being more influenced by religion, and in modern times, by consumerism and the media), to schools. Much of the education has been developed by and targeted towards middle-class whites. As will be described in more detail, the two major movements to formalize sexuality education in the United States were spearheaded for the advancement of either “social protection” or “social justice.” Throughout history, the goals, content, and methodologies of sexuality education in these two movements have often been in opposition to one another.
According to D’Emilio and Freedman (1988), young people in colonial America learned about sexuality through two primary mechanisms. In these agrarian communities, observation of sexual activity among animals was common. Observation of sexual activity among adults was also common, since families lived in small, often-unpartitioned dwellings, where it was not unusual for adults and children to sleep together. Second, more formal moral instruction about the role of sexuality in people’s lives came from parents and clergy, with lawmakers endorsing the religious doctrines. The major message was that sexual activity ought to be limited to marriage and aimed at procreation. However, within the marital relationship, both the man and woman were entitled to experience pleasure during the procreative act.
Ministers throughout the colonies invoked biblical injunctions against extramarital and nonprocreative sexual acts, while colonial statutes in both New England and the Chesapeake area outlawed fornication, rape, sodomy, adultery, and sometimes incest, prescribing corporal or capital punishment, fines, and in some cases, banishment for sexual transgressors. Together, these moral authorities attempted to socialize youth to channel sexual desires toward marriage (D’Emilio and Freedmen 1988, 18)
A small minority of colonists also were exposed to a limited number of gynecological and medical-advice texts from London. These underscored the primary goal of sexuality as reproduction, with pleasure only to be associated with this goal.
After the War for American Independence, small autonomous rural communities gave way to more-commercialized areas, and church and state regulation of morality began to decline. Individual responsibility and choice became more emphasized. Thus, instruction on sexuality changed from community (external) control to individual (internal) control. For example, between the 1830s and 1870s, information about contraceptive devices and abortion techniques circulated widely through printed matter (pamphlets, circulars, and books) and lectures. However, peer education was the primary source of sexuality education, with more-“educated” people, especially women, passing along their knowledge to friends and family members.
Increasing secularization and the rise of the medical profession spawned a health-reform movement in the 1830s that emphasized a quest for physical, as well as spiritual, perfection. With advances in publishing and literacy, a prolific sexual-advice literature, written by doctors and health reformers of both genders, emerged. The central message was that, for bodily well-being (as well as economic success), men and women had to control and channel their sexual desires toward procreative, marital relations. “Properly channeled, experts claimed, sexual relations promised to contribute to individual health, marital intimacy, and even spiritual joy” (D’Emilio and Freedman 1988, 72). The popularity of these materials demonstrated Americans’ need for and interest in sexuality education. Much of the self-help and medical-advice literature directed at men emphasized the dangers of masturbation. Women were taught that they had less sexual passion than men, and their role was to help men to control their sexual drives. In other words, a standard of female “purity” was the major theme of the sexuality education of the time.
Two studies of women’s sexuality conducted in the early 1900s provide insight into the sources of sexual information for women during the nineteenth century. Katharine B. Davis (1929) studied one thousand women (three quarters born before 1890) and Dr. Clelia Mosher (1980) surveyed forty-five women (four fifths born between 1850 and 1880). Over 40 percent of the women in Davis’ study and half in Mosher’s reported that they received less-than-adequate instruction about sex before marriage. Those who indicated that they had received some sexual information identified Alice Stockham’s advice manual, Tokology, about pregnancy, childbirth, and childrearing as their chief source.
In the later nineteenth century, a combined health and social-reform movement developed, that attempted to control the content of and access to sexuality education. Middle-class reformers organized voluntary associations, such as the Women’s Christian Temperance Union (WCTU), to address issues, including prostitution and obscenity. The social-purity movement in the late nineteenth century added the demand for female equality and a single sexual standard to the earlier moral-reform movements. The WCTU spearheaded a sex-education campaign through the White Cross to help men resist sexual temptation. Social-purity leaders authored marital advice books that recognized women’s sexual desires and stressed that women could enjoy intercourse only if they really wanted it. Women’s rights and social-purity advocates issued the first formal call for sex education in America. They argued that women should teach children about sex: “Show your sons and daughters the sanctities and the terrors of this awful power of sex, its capacities to bless or curse its owner” (D’Emilio and Freedman 1988, 155). They demanded a public discourse of sexuality that emphasized love and reproductive responsibility rather than lust.
An example of the restricted character of sexuality education at the time was the enactment of the 1873 “Comstock Law” for the “Suppression of Trade in, and Circulation of Obscene Literature and Articles of Immoral Use.” This revision of the federal postal law forbade the mailing of information or advertisements about contraception and abortion, as well as any material about sexuality. The Comstock Law was in effect until being overturned by a federal appeals court in 1936 in a decision about contraception: United States v. Dow Package.
Yet, the turn of the century ushered in a more “progressive” era fueled by industrial capitalism. Progressive reform provoked by the middle class called upon government and social institutions, including schools, to intervene in social and economic issues, such as sex education. One of the major movements for sex education was the social-hygiene movement spearheaded by Dr. Prince Morrow to prevent the spread of syphilis and gonorrhea. In 1905, he formed the Society of Sanitary and Moral Prophylaxis in New York City, later renamed the American Social Hygiene Association. This society was joined by the WCTU, YMCA, state boards of health, and the National Education Association in an “unrelenting campaign of education to wipe out the ignorance and the prejudices that allowed venereal diseases to infect the nation” (D’Emilio and Freedman 1988, 205). They held public meetings and conferences, published and distributed written materials, and endorsed sex education in the public schools. While insisting on frank and open discussions of sexual-health matters, they promulgated the traditional emphasis of sexuality in marriage for reproductive purposes and the avoidance of erotic temptation (like masturbation). More-conservative Americans considered such openness to be offensive. Former-President Howard Taft described sex education as “full of danger if carried on in general public schools” (D’Emilio and Freedman 1988, 207). Others considered this type of education to be too restrictive. For example, Maurice Bigelow, Professor of Biology at Columbia University Teachers’ College, objected to the terms “sex” and “reproduction” being used synonymously. Not until after 1920 would these activists see any progress towards the goal of having some basic sex (reproductive) instruction integrated into any school curriculum.
The early 1900s found American minds being expanded by the writings of Sigmund Freud and Havelock Ellis, among others. These psychologists helped popularize the notion of sexuality as a marker of self-identity and a force permeating one’s life, which, if repressed, risks negative consequences. In addition, socialist and feminist ideologies and the industrial economy created an environment fertile for the demand of birth-control information and services. These events spearheaded the second major movement for sexuality education, which was based on social-justice issues, particularly for women and the poor.
In 1912, Margaret Sanger began a series of articles on female sexuality for a New York newspaper, which was confiscated by postal officials for violating the Comstock antiobscenity law. Later, to challenge the constitutionality of this law, she published her own magazine, The Woman Rebel, filled with information about birth control. She was charged with nine counts of violating the law, with a penalty of forty-five years in prison, after writing and distributing a pamphlet, Family Limitation. To avoid prosecution, she fled to Europe; but in her absence, efforts mounted to distribute birth-control information. By early 1915, activists had distributed over 100,000 copies of Family Limitation, and a movement for community sexuality education was solidified. Public sentiment in favor of the right to such information was so strong that charges were dropped against Sanger when she returned to America. Community education about and access to birth control, particularly for middle-class women, began to become accepted, if not expected, as a matter of public health, as well as an issue of female equality (social justice).
Premarital experience became a more-common form of sexuality education among the white middle-class, beginning in the 1920s and accelerating as youth became more autonomous from their families (through automobiles, attendance at college, participation in more leisure activities like movies, and war experiences). Dating, necking, and petting among young peers became a norm. “Where adults might see flagrantly loose behavior, young people themselves had constructed a set of norms that regulated their activity while allowing the accumulation of experience and sexual learning” (D’Emilio and Freedman 1988, 261).
Courses on marriage and the family and (sexual) hygiene were being introduced into the college curriculum. Marriage manuals began to emphasize sexual expression and pleasure, rather than sexual control and reproduction, with more-explicit instructions as to how to achieve satisfying sexual relationships (such as “foreplay” and “simultaneous orgasm”). By the end of the 1930s, many marriage manuals were focusing on sexual “techniques.” In addition, scientific reports, such as Sexual Behavior in the Human Male by Alfred Kinsey and his associates (1948) and the corresponding Sexual Behavior in the Human Female (1953), were major popular works primarily read by the middle class. These books provided sexuality education about the types and frequencies of various sexual expressions among white Americans to more than a quarter of a million people. They also are considered landmarks in sexuality education:
What they [Americans] have learned and will learn may have a tremendous effect on the future social history of mankind. For they [Kinsey and colleagues] are presenting facts. They are revealing not what should be, but what is. For the first time, data on human sex behavior is entirely separated from questions of philosophy, moral values, and social customs. (D’Emilio and Freedman 1988, 286)
As scientific information on sexuality became readily available to the American public, more-explicit presentation of sexual material in printed and audiovisual media became possible through the courts’ decisions narrowing the definition of obscenity. The proliferation of such sexually explicit materials was encouraged by the expansion of the consumer-oriented economy. For example, advertising was developing into a major industry, beginning in the 1920s. Sex was used to sell everything from cars to toothpaste. Gender-role education, in particular, was an indirect outcome of the advertising media. A “paperback revolution” began in 1939 placing affordable materials, such as “romance novels,” in drugstores and newsstands all over the country.
In December 1953, Hugh Hefner published the First issue of Playboy, whose trademark was a female “Playmate of the Month” displayed in a glossy nude centerfold. The early Playboy philosophy suggested males should “enjoy the pleasures the female has to offer without becoming emotionally involved” (D’Emilio and Freedman 1988, 302). By the end of the 1950s, Playboy had a circulation of 1 million, with the readership peaking at 6 million by the early 1970s. Many a man identified Playboy as his first, and perhaps most influential, source of sex education.
By the 1970s, sex manuals had taken the place of marital advice manuals. Popular books like the 1972 Joy of Sex by Dr. Alex Comfort encouraged sexual experimentation by illustrating sexual techniques. Sexual references became even more prolific in the mainstream media. For example, the ratio of sexual references per page tripled between 1950 and 1980 in magazines, including Reader’s Digest, Time, and Newsweek. In addition, Masters and Johnson’s groundbreaking book, Human Sexual Response, emphasizing that women’s sexual desires and responses were equal to those of men, was published in 1966. The media were influencing Americans - female and male, married and single - to consider sexual pleasure as a legitimate, necessary component of their lives.
Yet, even with the explicit and abundant presentation of sexuality in the popular media, parents were still not likely to provide sexuality education to their children, nor were the schools.
In 1964, a lawyer, a sociologist, a clergyman, a family life educator, a public health educator, and a physician came together to form the Sex Information and Education Council of the United States (SIECUS). SIECUS is a nonprofit voluntary health organization with the aim to help people understand, appreciate, and use their sexuality in a responsible and informed manner. Dr. Mary Calderone was a co-founder and the first executive director. SIECUS soon became known all over the country as a source of information on human sexuality and sex education.
This private initiative for sexuality education was followed by a governmental one in 1966 when the Office of Education of the federal Department of Health, Education, and Welfare announced its newly developed policy supporting
family life and sex education as an integral part of the curriculum from preschool to college and adult levels; it will support training for teachers... it will aid programs designed to help parents... it will support research and development in all aspects of family life and sex education. (Haffner 1989, 1)
In 1967, a membership organization, first called the American Association of Sex Educators and Counselors, was formed to bring together professionals from all disciplines who were teaching and counseling about human sexuality. The organization later expanded to include therapists, and is known today as the American Association of Sex Educators, Counselors, and Therapists (AASECT). Opposition to sexuality education from conservative political and religious groups grew quickly. In 1968, the Christian Crusade published, “Is the Schoolhouse the Proper Place to Teach Raw Sex?” and the John Birch Society was calling sex education a “Communist plot.” In response, over 150 public leaders joined the National Committee for Responsible Family Life and Sex Education.
In 1970, Maryland became the first state to mandate family-life and human-development education at all levels in their public schools. However, the new “purity” movement by conservatives was under way, coordinating over 300 organizations throughout the country to oppose sex education in the public schools. Several states passed antisexuality-education mandates, with Louisiana barring sex education altogether in 1968. By the late 1970s, only half-a-dozen states had mandated sex education into their schools, and implementation in the local classrooms was limited.
In 1972, AASECT began developing training standards and competency criteria for certification of sexuality educators, counselors, and therapists. A list of the professionals who have become certified in these three areas is provided in a published register so that other professionals and consumers can locate people who are trained. (Currently this list identifies over 1,000 certified professionals.) AASECT also has developed a code of ethics for professionals working in these fields.
In 1979, the federal government through the Department of Health, Education, and Welfare conducted a national analysis of sex-education programs in the United States. The researchers calculated that less than 10 percent of all students were receiving instruction about sexuality in their high schools. The report’s overall conclusion stated:
Comprehensive programs must include far more than discussions of reproduction. They should cover other topics such as contraception, numerous sexual activities, the emotional and social aspects of sexual activity, values clarification, and decision making and communication skills. In addition to being concerned with the imparting of knowledge, they should also focus on the clarifying of values, the raising of self-esteem, and the developing of personal and social skills. These tasks clearly require that sex education topics be covered in many courses in many grades. (Kirby, Atter, and Scales 1979, 1)
When AIDS burst upon the scene in the 1980s, education with the goal of “social protection” from this deadly disease was targeted for inclusion in public-school curricula. In a relatively short time, most states came to require, or at least recommend, that AIDS education be included in school curricula. The number of states mandating or recommending AIDS education surpassed those mandating or recommending sexuality education. Money and other resources were being infused into AIDS-education initiatives. For example, in 1987-88, 80 percent of the $6.3 million spent nationwide on sexuality education went specifically to AIDS-education efforts. Today, policies and curricula addressing AIDS tend to be much more specific and detailed than those dealing with other aspects of sexuality education, including pregnancy prevention. This may lead to students receiving a narrow and negative view of human sexuality (e.g., “sex kills!”).
Throughout this time, SIECUS remained committed to comprehensive sexuality education, as emphasized in its mission statement: “SIECUS affirms that sexuality is a natural and healthy part of living and advocates the right of individuals to make responsible sexual choices. SIECUS develops, collects, and disseminates information and promotes comprehensive education about sexuality” (Haffner 1989, 4). In 1989, SIECUS convened a national colloquium on the future of sexuality education, “Sex Education 2000,” to which sixty-five national organizations sent representatives. The mission was to assure that all children and youth receive comprehensive sexuality education by the year 2000. Thirteen specific goals for the year 2000 were set forth as follows:
To aid in the attainment of the third goal of providing comprehensive sexuality education in the schools, a national Task Force with SIECUS’s leadership published Guidelines for Comprehensive Sexuality Education, Kindergarten Through 12th Grade in 1991. These guidelines, based on six key concepts, provide a framework to create new sexuality-education programs or improve existing ones. The guidelines are based on values related to human sexuality that reflect the beliefs of most communities in a pluralistic society. They represent a starting point for curriculum development at the local level. Currently, another Task Force is working on ways to help providers of preschool education incorporate the beginnings of comprehensive sexuality education into their programs. In 1994, SIECUS also launched an international initiative in order to disseminate information on comprehensive sexuality education to the international community and to aid in the development of specific international efforts in this area.
Yet, in light of progress that has been made, challenges to sexuality programs from conservative organizations have become more frequent, more organized, and more successful than ever before (Sedway 1992). These nationally organized groups, including Eagle Forum, Focus on the Family, American Family Association, and Citizens for Excellence in Education, target local school programs that do not conform to their specific ideology. They attempt to control what others can read or learn, not just in sexuality education (which now is the major target), but in all areas of public education, including science (with the teaching of creationism), history, and literature (with censorship of many classics in children’s literature). Although these groups represent a minority of parents in a school district, through well-organized national support, they often effectively use a variety of intimidating tactics to prevent the establishment of sexuality-education programs altogether or establish abstinence-only ones. Their tactics include personal attacks on persons supporting comprehensive sexuality education, threatening and sometimes pursuing costly litigation against school districts, and flooding school boards with misinformation, among other strategies. The greater impact of this anti-sexuality-education campaign on education, in general, and American society, overall, has been poignantly described:
In another sense, the continuing series of attacks aimed at public education must be viewed in the context of the larger battle - what has come to be known as a “Cultural Civil War” - over free expression. Motion pictures, television programs, fine art, music lyrics, and even political speech have all come under assault in recent years from many of the same religious right leaders behind attacks on school programs. In the vast majority of cases, in the schools and out, challengers generally seek the same remedy, i.e., to restrict what others can see, hear, or read. At stake in attacks on schoolbooks and programs is students’ exposure to a broad spectrum of ideas in the classroom - in essence, their freedom to learn. And when the freedom to learn is threatened in sexuality education, students are denied information that can save their lives. (Sedway 1992, 13-14)
National youth-serving agencies (YSAs) in the United States provide sexuality education to over two million youths each year. Over the past two decades, YSAs began developing such programs, primarily in response to the problems of adolescent pregnancy and HIV/AIDS.
Second only to schools in the number of youth they serve, youth-serving agencies are excellent providers of sexuality education programs, both because they work with large numbers of youth, including many under-served youth, and because they provide an environment that is informal and conducive to creative and experiential learning. Some YSAs reach youth who have dropped out of school. Others reach youth who have not received sexuality education programs in their schools. The people who work at YSAs often build close relationships with the youth in their programs which allows for better communication and more effective educational efforts. (Dietz 1989/1990, 16)
For example, the American Red Cross reaches over 1 million youth each year in the U.S. with their “AIDS Prevention Program,” “Black Youth Project,” and “AIDS Prevention Program for Hispanic Youth and Families.” The Boys Clubs of America has developed a substance abuse/pregnancy prevention program, called “Smart Moves.” The Girls Clubs of America has a primary commitment to providing health promotion, sexuality education, and pregnancy-prevention services to its members and reaches over 200,000 youth each year. The Girl Scouts of the U.S.A. developed a curriculum, “Decision for Your Life: Preventing Teenage Pregnancy,” that focuses on the consequences of teen parenthood and the development of communication, decision-making, assertiveness, and values-clarification skills. The March of Dimes Birth Defects Foundation developed the “Project Alpha” sexuality-education program that explores teenage pregnancy from the male perspective and helps young men learn how to take more responsibility. The National Network of Runaway and Youth Services has developed an HIV/AIDS education program for high-risk youth, called “Safe Choices.” The program provides training for staff at runaway shelters, residential treatment facilities, detention facilities, group homes, street outreach programs, hot lines, foster-family programs, and other agencies that serve high-risk youth.
In addition to the national efforts of YSAs, many local affiliates have designed their own programs to meet the needs of their local communities in culturally sensitive ways. For example, the National 4-H Council estimates that most state extension offices have developed their own programs to reduce teenage pregnancy in their areas.
More than 85 percent of the American public approve of sexuality education being provided in the schools, compared with 76 percent in 1975 and 69 percent in 1965 (Kenney, Guardado, and Brown 1989). Today, roughly 60 percent of teenagers receive at least some sex education in their schools, although only a third receive a somewhat “comprehensive” program.
Each state can mandate or require that sexuality education and/or AIDS education be provided in the local school districts. Short of mandating such educational programs, states may simply recommend that the school districts within their boundaries offer education on sexuality, in general, and/or more-specific AIDS education. In 1992, seventeen states had mandated sexuality education and thirty more recommended it; see Table 3 (Haffner 1992). In addition, thirty-four states had mandated AIDS education, while fourteen more recommended it. Only four states (Massachusetts, Mississippi, South Dakota, and Wyoming) had no position on sexuality education within their schools; whereas Ohio, Wyoming, and Tennessee had no position on AIDS education. In 1995, the NARAL and NARAL Foundation (1995) issued a detailed state-by-state review of sexuality education in America with selected details of legislative action in 1994 and 1995.
Although the majority of states either mandate or recommend sexuality and AIDS education, this does not guarantee that local school districts are implementing the suggested curricula. Inconsistencies in and lack of implementation of these curricula result from: absence of provisions for mandate enforcement, lax regulations regarding compliance, diversity in program objectives, restrictions on course content, lack of provisions for teacher training, and insufficient evaluation.
In 1988, SIECUS conducted a project to examine and evaluate the recommended state sexuality and AIDS-education curricula (Di Mauro 1989-90). Of the twenty-three state curricula that they evaluated for sexuality education, only 22 percent were deemed to be accurate. Although most curricula stated that human sexuality is natural and positive, there was a lack of any content in the curricula to support this concept. Most focused on the negative consequences of sexual interaction, and little attention was paid to the psychosocial dimensions of sexuality, such as gender identification and roles, sexual functioning and satisfaction, or values and ethics. Only one half of the curricula provided thorough information about birth control.
In an evaluation of the thirty-four state-recommended AIDS-education curricula, 32 percent were found to be accurate in basic concepts and presentation. The majority (85 percent) emphasized abstinence and “just say no” skills, whereas only 9 percent covered safer sex as a preventive practice. Thorough information about condoms was provided in less than 10 percent of the curricula. There was no mention of homosexuality in over one third of the curricula. In 38 percent, homosexuals were identified as the “cause of AIDS.” The Utah curriculum was especially negative and restrictive:
Utah’s teachers are not free to discuss the “intricacies of intercourse, sexual stimulation, erotic behavior”; the acceptance of or advocacy of homosexuality as a desirable or acceptable sexual adjustment or life-style; the advocacy or encouragement of contraceptive methods or devices by unmarried minors; and the acceptance or advocacy of “free sex,” promiscuity, or the so-called “new morality.” This section of their curriculum is replete with warnings of legal violations for instructors crossing prohibition lines; their guidelines indicate that with parental consent it is possible to discuss condom use at any grade level, but without it, such discussions are Class B misdemeanors. (Di Mauro 1989-90, 6; see also the discussion of Mormon sexuality in Section 2A.)
Table 3
State Requirements for Sexuality, STD, and HIV/AIDS Education in Primary and Secondary Schools
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Sexuality Education - Required from Kindergarten Through Senior High School Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Illinois, Iowa, Kansas, Maryland, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Rhode Island, Tennessee, Vermont, Virginia, and West Virginia Sexuality Education - Required for Grades Five or Six Through Senior High School South Carolina, Texas, and Utah Sexuality Education - Not Required Alaska, Arizona, California, Colorado, Connecticut, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Washington, Wisconsin, and Wyoming STD/HIV/AIDS Education - Required from Kindergarten Through Senior High School Alabama, Arizona, Arkansas, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island,1 Tennessee,2 Vermont, Virginia, Washington, and Wisconsin STD/HIV/AIDS Education - Required Grades Five or Six Through Senior High School California, Illinois, Maryland, Oklahoma, South Carolina, Texas, Utah,3 and West Virginia STD/HIV/AIDS Education - Not Required Alaska, Colorado, Hawaii, Kentucky, Louisiana,4 Maine, Massachusetts, Mississippi, Montana, Nebraska, North Dakota, South Dakota, and Wyoming |
1 Instruction in sexuality and HIV/AIDS is required at least once a year in all grades.
2 Instruction in sexuality and HIV/AIDS is required only in counties with more than 19.5 pregnancies per 1,000 females aged 15 to 17. Only one county did not meet this standard.
3 HIV/AIDS education is required from third to twelfth grades.
4 Louisiana law prohibits sex education before the seventh grade, and in New Orleans, before the third grade.
Source: Sexuality Education in America: A State-by-State Review. NARAL/The NARAL Foundation, 1995.
Currently, a broad focus on sexuality education is being supplanted by a narrow focus on AIDS education. Sexuality and AIDS education are being treated independently with separate curricula and teacher training. The report concluded that: “What is needed [for each state] is a comprehensive sexuality education or family-life education curriculum with an extensive AIDS education component that contextualizes preventive information within a positive, life-affirming approach to human sexuality” (Di Mauro 1989-90, 6).
Yet, recommended curriculum content cannot automatically be equated with what is actually being taught in the classroom. To determine what is being taught, a study of public school teachers in five specialty areas (health education, biology, home economics, physical education, and school nursing) in grades seven through twelve was conducted (Forrest and Silverman 1989). It was estimated that nationwide 50,000 public school teachers were providing some type of sexuality education in grades seven through twelve in 1987-88; representing 45 percent of the teachers employed in those areas. Roughly 38.7 hours of sex education were being offered in grades seven through twelve; with 5.0 hours devoted to birth control and 5.9 hours covering STDs.
The teachers cited the encouragement of abstinence as one of their primary goals. The messages that they most want to give included: responsibility regarding sexual relationships and parenthood, the importance of abstinence and ways of resisting pressures to become sexually active, and information on AIDS and other STDs. The teachers agreed that sexuality education belongs in the schools and that students should be taught to examine and develop their own values about sexual behaviors. They reported that there is often a gap between what should be taught, and when and what actually is allowed to be taught. The largest gap concerned sources of birth-control methods; 97 percent of the teachers believed they should be allowed to provide information to students about where they could access birth control, but this was allowed in less than half of their schools. In fact, one quarter of the teachers were permitted to discuss birth control with students only when they are asked a student-initiated question. In addition, over 90 percent of the teachers believed that their students should be taught about homosexuality and abortion, topics that are often restricted by school districts. In addition, the teachers believed that the wide range of sexuality topics should be addressed with students no later than seventh or eighth grade; however, this is not usually done until tenth through twelfth grades, if at all.
The teachers described many barriers to implementing quality sexuality education in their classrooms. The major problem that they identified was opposition or lack of support from parents, the community, or school administrators. They also felt that they lacked appropriate materials because of the difficulties in getting current relevant materials approved for use. They also encountered student-related barriers, such as discomfort, lack of basic knowledge of anatomy and physiology, and misinformation, poor attitudes, and a lack of values and morals reflecting favorable attitudes toward teen pregnancy. Teachers also lacked enough time and training to teach the material effectively. Almost none of them were certified as sexuality or family-life educators by the American Association of Sex Educators, Counselors, and Therapists or the National Council on Family Relations. The level of the teachers’ own knowledge on sexual topics was questionable, and some experienced personal conflicts in dealing with certain issues.
The authors concluded that:
Perhaps the most important step toward improved sex education would be increased, clear support of the teachers. One form this support should take is the development of curricula that provide teachers with constructive, planned ways to raise and deal with the topics on their students’ minds, since the data indicate that students will often raise topics even if they are not in the curriculum. Greater support should also help increase the availability of high-quality instructional materials and on-going education and information for teachers. Adequate teaching materials and support for teaching in earlier grades the topics students want to know about might help solve the problem of student inattention and negative reactions, to say nothing of helping with the problems of teenage pregnancy and the spread of AIDS and other STDs. (Forrest and Silverman 1989, 72)
Yet, in recent years, well-organized conservative organizations throughout the United States have been promoting the adoption of their own abstinence-only curricula in the public schools. Since 1985, the Illinois Committee on the Status of Women has received $1.7 million in state and federal funds to promote such a curriculum, called Sex Respect. They have been successful in having Sex Respect adopted in over 1,600 school systems, even though this curriculum is designed to proselytize a particular conservative sexual-value system. The Sex Respect curriculum has been criticized because it:
(1) substitutes biased opinion for fact; (2) conveys insufficient and inaccurate information; (3) relies on scare tactics; (4) ignores realities of life for many students; (5) reinforces gender stereotypes; (6) lacks respect for cultural and economic differences; (7) presents one side of controversial issues; (8) fails to meaningfully involve parents; [and] (9) is marketed using inadequate evaluations. (Trudell and Whatley 1991, 125)
Careful scientific evaluation of over forty sexuality- and AIDS-education curricula commissioned separately by the Centers for Disease Control and the World Health Organization resulted in the following conclusions:
Researchers over the past fifty years have consistently found that adolescents identify peers, particularly of their same gender, as their primary source of sexuality education, followed by various types of media, including print and visual media. Parents and schools are usually identified as significantly less-influential sources.
Males seem to be more dependent on peers for their sexuality education than are females. One problematic aspect of receiving sexuality education informally from peers is that the information they provide is often inaccurate. However, when peers are formally trained to provide sexuality education, such as on the high school or college level, they are very effective in providing information and encouraging the development of positive attitudes towards responsible and healthy sexual expression. Thus, the peer model is being used more widely in school and community sexuality-education programs.
The various media are pervasive and influential sources of sexuality education in American culture. Media have been identified by adolescents and college students as being more influential than their families in the development of their sexual attitudes and behaviors. As to television, the radio, and movies, adolescents spend more time being entertained by the media than any other activity, perhaps with the exception of sleeping (Haffner and Kelly 1987).
Television, in particular, has been identified as the most influential source of sexual messages in American society, even though sexual behavior is not explicitly depicted. Yet, in an analysis of the sexual content of prime-time television programming, about 20,000 scenes of suggested sexual intercourse and other behaviors, and sexual comments and innuendos were documented in one year (Haffner and Kelly 1987). These portrayals of sexual interaction are six times more likely to happen in an extramarital, rather than a marital, relationship. In soap operas, 94 percent of the sexual encounters happen between people who are not married to one another. Minority groups are extremely underrepresented on TV, with gay and lesbian characters nearly nonexistent.
In the United States, by the time a child graduates from high school, she or he will have spent more time watching TV than being in a formal classroom setting. There is conflicting evidence as to the impact media portrayals have on youth’s developing sexuality (Haffner and Kelly 1987). Gender-role stereotyping is a pervasive aspect of television programming, with children who watch more TV demonstrating more stereotypic gender-role behaviors than those who watch less. Some studies have linked young people’s television-viewing habits, including the watching of music videos, to the likelihood that they would engage in sexual intercourse, while others have not supported this relationship. Yet, there is no denying that TV serves as a sexuality educator. Adolescents report that TV is equally or more encouraging about engaging in sexual intercourse than are their friends, and those that have high TV-viewing habits are likely to be dissatisfied about remaining virgins. In addition, those who believe that TV accurately portrays sexual experiences are more likely to be dissatisfied with their own.
Soap operas are one of the most popular television genres. Depictions of sexual behaviors are common. Yet, television censors still establish rules, such as not showing unbuttoning clothes or the characters at the moment of “penetration.” Unfortunately, very few references to or depictions of safer sex are part of television programs. As the National Academy of Sciences concluded, the media provide “young people with lots of clues about how to be sexy, but... little information about how to be sexually responsible” (Haffner and Kelly 1987, 9).
Sexuality has become a focal point of some newer types of television programming. Sexual topics, such as teenage pregnancy, incest, or AIDS, are often the subject matter of made-for-TV movies and “after-school specials.” In addition, the “sexually unconventional,” such as transvestites, sex addicts, or bigamists, are often the guests of television talk shows, such as Donahue, Oprah, and Geraldo. Some critics believe that this diversity has encouraged viewers to become more tolerant and open, whereas others believe it has done the opposite, reinforcing negative and hostile attitudes. Among adolescents and young adults, music videos have become one of the most popular forms of television entertainment. Yet, context studies of these music videos indicate that women tend to be treated as “sex objects.” Madonna is one exception, depicting a powerful image of female sexuality.
The motto that “Sex Sells” has been generously applied to television advertising. Television uses sexual innuendos and images to sell almost every product from toothpaste to automobiles. The most sexually explicit commercials are generally those for jeans, beer, and perfumes. Paradoxically, commercials and public service announcements for birth control methods are banned from television. Those for “feminine hygiene” products and the prevention of sexually transmissible diseases, including AIDS, are quite restricted.
Subscriber cable television offers more sexually oriented programming, such as the Playboy Channel, than does network TV. However, the Exxxtacy Channel was forced out of business because of numerous government obscenity prosecutions. Virtual-reality technology is being developed to allow cable subscribers to use goggles, gloves, and body sensors to enjoy their own virtual sexual reality.
Film making is a huge business and American films are marketed worldwide. Movies have been reported as one of the leading sources of sexual information for adolescent Anglo-American, Latino, and Native American males (Davis and Harris 1982). Films are given greater license to depict sexual behavior explicitly than on television; however, they are still censored. In fact, films, such as Basic Instinct, have more explicit sex in their uncut versions that are marketed abroad than the “cut” versions that are marketed domestically. Female nudity has become acceptable, whereas male frontal nudity is still censored. Sexual behaviors other than heterosexual intercourse tend to be missing from most films.
Video cassettes and videocassette recorders (VCRs) have revolutionized the viewing habits of Americans. Two hundred million X-rated video cassettes were rented in the U.S. in 1989. One study of college students determined that males viewed about six hours and females two hours of sexually explicit material on their VCRs a month (Strong and DeVault 1994).
Another very popular form of media, directed at females, is the romance novel, comprising 40 percent of all paperback book sales in the U.S. Romance novels are believed to both reflect and create the sexual fantasies and desires of their female American audience. The basic formula of this form of media is: “Female meets devastating man, sparks fly, lovers meld, lovers are torn apart, get back together, resolve their problems, and commit themselves, usually, to marriage” (Strong and DeVault 1994, 22).
Sexual language is disguised by euphemisms. For example, the male penis is referred to as a “love muscle” and the female vagina as a “temple of love.” Yet, romance novels are filled with sensuality, sexuality, and passion, with some people considering them soft-core pornography.
Young males in the U.S. tend to learn about sexuality through more-explicit magazines, such as Playboy and Penthouse. Playboy is one of the most popular magazines worldwide, selling about 10 million issues monthly. Half of college men, but much fewer women, report that pornography has been a source of information for them regarding sexual behaviors (Duncan and Nicholson 1991).
Finally, with increased public access to computer technology, sexuality education is now being offered through the computer-based superhighway. This represents the “wave of the future” and is thoroughly discussed in a section at the end of this chapter.
It is widely believed that parents should be the primary sexuality educators of their children. They certainly provide a great deal of indirect sexuality education to their children through the ways that they display affection, react to nudity and bodies, and interact with people of different genders and orientations - as well as the attitudes they express (or the lack of expression) towards a myriad of sexual topics.
However, most parents in the United States provide little direct sexuality education to their children, even though the majority of children express the desire to be able to talk to their parents about sexuality. Studies of American adolescents consistently find that up to three quarters state that they have not discussed sexuality with their parents (Hass 1979; Sorenson 1973). Parents have expressed the following as barriers to discussing sexuality with their children: anxiety over giving misinformation or inappropriate information for the developmental level of their children; lack of skills in communicating about sexuality, since very few parents ever had role models on how to handle such discussions; and fear that discussing sexuality with their children will actually encourage them to become involved in sexual relationships.
When sexuality education occurs in the home, the mother is generally the parent who handles such discussions with both daughters and sons. Studies do indicate that, when parents talk to their children about sexuality, the children are more likely to wait to become involved in sexual behaviors until they are older, than those children who have not talked with their parents (Shah and Zelnick 1981). Further, when parent-educated teens do engage in sexual intercourse, they are more likely to use an effective means of birth control consistently and to have fewer sexual partners. In addition, high family sexual communication seems to be related to similarity in sexual attitudes between parents and their children.
Recognizing the importance of having parents involved in their children’s sexuality education, efforts are being made to prepare parents to become better sexuality educators. Sexuality-education programs for parents are offered separate from, and in conjunction with, children’s programs in some schools, and through some community and religious organizations. The goals of these programs include developing parents’ communication skills so that they can become more “askable,” increasing their knowledge about various aspects of sexuality, and exploring their attitudes and values surrounding these issues. For example, the National Congress of Parents and Teachers’ Associations (PTA) has created programs and publications on aspects of sexuality and HIV/AIDS prevention for use by local affiliates.
It is clear that we must continue to strive to reach all Americans with positive and comprehensive sexuality education through all of our available informal and formal channels. It is also imperative that sound qualitative and quantitative research methodologies be used to ascertain the impact of differing sexuality education strategies and sources on the diverse groups of people - e.g., gender, age, orientation, race and ethnicity - in the United States.
* With input from J. Kenneth Davidson, Sr.
Five weaknesses or shortcomings and three challenges can be identified in the current research on autoerotic attitudes and behavior patterns in the U.S.A. The weaknesses are:
The challenges include:
In 1985, Mary Calderone, M.D., a pioneer of American sexology and co-founder of the Sex Information and Education Council of the United States, documented the presence of a functioning erectile reflex in a seventeen-week-old male fetus. Considering the homologies of the male and female genital systems, it is logical to assume that females also develop the capacity for cyclical vaginal lubrication while still in the womb. In a 1940 study of boys three to twenty weeks old, seven of nine infants had erections from five to forty times a day. Seven-month-old girls have been observed experiencing what to all appearances can only be judged to be a reflexive orgasm induced by rubbing or putting pressure on their genitals.
The natural reflexes that result in fetal and infant erections and vaginal lubrication are very much like the knee jerk and other reflexes, except that they are accompanied by smiles and cooing that clearly suggest the infant is enjoying something quite pleasurable (Martinson 1990, 1995). Sooner or later, most children learn the pleasures of stimulating their genitals. Once that connection is made, the threat of punishment and sin may not be enough to keep a child from masturbating. Generally, American adults are very uncomfortable with masturbation by infants and children. There are exceptions, of course, as for instance, the practice of indigenous Hawaiian adult caregivers masturbating or fellating infants to calm them at night.
Most children seem to forget their early masturbation experiences. Two thirds of the males in Kinsey’s study reported hearing about masturbation from other boys in their prepubescent or early adolescent years before they tried it themselves. Fewer than one in three males reported they rediscovered masturbation entirely on their own. Two out of three females in Kinsey’s sample learned about masturbation by accident, sometimes not until after they were married. Some women reported they had masturbated for some time before they realized what they were doing.
In the 1940s, Kinsey and his associates reported that close to 90 percent of males and about 50 percent of females masturbated by the midteens. Studies in the 1980s show an increase in these numbers, with a fair estimate that today nearly three quarters of girls masturbate by adolescence and another 10 percent or so wait until their 20s. About 80 percent of adolescent girls and 90 percent of adolescent boys masturbate with frequencies ranging from once a week to about daily (Hass and Hass 1993, 151, 285).
Race and ethnicity, religion, educational level, and sexual education appear to be important variables that affect the incidence of masturbation. African-Americans engage in masturbation less often than whites and are more negative about it. Very little is known about Latino masturbation attitudes and practices. We are not aware of any studies on masturbation among other major groups, such as Asians and Native Americans. Religion is a key variable, especially given the continuing condemnation of masturbation by the Roman Catholic Church. Granted many Catholics engage in masturbation, but on a continuum, they are more likely to experience guilt feelings than Protestants or Jews. Likewise, persons from fundamentalist-Protestant backgrounds are more likely to have negative attitudes toward masturbation than liberal Protestants. Kinsey and many subsequent researchers have found that, as education level increases, especially among women, the acceptance and approval of masturbation as a sexual outlet increases. Finally, experience with sex education is an important variable (Heiby and Becker 1980). Persons who have had sex education appear to hold more-tolerant attitudes.
Data indicate that about 72 percent of young husbands masturbate an average of about twice a month. About 68 percent of young wives do so, with an average frequency of slightly less than once a month (Hunt 1974, 86). According to data reported by Edward Brecher in Love, Sex and Aging (1984), women in their 50s, 60s and 70s reported a consistent masturbation frequency of 0.6 to 0.7 times a week. In their 50s, men reported masturbating 1.2 times a week with a decline to 0.8 times a week in their 60s, and 0.7 times a week over age 70.
The incidence of masturbation has continued to increase in recent years among both college and postcollege women. During the 1980s, between 46 percent and 69 percent of college women in several surveys reported masturbating. In the 1990s, other surveys have found 45 percent to 78 percent. Postcollege women also became more accepting of masturbation as they received psychological permission, instruction, and support in learning about their own bodies. In fact, in self-reports of masturbation, a majority of postcollege-age, college-educated women indicated this was a sexual outlet. In a large-scale sample of college-educated women, without regard to marital status, frequency of masturbation was 7.1 times per month. By contrast, high-school-educated, married women engaged in masturbation only 3.7 times per month (Davidson and Darling 1993).
Not all women feel comfortable with masturbation. Among college women, 30 percent reported “shame” as a major reason for not engaging in this outlet. Other research indicates that only about half of college women believe that masturbation is a “healthy practice.” Even with the apparent increasing incidence of masturbation, considerable data exist that suggest negative feelings toward the practice still deter many college women from choosing this source of sexual fulfillment. And, of those who do engage in masturbation, they do so much less frequently than men, 3.3 times a month for college women compared with 4.8 times for college men (Davidson and Darling 1993).
In general, women are more likely than men to report guilt feelings about their masturbation. Further, substantial evidence suggests that such guilt feelings may interfere with the physiological and/or psychological sexual satisfaction derived from masturbation. In fact, the presence of masturbatory guilt has various implications for female sexuality. Such guilt feelings have been found to inhibit the use of the diaphragm, which necessitates touching the genitals for insertion (Byrne and Fisher 1983). Presumably, this would also affect use of other vaginally inserted contraceptives. Women with high levels of masturbatory guilt experience more emotional trauma after contracting an STD, and exhibit greater fear about telling their sex partner about being infected, than women with low masturbatory guilt. Masturbatory guilt may also inhibit women from experiencing high levels of arousal during foreplay as a prelude to having vaginal intercourse.
One indication of changing attitudes of women toward self-loving is the publication of Sex for One: The Joy of Selfloving, by Betty Dodson (1988), and her subsequent appearance on television talk shows. At the same time, the swift dismissal of the U.S. Surgeon General for daring to suggest that masturbation might be mentioned as part of safer-sex education for children indicates that a prevailing negative societal attitude toward masturbation continues.
* With input from Paul Okami.
Within American culture, childhood sexuality remains an area that has been largely unexplored by researchers. Childhood is widely seen as a period of asexual innocence. Strong taboos continue concerning childhood eroticism, and childhood sexual expression and learning are still divisive social issues. This general ambience of anxiety associated with the sexuality of children is probably understandable, given the general history of sexuality in the U.S.A., with its focus on adult dyadic sex within committed intimate relationships and its opposition to other sexual expressions. This ambience remains, despite the fact that nearly a century has passed since Freud introduced his theory of psychosexual stages with an emphasis placed on the sexual character of childhood development. This reluctance to accept childhood sexuality is somewhat ironic, because Freudian theory, with its concepts of psychosexual stages (oral, anal, phallic, and latency), penis envy, the Oedipus/Electra complexes, repression, and the unconscious, has been immensely popular in the United States throughout much of the twentieth century. Yet, the general American public has been able to ignore the prominence given to childhood sexual development by Freudian theorists and to maintain its central belief that childhood is and ought to be devoid of sexuality.
Perhaps no area reviewed in this section has been the subject of less scientific research than this topic of childhood sexuality. To some extent, the paucity of research has been due to general social concerns about the ethical implications of studying children or assumptions about the possible harm to children that would result if they were to be included in sexuality research. Researchers have frequently had difficulty gaining the permission of legal guardians to ask children questions about their knowledge of sexuality. In this atmosphere, it would be exceedingly difficult to get permission to ask children about their sexual behavior. One consequence of this general social concern has been that most of the relevant research has been confined to asking adults or college students to report retrospectively about events that occurred in their childhood. There are rather clear and obvious limitations to this approach.
On the other hand, we should recognize that many American scientists themselves have been unwilling to study the sexuality of children. A recent review, Sexuality Research in the United Slates: An Assessment of the Social and Behavioral Sciences (di Mauro 1995), is notable for the fact that it never mentions childhood sexuality. It might be interesting to determine the extent to which American researchers accept the premise that scientific explorations of sexuality might be harmful to children. For example, the field of child development, a sizable branch of American psychology, has largely ignored the issue of sexuality in their work (Maccoby and Martin 1983; Mussen 1983). An examination of standard developmental texts or reviews of the child development research literature is striking for its omission of sexuality. Significant bodies of child-development research in such important areas as language acquisition, cognition, communication, social behavior, parent-child interaction, attachment (Allgeier and Allgeier 1988), parenting styles, and child compliance have emerged with scant attention to the possible sexual elements of these areas, or to the ways in which these areas might be related to sexual development (Mussen 1983). As just one example, Piaget never investigated the issue of children’s sexual cognition, and there has been little subsequent research exploring the application of his theoretical model to sexual development. Similarly, the emergence of family systems theory has also largely ignored the sexuality of children - except to explain the occurrence of incest.
At the same time, it is just as true that sexuality researchers have largely ignored the work of child developmentalists and other scientific disciplines in their own work. They have speculated about how theories of psycho-analysis, social learning, cognition, attribution, social exchange, and symbolic interactionism might be applied to the sexuality of children or to the process of sexual development, but they have rarely tested such assertions empirically (see Allgeier and Allgeier 1988 and Martinson 1976 for examples). Moreover, sex researchers have largely failed to examine how the various processes studied by developmentalists relate to sexuality.
A third domain of this fractured American approach to child development is the fairly recent emergence of professional fields devoted solely to the issue of child sexual abuse. We present a review of child sexual abuse itself later in this chapter (see Section 8A2). Here, we wish to make the point that professional groups - e.g., social workers and family therapists devoted to the treatment of victims of child sexual abuse - have emerged, largely since the 1970s, with a corresponding body of work devoted to that concern. After having been largely neglected for much of the twentieth century, the treatment of child sexual abuse has become a sizable “industry” in recent years. Unfortunately, much of the work that has been done within this perspective has failed to consider existing data on normative childhood sexuality (Okami 1992, 1995). For example, it is frequently asserted that child sexual abuse has the negative consequence of “sexualizing” the child’s world. We do not mean to claim that child sexual abuse is either harmless or nonexistent. However, the notion that a “sexualized” childhood is a tragic outcome of sexual abuse rests on the American premise that childhood should be devoid of sexuality. It assumes that childhood should not be sexual. From this perspective, the concept of child sexual abuse has been extended to include family nudity - a point certain to shock naturists in many countries around the world - parents bathing with their children, “excessive” displays of physical affection (such as kissing and hugging), and even children of the same age engaging in sex play (Okami 1992, 1995). Thus, we seem to have come full circle. Many professionals have come to accept the premise that childhood ought to be an innocent period, free of sexuality. The fact that this view ignores much of the existing data seems to have had little impact on either the American public or many professionals working with children.
In reviewing the process of child sexual development and the phenomenon of child eroticism, it is crucial to consider the meanings that children attach to their experience. There is a tendency to interpret childhood experiences in terms of the meanings that adults have learned to attach to similar events. This ignores the reality that young children almost certainly do not assign the same meanings to “sexual” events as adults. They have yet to conceptualize a system of experiences, attitudes, and motives that adults label as “sexual” (Allgeier and Allgeier 1988; Gagnon and Simon 1973; Martinson 1976). A good example is provided by the case of childhood “masturbation.” Young children often discover that “playing” with their genitals is a pleasurable experience. However, this may well not be the same as “masturbating.” Masturbation, as adults understand that term, is a set of behaviors defined as “sexual” because they are recognized as producing “sexual arousal” and typically having orgasm or “sexual climax” as a goal. Young children have yet to construct this complex set of meanings. They know little more than that the experience is pleasurable; it feels good. In fact, it would be useful to see research that examines the process by which children eventually learn to label such self-pleasuring as a specifically sexual behavior called masturbation.
From this perspective, sexual development is, to a considerable extent, a process characterized by the gradual construction of a system of sexual meanings. Gagnon and Simon (1973) have provided a theoretical model of sexual scripting that examines how these meanings are assembled in a series of stages through social interaction with various socialization agents. In their discussion of the model, Gagnon and Simon stressed their intention that it would serve as an organizing framework for future research on the process of sexual development. Although we believe that the model does provide a potentially fruitful framework for thinking about the process of sexual development, and despite the fact that more than twenty years have passed since its original presentation, there is nearly as great a need for research of this type today as when they formulated the model.
One component of the model proposed by Gagnon and Simon (1973) was the concept of assemblies, by which they meant to convey their view that sexual development is actively constructed by humans rather than merely being an organic process. Among the major assemblies they identified were:
Gagnon and Simon maintained that these assemblies were constructed through interactions with a variety of socialization agents, such as parents and family members, same-sex peers, cross-sex peers, and the mass media. To this list, we would suggest adding the church, the school, the neighborhood/community, and boyfriends/girlfriends as potentially important socialization agents. For Gagnon and Simon, the task for researchers was to examine and identify the associations between the activities of various socialization agents and the corresponding construction of specific sexual assemblies. Although a fair amount of research has been conducted on such associations among adolescents (see the following section), sadly there remains relatively little research along these lines for younger children. As such, we will not present a detailed discussion of the activities of each socialization agent here.
Lacking space to review each of the assemblies, we have had to be selective and have chosen to focus on the more explicitly erotic dimensions. However, we do wish to note that each is ultimately important to a full understanding of sexual development, and it is likely that each of these assemblies is related to the others. Although we do not have space to review the research on the development of gender roles and gender identity, it appears that most American children have formed a stable gender identity by the age of 2 or 3 (Maccoby and Martin 1983; Money and Ehrhardt 1972). It also seems likely that, as children acquire sexual information and experience, they filter what they learn in terms of what is appropriate for males and females. Since norms for male and female behavior, both sexual and nonsexual, tend to differ, this filtering process seems likely to lead to differences in the content of and processes of male and female sexual development.
On the other hand, we would caution the reader to resist the temptation to conclude that gender differences in sexuality are invariably large, or that they apply to all dimensions of sexuality. Recent reviews of existing research indicate that many aspects of sexuality are not characterized by male-female differences and that many differences are small in magnitude (Oliver and Hyde 1993). Ultimately, the issue is a matter for empirical investigation. Unfortunately, there has been relatively little empirical research attempting to link gender-role development (of which there has been a great deal of research in the last thirty years) with the processes of more overtly sexual development.
Childhood Sexual Eroticism and Expression. Martinson (1976) has drawn a distinction between what he calls reflexive and eroticized sexual experiences. Reflexive experience is pleasurable and may be a result of learning contingencies, but eroticized experience is characterized by self-conscious awareness and labeling of behavior as sexual. As a general guideline, younger and less-experienced children would seem more likely to react to sexual stimuli in a reflexive manner; older and more-experienced children are more likely to have learned erotic meanings and to define similar behaviors as “sexual.” However, there has been virtually no research detailing the process in which this transition occurs or identifying the factors associated with it.
Sexual Capacity and Autoerotic Play. It has been clear for several decades that infants are capable of reflexive sexual responses from birth. Male infants are capable of erections, and female infants are capable of vaginal lubrication (Allgeier and Allgeier 1988; Halverson 1940). Lewis (1965) observed pelvic thrusting movements in infants as early as eight months of age. Generally, these events appear to be reactions to spontaneous stimuli, such as touching or brushing of the genitals. However, the Kinsey research group (1953) did report several cases of infants less than 1 year of age who had been observed purposely stimulating their own genitals. In their cross-cultural survey, Ford and Beach (1951) reported that, in cultures with a permissive norm, both boys and girls progress from absent-minded fingering of their genitals in the first year of life to systematic masturbation by the age of 6 to 8.
With few exceptions, most research on childhood sexual experiences has asked adolescents or adults to describe events in their past. Males participating in such studies commonly report memories of what they call “their first pleasurable erection” at such ages as 6 and 9 (Martinson 1976), although, as we have just seen, studies of infants themselves document the occurrence of erections from birth. Kinsey and his associates (1953) did report that almost all boys could have orgasms without ejaculation three to five years before puberty, and more than one half could reach orgasm by age 3 or 4. Comparable data for females have not been presented. In addition, both boys and girls between the ages of 6 and 10 have reported becoming sexually aroused by thinking about sexual events (Langfeldt 1979).
Much has been made in the U.S.A. of the fact that sexual arousal in boys is readily visible (erections). A number of authors have argued that this increases the probability that young boys will “discover” their penis and are, thus, more likely to stimulate their own genitals than are girls. This idea has become part of the folklore of American culture. We know of no evidence that substantiates this idea. In fact, Galenson and Roiphe (1980) report that there are no gender differences in autoerotic play during the first year of life.
American culture does not encourage such childhood sex play and actively seeks to restrict it. In a study in the 1950s, only 2 percent of mothers reported that they were “permissive” about their own children’s sex play (Sears, Maccoby, and Levin 1957). It is also interesting to note that the researchers in this study did not provide a response category that allowed mothers to indicate they “supported” or “encouraged” sex play. Martinson (1973) found this pattern extended well into the 1970s. In a later investigation of parental views toward masturbation, Gagnon (1985) found that the majority (86 percent) of this sample believed that their preadolescent children had masturbated. However, only 60 percent of the parents thought that this was acceptable, and only one third wanted their children to have a positive attitude about masturbation.
Sex Play with Other Children. The capacity to interact with another person in an eroticized manner and to experience sexual feelings, either homosexual or heterosexual, is clearly present by the age of 5 to 6. Langfeldt (1979) did observe both mounting and presenting behaviors in boys and girls at 2 years of age. He also observed that prepubertal boys who engaged in sex play with other children typically displayed penile erections during sex play. Ford and Beach (1951) found that children in cultures, unlike the U.S.A., who are able to observe adult sexual relations will engage in copulatory behaviors as early as 6 or 7 years of age. Moreover, in some cultures, adults actively instruct children in the techniques or practice of sexual relations (Ford and Beach 1951; Reiss 1986). This cross-cultural evidence appears to have had little impact on the way in which most Americans, including many sexuality professionals, think about childhood sociosexual interactions.
Again, most of the research in the U.S.A. has been based on recall data from adolescents or adults. Our impressions of childhood sexual interactions are biased toward periods that such older respondents can remember. A number of studies have examined the frequency of childhood sexual behaviors (Broderick 1965, 1966; Broderick and Fowler 1961; Goldman and Goldman 1982; Kinsey et al. 1948, 1953; Martinson 1973, 1976; Ramsey 1943). Taken together, these studies demonstrate that many American children develop and maintain an erotic interest in the other or same sex, and begin experiencing a wide range of sexual behaviors as early as age 5 to 6. It is not uncommon for Americans to report that they remember “playing doctor” or similar games that provide opportunities for observing and touching the genitals of other children, undressing other children, or displaying their own genitals to others. Many American children also acquire experience with kissing and deep kissing (what Americans call French kissing). In fact, generations of American children have played institutionalized kissing games, such as “spin the bottle” and “post office.” These studies also provide evidence that at least some American children experience sexual fondling, oral sex, anal sex, and intercourse prior to puberty. Many of these behaviors are experienced in either heterosexual or homosexual combinations or both.
We have purposely avoided reporting the specific frequencies of the childhood sociosexual experiences in these studies because each possesses severe limitations with respect to generalizability. Most have had small samples drawn from a narrow segment of the total population in a specific geographic region. As early as the 1960s, researchers found evidence of racial and community differences in the rate of such behaviors (Broderick 1965, 1966; Broderick and Fowler 1961). In addition, most have used volunteer samples, with respondents who were trying to recall events that had occurred ten or more years earlier. Moreover, these studies were conducted over a period of five decades, during which there would seem to be great potential for changes. Comparisons among these studies are virtually impossible. As a result, we would have little confidence in the specific accuracy of frequency estimates.
A review of a few of these studies illustrates this point. Interviewing a group of boys in a midwestern city in the early 1940s, Ramsey (1943) found that 85 percent had masturbated prior to age 13, one third had engaged in homosexual play, two thirds had engaged in heterosexual play, and one third had attempted or completed intercourse. The Kinsey group (1948), using a broader sample of adults, reported that 45 percent had masturbated by age 13, 30 percent had engaged in homosexual play, 40 percent had engaged in heterosexual play, and 20 percent had attempted intercourse. For girls, the Kinsey group (1953) reported that roughly 20 percent had masturbated prior to age 13, roughly one third had engaged in both heterosexual and homosexual play, and 17 percent had attempted intercourse. They also reported an actual decline in sexual behaviors after age 10 (Kinsey et al. 1948). The large differences between the Ramsey and Kinsey findings could be due to sample size, differences in geographic region or size of the city, differences in the time period of data collection, or differences in the age range ’of the samples. Here, it is interesting to note that the Kinsey group (1948) also interviewed a small sample of boys. Roughly 70 percent reported some form of child sex play, a figure that is much closer to Ramsey’s findings. In the larger Kinsey sample, only 57 percent of adult males and 48 percent of adult females reported memories of childhood sex play, usually between the ages of 8 to 13 (Kinsey et al. 1948, 1953). It would seem possible, then, that studies with adult samples recalling their childhood experiences might well yield lower estimates than studies of children themselves.
John Money (1976) and Money and Ehrhardt (1972) argue that childhood sex play with other children is a necessary and valuable form of rehearsal and preparation for later adult sexual behavior. He has also suggested that such sex play may occur as part of a developmental stage in childhood. Certainly, this phenomenon has been observed in other primate species, such as the chimpanzee (DeWaal 1982). However, Kilpatrick (1986, 1987) found no differences in various ages of adult sexual functioning between persons who had childhood sexual experiences with other children and those who did not. Given the complexity of the model of sexual assemblies we have presented here, it is not surprising that the effects are not that simple.
Sibling Incest. We discuss incest and child sexual abuse more fully later in Section 8A on coercive sex. Here, we merely wish to note that, in one of the few studies of sibling incest with a nonclinical sample, Finkelhor (1980) found that 15 percent of female and 10 percent of male college students reported having a sexual experience with a brother or sister. Approximately 40 percent of these students had been under the age of 8 at the time of the sexual activity, and roughly 50 percent had been between the ages of 8 and 12. Three quarters of the experiences had been heterosexual. Some type of force had been used in one quarter of the experiences. The most common sexual activities were touching and fondling of the genitals. Only 12 percent of the students had ever told anyone about these sexual activities with a brother or a sister. Interestingly, most of the students reported that they did not have either strong positive or negative feelings about these experiences. Positive reactions were reported by 30 percent, and another 30 percent reported negative reactions. Positive reactions were associated with consensual activities (no force had been used) and an age difference of four or fewer years. For males, there were no correlations between prior sibling experiences and current sexual activity. Among females, those who had had sibling sexual experiences were more likely to be currently sexually active. Those women who had positive sibling experiences after age 9 had significantly higher sexual self-esteem, whereas those who had sexual experiences before age 9 with a sibling more than four years older had lower self-esteem.
Sexual Contacts with Adults. A recent national survey (Laumann et al. 1994) found that 12 percent of men and 17 percent of women reported they had been sexually touched by an older person while they were children. The offender was typically not a stranger, but a family friend or a relative, a finding that is comparable to more-limited samples. We present a more complete review of sexual contacts with adults later in Section 8A2 on child sexual abuse and incest. Relatively few studies of adult-child sexual contacts have been conducted with nonclinical samples. In general, they indicate that children experience a wide range of reactions, from highly negative or traumatic to highly positive, to such contacts in both the short term and long term (Kilpatrick 1986, 1987; Nelson 1986; Farrell 1990). Moreover, there do not appear to be any simple or direct correlations between such childhood experiences and later measures of adult sexual functioning. In her study of incest, Nelson (1986) found no correlation between affective outcomes and type of erotic activity, sexual orientation, or consanguinity. Kilpatrick (1986) did find that the use of force or abuse was significantly related to impaired adult sexual functioning in several areas.
Same-Sex Childhood Experiences. Our discussion to this point has not focused exclusively on heterosexual experience, but it is certainly fair to say that investigations of heterosexual child sex play have dominated existing research. One study of 4- to 14-year-old children found that more than one half of boys and one third of girls reported at least one homosexual experience (Elias and Gebhard 1969). Masturbation, touching of the genitals, and exhibition were the most common activities, although there were also some reports of oral and anal contacts. The fact that children have had such a homosexual experience does not appear to be related to adult sexual orientation (Bell, Weinberg, and Hammersmith 1981; Van Wyk and Geist 1984).
Storms (1981) has hypothesized that such experiences may be related to adult sexual orientation as a function of sexual maturation. He suggests that persons who become sexually mature during the period of homosocial networks (discussed below) may be more likely to romanticize and eroticize these childhood homosexual experiences and, thus, develop a later preference for sexual partners of the same gender. In effect, when sexual maturation, goal-directed masturbation, homosexual explorations, and eroticized fantasies are paired before heterosexual socialization occurs (typically at about age 13), they are more likely to lead to a homosexual orientation later. As far as we know, Storms’s ideas have never been directly tested through research.
Childhood Social Networks. During middle childhood (roughly ages 6 to 12), both boys and girls in the U.S.A. tend to form networks of same-sex friends. A pattern of gender segregation, where boys and girls have separate friends and play groups, is central to the daily life of middle childhood. This pattern of homosocial networks is readily observable at elementary schools across the U.S.A. Girls and boys tend to cluster at school into separated, same-sex groups. At lunchtime, they frequently sit at separate “girl’s tables” and “boy’s tables.” On the playground, space and activities tend to be gendered. After school, children tend to associate and play in gender-segregated groupings. In fact, this pattern of gender separation may be more pronounced in middle childhood in the U.S.A. than the more-publicized racial segregation.
It should be acknowledged that these homosocial networks are not characterized by a total separation of the genders. There are some opportunities for heterosocial interactions and play, and children do vary with respect to the extent in which they associate with the other sex. As just one obvious example, some girls, who are known as “tomboys,” spend considerable time associating with boys. Still, to a large extent, the worlds of boys and girls in middle childhood in the U.S.A. are separated.
Maltz and Borker (1983) have suggested that these homosocial networks can be viewed as distinct male and female cultures. As cultures, each has its own set of patterns, norms, and rules of discourse. Boys tend to play in groups that are arranged in a hierarchy. They stress a norm of achievement (“doing”) and emphasize competitive, physical activities. Conflict is overt and is often resolved directly through physical Fighting. Differentiation between boys is made directly in terms of power and status within the group. Since boys belong to more than one such group, and because group memberships do change over time, each boy has an opportunity to occupy a range of positions within these hierarchies. Boys’ groups also tend to be inclusive. New members are easily accommodated, even if they must begin their membership in a lower-status position. Courage and testing limits are prime values of boys’ groups, and breaking rules is a valued form of bonding. In examining how these patterns influence male communication, Maltz and Borker (1983) report that males are more likely to interrupt others, they are more likely to ignore the previous statement made by another speaker, they are more likely to resist an interruption, and they are more likely to directly challenge statements by others.
Girls tend to associate in smaller groups or friendship pairs. Girls, for example, tend to be highly invested in establishing and maintaining a “best friend” relationship. They stress a norm of cooperation (“sharing”) and pursue activities that emphasize “working together” and “being nice.” They frequently play games that involve “taking turns.” Friendship is seen as requiring intimacy, equality, mutual commitment, and cooperation. However, girls’ groups also tend to be exclusive. Membership is carefully reserved for those who have demonstrated they are good friends. Conflict tends to be covert, and it is highly disruptive, leading to a pattern of shifting alliances among associates. Differentiation between girls is not made in terms of power, but rather in relative closeness. Girls are more likely to affirm the value of rules, especially if they are seen as serving group cohesion or making things fair. Girls may break rules, but their gender group does not provide the intense encouragement and support for this behavior seen among boys. Maltz and Borker (1983) note that girls are more likely to ask questions to facilitate conversation, they are more likely to take turns talking, they are more likely to encourage others to speak, and they are more likely to feel quietly victimized when they have been interrupted.
These largely segregated gender networks in middle childhood serve as the contexts for learning about adolescent and adult sexual patterns, as well as for other areas of social life. There is, of course, a certain irony to the fact that homosocial networks serve as a principal learning context for heterosexuality in a culture with such strong taboos against homosexuality as the U.S.A. In fact, Martinson (1973) has argued that these gender networks and this period serve as the settings for a fair amount of homosexual exploration and activity. In one sense, it is almost certainly true that some homosexual activity results from these patterns of social organization. However, this assertion is largely undocumented, and we are not aware of any studies that compare the level of homosexual activity in cultures with homosocial networks with cultures having some other form of childhood networks.
Thorne and Luria (1986) have used this concept of gendered cultures to examine the process of sexual learning in middle childhood. They found that “talking dirty” is a common format for the rule-breaking that characterizes boys’ groups. They noted that talking dirty serves to define boys as apart from adults, and that boys get visibly excited while engaging in such talk. Boys also often share pornography with each other and take great care to avoid detection and confiscation by adults. These processes provide knowledge about what is sexually arousing, and they also create a hidden, forbidden, and arousing world shared with other boys, apart from adults and girls. Miller and Simon (1981) have argued that the importance attached to rule violations creates a sense of excitement and fervor about sexual activity and accomplishment.
One other feature of boys’ groups is that they serve as a setting for learning both homoeroticism and homophobia. Boys learn to engage in what Thorne and Luria call “fag talk.” That is, they learn to insult other boys by calling them names, like “faggot” and “queer.” Eventually, they learn that homosexuality is disapproved by the male peer group. Boys at age 5 to 6 can be observed touching each other frequently. By age 11 to 12, touching is less frequent and reduced to ritual gestures like poking each other. On the other hand, much of the time spent with other boys is spent talking about sex. This serves to maintain a high level of arousal within the group. Moreover, the sanctioning of rule-breaking leads to some homosexual experimentation that is kept hidden from the group. Homosexual experiences may become one more form of breaking the rules and one more feature of the secret, forbidden world of sexuality.
In contrast, girls are more likely to focus on their own and their friends’ physical appearance. They monitor one another’s emotions. They share secrets and become mutually vulnerable through self-disclosure. They have giggling sessions with their friends, with sex often being the source of amusement. Their talks with other girls tend to focus less on physical activities and more on relationships and romance. They also plot together how to get particular boys and girls together in a relationship.
These sexual patterns are largely consistent with the norms of the respective gender cultures. Males tend to focus on physical activities; females on cooperation and sharing. They are also quite consistent with patterns that will become firmly established in adolescent sociosexual patterns. Thus, male and female peer groups become the launching pads for heterosexual coupling as boys and girls begin to “go together.” Finally, they serve to heighten the romantic/erotic component of interactions with the other gender.
As we stated at the beginning of this section and as should be apparent from the review of sex education in the U.S.A., there are a number of issues concerning childhood sexuality that have been controversial for decades. Moreover, several new issues have become points of social conflict in recent years. We can only briefly mention four here.
The Oedipus and Electra Complexes. The Goldmans’ (1982) multinational study of children and sexual learning, including a sizable American sample, raises questions about these complexes. Freud’s thesis about castration anxiety and its resolution (typically by the age of 5) would presumably require some awareness of genital differences between males and females, unless one wishes to interpret Freud’s terminology strictly as metaphorical. In the Goldman study, the majority of English-speaking children did not understand these differences until they were 7 to 9 years old. Interestingly, a majority of the Swedish children could accurately describe these differences by the age of 5.
Is There a Latency Period? The notion of a latency period, roughly from ages 6 to 11, has had great appeal in American culture. This may be due to the impression that the homosocial networks of middle childhood reflect a lack of sexual interest, and to the fact that many Americans prefer to believe that childhood is a period of sexual innocence. Freud (1938) originally proposed in 1905 that middle childhood is characterized by relative sexual disinterest and inactivity, something like a dormant period. Freud also maintained that latency was more pronounced among boys than girls. The review above should certainly dispel the notion that childhood, at any point, is essentially characterized by sexual disinterest.
In addition, Broderick (1965, 1966) not only provided evidence of active sex play during middle childhood, but also demonstrated that most children indicate they wish to marry as an adult, and that most of these children are actively involved in a process of increasing heterosocial interaction and love involvements during childhood, A majority said they had had a boyfriend or girlfriend and had been in love, and 32 percent had dated by age 13. If anything, we would expect that the age norms for many of these behaviors have actually decreased since that time. Interestingly, those children who indicated that they did not wish to marry eventually were substantially less likely to report any of these activities.
Parental Nudity. Experts have disagreed over the years as to the impact of parental nudity on children (Okami 1995). Some have argued that childhood exposure to parental/adult nudity is potentially traumatic - largely because of the large size of adult organs. Others have insisted that strong taboos on family nudity may lead to a view that the body is unacceptable or shameful. This group has argued that a relaxed attitude toward nudity can help children develop positive feelings about sexuality. Similar concerns have been expressed about the primal scene and sleeping in the parental bed. In a survey of 500 psychiatrists, 48 percent indicated that they believe that children who witness their parents engaging in intercourse do suffer psychological effects (Pankhurst 1979). American experts appear to overlook the fact that most families throughout the world sleep in one-room dwellings. In one study of these issues, Lewis and Janda (1988) asked 200 college students to report their childhood experiences. Exposure to parental nudity for ages zero to 5 and 6 to 11 was generally unrelated to a series of measures of adult sexual adjustment. Sleeping in the parental bed yielded several small, but significant correlations. Persons who had slept in their parents’ bed as children had higher self-esteem, greater comfort about sexuality, reduced sexual guilt and anxiety, greater frequency of sex, greater comfort with affection, and a higher acceptance of casual sex as college students.
Okami (1995) reviewed the literature in these same three areas. His review provides a thorough summary of clinical opinions in each area, as well as an assessment of the empirical evidence. Despite the growing number of clinical professionals who label such acts as sexual abuse, there is virtually no empirical evidence of harm. In fact, the only variable found to be associated with harm is cosleeping, which has been found to be associated with sleep disturbances. However, Okami notes that these sleep disturbances may well have preceded and precipitated the cosleeping, rather than vice versa.
Female Genital Cutting. In December 1996, the Center for Disease Control and Prevention (CDC) estimated that more than 150,000 women and girls of African origin or ancestry in the United States were at risk in 1995 of being subjected to genital cutting or had already been cut. This estimate was based on 1990 Census Bureau data gathered before the recent increase in refugees and immigrants from the 28 countries that span Africa’s mid-section where female genital cutting varies widely in prevalence and severity (Dugger 1996ab). A second source cites a different estimate from the CDC using data on how much circumcision is practiced in immigrants’ homelands and, making assumptions about sex and age, that about 270,00 African females in the United States were circumcised in their home country or are at risk here (Hamm 1996)
In 1996, Congress adopted a dual strategy to combat the practice here. In April 1996, Congress passed a bill requiring the Immigration and Naturalization Service to inform new arrivals of U.S. laws against genital cutting. It also mandated the Department of Health and Human Services to educate immigrants about the harm of genital cutting and to educate medical professionals about treating circumcised women. A law, which went into effect March 29, 1997, also criminalizes the practice, making it punishable by up to five years in prison and a fine of up to $250,000 for individuals and $500,000 for organizations such as hospitals. Enforcement of the law, however, is problematic for several reasons. First, no one is sure how the law will apply to those immigrants who take their daughters out of the country for the rite. Second, doctors who spot cases of genital mutilation are reluctant to report it for fear of breaking up tight-knit families. Also, when the wounds are healed, it is impossible to ascertain whether the rite was performed here or before arrival in the United States. Finally, there is the secretiveness surrounding this rite of passage, which many African cultures consider essential, and also the hidden nature of the wounds and scars. Sierra Leoneans, for instance, who consider genital cutting part of an elaborate, highly secret initiation rite, view questions about it as a profound invasion of their privacy (Dugger 1996ab).
A government’s prevention program focuses on educating both old and recent immigrants in how to survive and assimilate in American society while maintaining their own culture and religion. To this purpose, the U.S. Department of Health and Human Services has organized meetings with advocates for refugees and nonprofit groups that work closely with Africans to develop strategies for combating this practice. Muslim religious leaders, for instance, are invited to explain that the Koran does not require this practice. However, lack of a specific budget hampers this effort.
In one attempt to ameliorate this clash of cultural values, doctors at Harborview Medical Center in Seattle, Washington, persuaded Somali mothers to be satisfied with nicking the clitoral hood without removing any tissue. The ritual usually involves removing the clitoris and sewing the labia closed. The compromise was abandoned in December of 1996 when the hospital was inundated with hundreds of complaints protesting even this compromise, even though the nicking of the clitoral hood has no short-or long-term negative consequences. The massive objection to this compromise raises serious questions of ethnocentrism on the part of the Americans who protested it. It seems somewhat ironic that such complaints would be made in a culture where we routinely circumcise penises. Although some maintained that the compromise of nicking may violate the letter of the law, it remains to be seen what kind of solution will be achieved in this matter (Dugger 1996b).
Child Pornography. It is widely believed, and the Federal Bureau of Investigation (FBI) perpetuates the notion, that child pornography is pervasive and increasing. Several state and federal laws have been enacted in the last twenty years to combat this perceived social problem. The mere possession of a photograph of a naked child has been criminalized in some states. Yet, it is virtually impossible to find any commercial child pornography in the U.S.A. In fact, most of the materials seized by the FBI are private photographs of naked children - with no adults appearing in the photos and no sexual behaviors depicted (Klein 1994; Stanley 1989). Efforts to raid child-pornography businesses have routinely failed to seize any child pornography. FBI sting operations may well have arisen from the corresponding frustrations of government agencies to find any child pornography. One recent legend now circulating is the claim that the U.S. government is now the largest producer of child pornography in the world. This claim is unsubstantiated as far as we know, but, again, it reflects the anxiety of American culture over the sexuality of its children.
In stark contrast to the relative inattention given to childhood sexuality in the U.S.A., Americans have been fascinated by the sexual behavior of adolescents throughout the twentieth century. One is tempted to describe the interest as an obsession. Perhaps no area of sexuality has received as much scrutiny, by both the general public and professionals, as the sexual practices of American teenagers. There have been literally hundreds of scientific studies attempting to determine the rate of adolescent premarital coitus, as well as other aspects of adolescent sexuality. The easy availability of populations to study is only one of the more-obvious reasons for this extensive research.
Since more than 90 percent of Americans ultimately do marry, investigations of adolescent sexual development and premarital sexual practices largely overlap. General trends have been well documented, compared to other areas of sexuality. Given the vast scope of this research, we can review only the highlights here. (For more extensive reviews of research on adolescent and premarital sexuality, see Cannon and Long 1971; Clayton and Bokemeier 1980; and Miller and Moore 1990.)
The issue of premarital sexuality (hereafter PS) and virginity has been a focus of considerable social conflict and concern throughout this century, and remains so to this day. Beginning in the early years of this century, a large literature documents the continuing concern of American adults about the increasing number of teenagers who have experienced sexual intercourse prior to marriage. Interestingly, each successive birth cohort of American adults in this century has been concerned about the tendency of their offspring to exceed their own rate of premarital coitus.
Much of the professional literature has reflected these same concerns. Through much of the twentieth century, the tone of most professional writings has been moralistic. Adults in the U.S.A., including most sexuality researchers, have tended to view adolescent premarital sexual intercourse, PS, as a deviant behavior, as a violation of existing social norms, and as a growing social problem (Spanier 1975). Research has tended to parallel this perspective by emphasizing the costs or negative consequences of adolescent sexuality, such as sexually transmitted disease (venereal disease), “illegitimate” pregnancy, and loss of reputation (Reiss 1960). This tone may have shifted to a less-judgmental, more-analytic perspective in the 1960s and 1970s (Clayton and Bokemeier 1980). However, with the emergence of AIDS and the rise of out-of-wedlock pregnancies in the early 1980s, the general tone has reverted in recent years, with studies of “risk-taking” behavior, “at-risk” youth, and portrayals of adolescent sexuality as a form of delinquency (Miller and Moore 1990).
Despite these adult concerns, it would be fair to suggest that premarital virginity has largely disappeared in the U.S.A., both as a reality and as a social ideal. As we approach the end of the century, the overwhelming majority of Americans now have sexual intercourse prior to marriage, and they begin at younger ages than in the past. “Love” has largely replaced marital status as the most valued criteria for evaluating sexual experience (Reiss 1960, 1967, 1980). Virtually all Americans believe that intimate relationships (like marriage) should be based on love, that love justifies sexual activity, and that sex with love is a more-fulfilling human experience. This view has not only been used to justify PS activity between loving partners, but has also become a criteria for evaluating marital sexuality itself and justifying a pattern of divorce and remarriage.
Premarital Sexual Behavior. These trends may not be quite as dramatic as most Americans imagine. A study of marriages in Groton, Massachusetts, from 1761 to 1775 found that one third of the women were pregnant at the time of their weddings (cited in Reiss 1980), demonstrating that PS was already fairly common in the colonial period (see discussion of bundling in Section 1A). Several early sexuality surveys also document that PS occurred among some groups prior to the twentieth century. Terman (1938) compared groups who were born in different cohorts around the beginning of the century. Of those born before 1890, 50 percent of the men and only 13 percent of the women had premarital coitus. Two thirds of the men who had PS did so with someone other than their future spouse, whereas two thirds of the women who had PS did so only with their future spouse. For those born after 1900, two thirds of the men and nearly half of the women had PS. The relative percentage having PS with their fiance also increased. Fully half of the men and 47 percent of the women had sexual relations with their fiance prior to marriage.
The Kinsey team (1953) found that one quarter of the women born before 1900 reported they had PS, whereas one half of those born after 1900 said they had PS. Like the Terman study, the major change was an increase in the percentage of women born after 1900 who had PS with their fiance. The Kinsey study also indicated that the period of most-rapid change was from 1918 to 1930 - the “Roaring Twenties.” Burgess and Wallin (1953) reported similar findings for a birth cohort born between 1910 and 1919. These studies indicated that roughly two thirds of the men born after 1900 had PS. The Kinsey studies also found that there had been comparable increases in female masturbation and petting behavior as well.
It is important to note that the growth of PS in the first half of the century occurred primarily within the context of ongoing, intimate relationships. It appears that the percentage of males and females having PS remained fairly stable through the 1950s and early 1960s. In a study of college students during the 1950s, Ehrmann (1959) found rates similar to the Kinsey figures cited above. Ehrmann found that males tended to have greater sexual experience with females from a social class lower than their own, but they tended to marry women from their own social class. Males who were “going steady” were the least likely to be having intercourse. In contrast, females who were “going steady” were the most likely to be having intercourse. In a study comparing college students in Scandinavia, Indiana, and Utah (predominantly Mormon), Christensen (1962) and Christensen and Carpenter (1962) found that rates of PS vary by the norms of the culture and that guilt is most likely to occur when PS is discrepant with those norms.
A second wave of increases in PS seems to have occurred in the period from 1965 to 1980. A number of studies of college students through this period indicated increasing percentages of males and females having premarital coitus (Bauman and Wilson 1974; Bell and Chaskes 1968; Christensen and Gregg 1970; Robinson, King, and Balswick 1972; Simon, Berger, and Gagnon 1972; Vener and Stewart 1974). For example, Bauman and Wilson (1974) found that, for men, the rate having PS increased from 56 percent in 1968 to 73 percent in 1972. For women, the increase was from 46 percent to 73 percent. There was no significant change in the number of sexual partners for either gender. Several of these studies indicate that the increases were still moderate by 1970 (Bell and Chaskes 1968; Simon et al. 1972). In an unusual study of male college students attending an eastern university in the 1940s, 1960s, and 1970s, Finger (1975) found that 45 percent had PS in 1943-44, 62 percent in 1967-68, and 75 percent in 1969-73.
Subsequent studies have indicated that this pattern of increasing PS characterized American youth in general. In a study of urban samples in the mid-1970s, Udry, Bauman, and Morris (1975) found that 45 percent of white teenage women had intercourse by age 20, and 80 percent of black women did. Roughly 10 percent of whites had PS by age 15 and 20 percent of blacks did Zelnik and Kantner found similar percentages in their studies in 1971 and 1976 (Udry, Bauman, and Morris 1975; Zelnik, Kantner, and Ford 1981).
Reports of increasing sexual activity among adolescents have not been limited to coitus. A number of researchers have reported similar increases in the rate of heavy petting (manual caressing of the genitals) through the late 1960s and 1970s (Clayton and Bokemeier 1980; Vener and Stewart 1974). There have also been reports of increasing levels of oral sex among adolescents (Haas 1979; Newcomer and Udry 1985). In some studies, teenage girls have been more likely to have participated in oral sex than intercourse, and between 16 percent to 25 percent of teens who have never had intercourse have had oral sex (Newcomer and Udry 1985). Weis (1983) has noted that this group may be involved in a transition from virginity to nonvirginity, at least among whites.
Perhaps the single best indicator of the trends occurring from 1965 to 1980 is the series of studies by Zelnik and Kantner in 1971, 1976, and 1979 (Zelnik et al. 1981). These studies, known as the National Surveys of Young Women, investigated the sexual histories of 15- to 19-year-old women. The 1971 and 1976 studies were full national probability studies while the 1979 study focused on women living in metropolitan areas. The Zelnik and Kantner research shows a dramatic rise in sexual activity for both black and white women from 1971 to 1976. The pattern of increases continued for white women through 1979, but PS rates for black women remained stable from 1976 to 1979. Among metropolitan women, PS rose from 30.4 percent in 1971 to 49.8 percent in 1979. For blacks, the rate moved from 53.7 percent in 1971 to 66.3 percent in 1976, and was 66.2 percent in 1979. The 1979 study also showed that 70 percent of males had PS intercourse; the figure for black men was 75 percent (Zelnik and Shah 1983; Zelnik et al. 1983).
In a review of these trends, Hofferth, Kahn, and Baldwin (1987) noted that females in the 1980s became sexually active at younger ages and that fewer teenagers married. As a result, the rate of PS increased. The proportion of women at risk of premarital pregnancy increased dramatically from 1965 to the 1980s. The out-of-wedlock pregnancy rate among teenagers increased for both blacks and whites from 1971 to 1976. This trend continued for whites through 1982, but remained level for blacks after 1976. Finally, they noted that, for women born between 1938 and 1940, 33.3 percent had PS by age 20. For women born between 1953 and 1955, the figure was 65.5 percent.
Despite recent claims in some quarters of a return to chastity and abstinence in the late 1980s and 1990s (McCleary 1992), there is no evidence of a decline in PS behavior. National data from 1988 indicate that one quarter of females have PS intercourse by age 15; 60 percent do so by age 19. About one third of United States males have PS intercourse by age 15, and 86 percent by age 19 (Miller and Moore 1990). In fact, a random telephone survey of 100 students attending a midwestern state university in 1994 found that 92 percent had had sexual intercourse; only 8 percent said they were still virgins. Nearly two thirds (63 percent) said that they had participated in what the survey described as a “one-night stand.” With respect to their most recent sexual intercourse, 42 percent reported using something to “protect” themselves. Of these, 84 percent reported using condoms; 16 percent said they used the pill (Turco 1994). If anything, the trends that have been well established throughout this century appear to be continuing. Given the continuation of patterns that have been frequently cited as leading to increasing rates of PS, such as industrialization, rapid transportation, dating, and “going steady,” we would not expect a reversal in what is now a century-long trend.
Premarital Sexual Attitudes (Permissiveness). There has also been a substantial number of studies examining the attitudes of Americans toward PS, although systematic research in this area began later than research on PS behavior. Reiss (1960) used the term “permissiveness” to describe the extent to which the attitudes of an individual or a social group approved PS in various circumstances. In general, research has found that PS attitudes have become progressively more permissive throughout this century, roughly parallel to the increases in PS behavior (Bell and Chaskes 1970; Cannon and Long 1971; Christensen and Gregg 1970; Clayton and Bokemeier 1980; Glenn and Weaver 1979; Vener and Stewart 1974). Reiss (1967) developed what has come to be called Autonomy Theory to explain this process. According to Reiss, PS permissiveness will increase in cultures where the adolescent system of courtship becomes autonomous with respect to adult institutions of social control, such as the church, parents, and the school. This appears to have happened in the U.S.A. and most other industrialized nations in the twentieth century.
By far, the biggest change has been the growth of a standard that Reiss (1960, 1967, 1980) called “permissiveness with affection,” in which PS is seen as acceptable for couples who have mutually affectionate relationships. This standard has grown in popularity in the U.S.A. as the double standard - the view that PS is acceptable for males but not females - has declined (Clayton and Bokemeier 1980; Reiss 1967, 1980). By 1980, a majority of adults as well as young people in the U.S.A. believed that PS is appropriate for couples involved together in a serious relationship (Glenn and Weaver 1979). Moreover, although there has been a historical tendency for males to be more permissive about PS than females, these gender differences have been diminishing in recent decades (Clayton and Bokemeier 1980).
Most research on adolescent sexuality has tended to focus on whether or not teenagers or college students have had PS intercourse. Although this allows us to provide reasonable estimates of the percentages of Americans who have had PS in various time periods and to track trends in the rate of virginity and nonvirginity, this same focus has frequently led researchers to ignore the circumstances in which adolescent sexuality occurs (Miller and Moore 1990). As a consequence, we cannot be as confident about the trends in several related areas, and many questions about the specific nature of adolescent sexual experiences and relationships remain to be explored.
First Intercourse. A good example of this lack of perspective is provided by the evidence concerning age at first intercourse. The available research indicates that the average age of first intercourse has been declining since 1970. It seems likely that this trend extends back prior to 1970, but the paucity of relevant data from earlier time periods makes such a conclusion highly tentative. As late as that year, only about one quarter of the males and 7 percent of the females who attended college had intercourse prior to age 18 (Simon et al. 1972). In the Zelnik and Kantner studies, the average age for females dropped from 16.5 in 1971 to 16.2 in 1976 (Zelnik et al. 1981). By 1979, the average age of first intercourse for women was 16.2; for males, it was 15.7. Blacks of both genders tended to experience sexarche at slightly younger ages than whites. Females had first partners who were nearly three years older; whereas males had first partners who were about one year older than they (Zelnik and Shah 1983).
In a study of college females in the 1980s, Weis (1983) found the average age of sexarche to be 16.2. A later study of college students found that the average age was 16.5 (Sprecher, Barbee, and Schwartz 1995). It should be noted, however, that persons who attend college may well be more likely to postpone sexual activity. It is conceivable that a trend of declining age at first intercourse is still occurring among populations that do not attend college, and it is possible that teenagers in the 1990s (who have yet to reach the age of college) may also be having intercourse at younger ages.
Intercourse appears to be, at least among whites, the culmination of a sequence of increasing and expanding experiences with kissing, petting, and possibly oral sex (Spanier 1975; Weis 1983). There is some evidence that women who have rehearsed these noncoital activities extensively, and thus gradually learned the processes of sexual interaction, are more likely to report positive reactions to their first intercourse (Weis 1983). Weis (1983) found that there is great variation as to when people go through these stages and how quickly.
Most authors have stressed the negative aspects of first intercourse for females by citing the finding that females are significantly more likely to report negative affective reactions to their first intercourse than males (Koch 1988; Sprecher et al. 1995). However, the available data strongly suggest that the differences between males and females may not be large in magnitude. It is clear that females report a wide range of affect, from strongly positive to strongly negative (Koch 1988; Schwartz 1993; Weis 1983), but it is also clear that many males report experiencing negative reactions as well. In a study of college students, the males were more likely to report experiencing high levels of anxiety, the females were less likely to report experiencing high levels of subjective pleasure, while sizable numbers of both genders reported experiencing guilt (Sprecher et al. 1995). Positive reactions to first intercourse have been found to be related to prior experience with noncoital sexual activities, having an orgasm in that first intercourse encounter, descriptions of the partner as gentle and caring (for females), involvement with the first partner for more than one month prior to first intercourse, continued involvement with the partner following the first intercourse, and situational factors, such as the consumption of alcohol (Schwartz 1993; Sprecher et al. 1995; Weis 1983). Several researchers have reported that age is associated with affective reactions, but Weis (1983) found that age was not as strongly or directly related as the level of prior noncoital experience. Schwartz (1993) also reported that Scandinavian teenagers were more likely to report positive reactions than a group of American adolescents.
Over the past three decades, a convergence of male and female PS behavior has been identified, with females reporting less emotional attachment to their first coital partners than in the past (Hopkins 1977; Kallen and Stephenson 1982; Koch 1988). Yet, there is still a significant difference between the genders, with males reporting more casual relationships and females more intimate relationships with their first partners (Koch 1988).
In the only national study of first intercourse, Zelnik and Shah (1983) found that more than 60 percent of the females were “going with” or engaged to their first partner. Another third described their first partner as a friend. Roughly a third of the males described their first partner as a friend, and 40 percent were “going with” or engaged to their first partner. The males were twice as likely to have their first intercourse with someone they had just met, although few males or females did this (Zelnik and Shah 1983).
Relationship factors have been reported to be associated with affective reactions to the first intercourse. However, the precise nature of this association remains unclear. There is some evidence that involvement with a partner for longer than one month, and continuing involvement following the first intercourse, are associated with positive affective reactions (Sprecher et al. 1995). There is some evidence that females who are “going with” or engaged to their first partner are more likely to experience positive affect (Weis 1983). However, Weis (1983) also found that attributions that the first partner was caring, considerate, and gentle were more strongly related to affective reactions. Moreover, many women who were “going with” or engaged to their first partner, nonetheless, described their partners as uncaring and inconsiderate. It should be noted that each of these studies found so few participants who were married at the time of their first intercourse that no analyses could be done for that relationship category. For example, not one woman in the Weis (1983) study was married at the time of her first intercourse.
Adolescents appear to have many reasons for becoming involved in PS behavior. Motivations most frequently mentioned by a group of college women for becoming involved in their First intercourse experience included (rank-ordered by declining frequency): love-caring, partner pressure, curiosity, both wanted to, alcohol or other drugs, and sexual arousal (Koch 1988). The comparable rank-ordering of motivations by a group of college men included: both wanted to, curiosity, love-caring, sexual arousal, to “get laid,” and alcohol/drug use. Women were four times more likely to report partner pressure than men, whereas men were seven times as likely to say they were looking to “get laid” and twice as likely to report sexual arousal as a motivation for sexarche (Koch 1988).
Most American teenagers describe their first intercourse as an “un-planned, spontaneous” event. Only 17 percent of the females and one quarter of the males in a national study said they had planned their first intercourse (Zelnik and Shah 1983). In the same study, less than one half of the males and females used a contraceptive. Those who had their first intercourse at age 18 or older were more likely to use a contraceptive. White women were more likely to have used some form of contraception, but black women were more likely to use a medically prescribed method. Women who described their first intercourse as planned were more likely to have used a contraceptive - fully three quarters of these women did. However, more than two thirds of these women relied on their partners to use a condom or withdrawal. Black women were more likely to use a contraceptive themselves, rather than rely on their partner.
Finally, various aspects of sexarche have been found to be significantly related to later sexual functioning among college students (Koch 1988). Women who had experienced first coitus at an earlier age had less difficulty reaching orgasm during later sexual interactions than did women who had sexarche at a later age. Men with earlier sexarche had less difficulty in keeping an erection during later sexual interactions than men who had been older at sexarche. Also, women who had reported negative reactions to their first intercourse were subsequently more likely than those who felt more positively to experience: lack of sexual interest, sexual repulsion, inability to reach orgasm, or genital discomfort, pain, or vaginal spasms. Men who reacted negatively to their first intercourse were more likely to ejaculate too quickly during later sexual experiences than men who had positive reactions. Both men and women were more likely to experience subsequent sexual functioning concerns when they were pressured by a close partner to engage in intercourse for the first time.
Number of Premarital Sexual Partners. It is difficult to provide good estimates on the number of PS partners prior to 1950, simply because researchers failed to ask such a question. On the other hand, it does seem clear that the increase in the percentage of American women who reported they had ever had PS after 1900 was due primarily to an increase in the percentage of women who reported they had PS only with their fiance (Kinsey et al. 1953; Terman 1938). In contrast, there is abundant evidence of a significant increase in the number of PS coital partners for females from the late 1960s through the late 1980s (Cannon and Long 1971; Clayton and Bokemeier 1980; Miller and Moore 1990; Vener and Stewart 1974; Zelnik et al. 1983). This finding is, however, potentially misleading. A close inspection of the results of pertinent studies reveals that most of the increase is explained by a shift from zero to one partner and from one to two partners. There were no increases in the percentage with seven or more partners.
Among males, there is some evidence that adolescent boys of recent decades are less likely to use the services of a prostitute than in the past (Cannon and Long 1971). In a unique study of males attending the same eastern university from the 1940s through the 1970s, Finger (1975) actually reported a decline in the number of PS partners with a corresponding increase in the frequency of sexual relations. This was primarily due to an increase in the percentage of men who had PS only with their girlfriends. Finger also reported a decline in the percentage of males reporting they ever had a homosexual experience. However, among those who had a homosexual experience, the frequency of such encounters had increased.
Although there appears to be consistent evidence that there have been significant increases in the number of PS partners throughout this century, at least for females, it should be stressed that, as late as 1990, the majority of American teens had had zero or one PS partner. Only 4 percent of white females, 6 percent of black females, 11 percent of white males, and 23 percent of black males reported six or more partners (Miller and Moore 1990). Thus, the widely held idea that large percentages of American adolescents are now “promiscuous” is greatly exaggerated.
Rates of Teen Pregnancy and Birth. In an examination of how the trends we have been reviewing are related to trends in adolescent pregnancy and birth, it is important to bear in mind that, as late as 1965, several states in the U.S.A. prohibited the sale of contraceptives to married couples. Such laws banning the sale of contraceptives to teenagers and/or single persons were common until 1977 (see Section 9A). Details on out-of-wedlock births, contraception, and abortion are presented later. Here, we want to note that the birthrate among unmarried women has been increasing since 1965, with a notable surge in the rate during the 1980s (Baldwin 1980; Forrest and Fordyce 1988; Miller and Moore 1990). Throughout this period, the percentage of unmarried, adolescent women exposed to the risk of pregnancy has been increasing. One principal reason for this is, of course, the increasing percentage of unmarried persons having PS in the U.S.A. (Forrest and Fordyce 1988).
However, there are several interesting twists among these trends, many of which do not fit with the conventional wisdom in the U.S.A. First, much of the increase since 1980 is attributable to women 20 years of age or older. In fact, the adolescent birthrate has actually been declining since the early 1970s (Baldwin 1980; Forrest and Fordyce 1988). Second, the overall birthrate for adolescent women increased through the late 1940s and 1950s, remained stable in the 1960s, increased in the early 1970s, and has been declining since (Baldwin 1980). The misperception, widespread through the U.S.A., that teen-pregnancy rates have been rising is largely due to two factors: (1) the increasing number of such pregnancies, but not the rate, when the children of the baby-boomer generation began having children, and (2) the fact that, as the average age at first marriage has been increasing, adolescent pregnancies are more likely to occur with unmarried women (Baldwin 1980; Miller and Moore 1990). Finally, the perception that adolescent pregnancy has become a recent social problem has emerged as the out-of-wedlock birthrate has increased more dramatically among white women in the last two decades (Baldwin 1980; Miller and Moore 1990).
Contraceptive Use. To most Americans, an increase in the rate of adolescent pregnancy (widely assumed, though not true) would seem to be an inevitable result of increases in PS activity. However, research in many European countries demonstrates that high rates of adolescent sexual activity can be associated with low rates of adolescent pregnancy, when contraceptives are used widely, consistently, and effectively (Jones et al. 1985). There seems little doubt that the U.S.A. has one of the highest adolescent-pregnancy rates among developed nations, largely because of inconsistent contraceptive use (Forrest and Fordyce 1988; Miller and Moore 1990).
It appears that roughly one half of adolescent women use no contraceptive during their first intercourse (Miller and Moore 1990), and most of the women reporting the use of some contraceptive during their first intercourse note that their partner used a condom (Weis 1983). Moreover, most adolescent girls who seek contraceptive services have been having sexual intercourse for some time, many for more than a year before they seek services (Miller and Moore 1990; Settlage, Baroff, and Cooper 1973). After this delay, it appears that roughly two thirds of American teenagers now use some form of contraceptive (Miller and Moore 1990).
Although these figures certainly indicate that large numbers of American youths continue to experience sexual intercourse with no contraceptive protection, they nonetheless represent an increase in contraceptive use over the last several decades. Research in the early 1970s indicated that two thirds to three quarters of American teens rarely or never used contraceptives (Sorensen 1973; Zelnik et al. 1981). Forrest and Fordyce (1988) report that overall use of medically sound contraceptives remained stable through the 1980s. Of those women age 20 or less who sought family-planning services in 1980, nearly three quarters used the pill. By 1990, this had dropped to 52 percent. In 1980, 14 percent had used no contraceptive at all (Eckard 1982).
By 1990, Peterson (1995) reported that 31.5 percent of 15- to 19-year-old women consistently used some form of contraceptive; 24.3 percent of 15-to 17-year-olds did so, as did 41.2 percent of 18- and 19-year-olds. This behavior appears to be unrelated to social class (Settlage et al. 1973). Among women of childbearing age (15 to 44), Peterson (1995) found that 52.2 percent of Hispanic, 60.5 percent of white non-Hispanic, and 58.7 percent of black non-Hispanic women reported using some form of contraceptive (see Table 6 in Section 9A under current contraceptive behavior).
Despite the popularity of the idea that adolescent pregnancy is a result of poor sexual knowledge, knowledge of one’s sexuality or birth control has not been shown to be a strong predictor of contraceptive behavior among teenagers (Byrne and Fisher 1983). No relationship was found between contraceptive use and early sex education by family, or a congruence between attitudes and behavior. Reiss, Banwart, and Foreman (1975), however, reported that contraceptive use among teenagers is correlated with endorsement of sexual choice (permissiveness), self-confidence about desirability, and involvement in an intimate relationship.
Of course, researchers are not content to provide descriptions of social trends. Instead, they seek to provide theoretically useful explanations of the factors underlying those trends. The essence of scientific analysis is the identification and testing of potential correlates of those trends. There have been thousands of studies of adolescent sexuality testing possible correlates. We cannot review them all here. We will, however, briefly identify several different approaches that have been used to explain the trends we have described above. We have tried to select perspectives that have enjoyed some popularity among sexuality professionals at some point. We have also tried to include explanatory models that represent the diversity of professional opinions about adolescent sexuality.
Changes in Social Institutions. By far, the most common approach to explaining the growing acceptance of PS within American culture and the increasing tendency of adolescents to have PS has been a sociological perspective that locates these trends as part of a series of social changes occurring in response to industrialization and urbanization. (Much of this explanation was presented in Section 1, where we reviewed the sexual history of the U.S.A.) As patterns of residence and community relations changed in the late nineteenth and early twentieth centuries, changes began to occur in most social institutions. These included changes in male-female roles, a lengthening of the period of formal education, and the emergence of new forms of heterosexual courtship (Ehrmann 1964; Reiss 1967, 1976). One example of the complex web of social changes that have occurred in the last century is the increasing average age of first marriage (Surra 1990). In one century, the average age at first marriage has shifted from the late teens to the mid-20s. Combined with the earlier age at which American adolescents reach puberty, this has led to a much longer period between physical maturation and marriage, thus, greatly expanding the probability that sexual activity will occur prior to marriage.
As social institutions changed in response to the growing industrial character of American society and the increasingly urban pattern of residence, new forms of adolescent courtship emerged. The custom of dating appeared in the 1920s following World War I, and the practice of “going steady” emerged in the 1940s following World War II (Reiss 1980). By the 1990s, the practice of “going together” has become so universally common that few American young people can conceive of other courtship forms. Dating provided a forum for adolescents to pursue male-female relationships independent of adult supervision and control. The appearance of modern transportation, such as the automobile, and the development of urban recreational businesses allowed adolescents to interact with each other away from home. Increasingly, decisions about appropriate sexual behavior were made by adolescents themselves. The practice of “going steady” placed adolescents into a relationship with many of the features of marriage. Steady relationships were defined as monogamous and exclusive with respect to sexuality and intimacy. As such, they carried high potential for intimacy, commitment, and feelings of love. Together, the increased independence and greater potential for intimacy led to increased rates of PS behavior (D’Emilio and Freedman 1988; Kinsey et al. 1948, 1953; Seidman 1991). There is evidence that this general pattern has occurred in other countries as a consequence of industrialization as well (Jones et al. 1985).
Reiss (1960, 1967) developed the Autonomy Theory of Premarital Permissiveness, mentioned earlier, to explain the association between social institutions and premarital sexual permissiveness. Essentially, Reiss maintained that, as adolescent courtship institutions (dating and going steady) become independent of adult institutions of social control (parental supervision, the schools, and the church), the level of premarital permissiveness in a culture increases. There has been considerable research testing the specific propositions of the theory since Reiss proposed it (Cannon and Long 1971; Clayton and Bokemeier 1980; Miller and Moore 1990). Generally, research from this perspective has tended to presume that PS has become normative within American culture.
Sources of Sexual Information and Sexual Knowledge. Several other explanations of PS behavior have been more likely to view it as a social problem and more likely to focus on the individual character of PS attitudes and behavior. One of the more popular and enduring ideas within American culture about adolescent sexual activity is the belief that sexual behavior and pregnancy risk are influenced by knowledge about sexuality and its consequences. In fact, advocates of sex education in the schools have argued for more than a century that American teens typically possess inadequate and inaccurate sexual knowledge. Some have maintained that sex education could solve such social problems as out-of-wedlock pregnancy and sexually transmitted disease by providing thorough and accurate information about sexuality. Embedded in these assertions is an underlying presumption that sexual decision making and behavior are primarily cognitive processes. Operating from this perspective, there have been dozens of studies of the sources of sexual information for children and adolescents in the U.S.A. Generally, these studies have found that young people in the U.S.A. are more likely to receive sexual information from their peers or the mass media than from adult sources, such as parents or the school (Spanier 1975; Wilson 1994). These studies have been used to conclude that peers are a poor source of sexual information, and that such inaccurate information leads directly to unwanted pregnancies and disease. We should note here that few studies of sexual information have sought to demonstrate a correlation between source of information and sexual decisions or outcomes. That connection has typically been assumed. (See also Section 3, which deals with formal and informal sources of sexual knowledge and education.)
However, in a national probability study of American college students, Spanier (1975; 1978) found no differences in premarital sexual behavior between those students who had ever had a sex-education course and those who had not - regardless of who taught the course, when it was offered, or what material was included. Moreover, a number of studies have found a weak correlation between sexual knowledge and sexual behavior or contraceptive use (Byrne and Fisher 1983). More generally, researchers have consistently found a low correlation between knowledge level and a variety of health-related behaviors, such as smoking, drug use, and eating patterns (Kirby 1985).
Cognitive Development. A somewhat similar focus on cognitive processes has been the basis for an argument that adolescents typically lack a sufficient level of cognitive development required for effective sexual decisions. A number of authors have argued that adolescence is characterized by a cognitive level that is inconsistent with sound sexual decision-making and contraceptive use (Cobliner 1974; Cvetkovich, Grote, Bjorseth, and Sarkissian 1975). Within this perspective, it has become common to describe adolescents as having an unreal sense of infallibility that leads them to underestimate the actual risks of sexual experience (Miller and Moore 1990).
Although references to the works of Jean Piaget have been common in this realm, actual empirical tests of a correlation between Piaget’s stages of cognitive development and sexual decisions remain to be conducted. Moreover, this explanation has failed to incorporate the cross-cultural evidence that adolescents in many other nations establish high rates of sexual frequency, maintain consistent contraceptive use, and experience low rates of adolescent pregnancy (Jones et al. 1985).
Interaction of Hormonal and Social Determinants. Udry (1990) has attempted to examine how pubertal development, hormones, and social processes may interact to affect the sexual behavior of adolescents. Hormonal studies seem to indicate that androgenic hormones at puberty directly contribute to explaining sexual motivation and noncoital sexual behaviors in Caucasian male and female adolescents (Udry and Billy 1987; Udry et al. 1985, 1986). Because of the differing social encouragement versus constraints for young white males and females, initiation of coitus seems to be strongly hormone dependent for males, whereas for females it seems to be strongly influenced by a wide variety of social sources with no identifiable hormone predictors. The interaction of hormonal and social determinants is unclear for African-American youth and does not fit the models for white youth that emphasize the importance of sociocultural context on sexual behavior.
Delinquency Models. Perhaps the zenith of models which regard adolescent sexuality as a social problem is the emergence of frameworks that explicitly define adolescent sexual behavior as a form of juvenile delinquency (Jessor and Jessor 1977; Miller and Moore 1990). Vener and Stewart (1974) reported that sexual behavior by 15- and 16-year-olds was correlated with the use of cigarettes, alcohol, and illicit drugs, and with less approval for traditional institutions like the police, the school, and religion.
In a subsequent study using this perspective, Jessor and Jessor (1977) conceptualized sexual behavior as a “problem behavior” if it occurred prior to age-appropriate norms. In other words, intercourse was characterized as deviant and delinquent if it occurred prior to the mean age (roughly 17 years of age at the time of the study). Jessor and Jessor found that such early sexual behavior was correlated with other “problem behaviors” such as alcohol use, illicit-drug consumption, and political protest. They concluded that these associations demonstrated that adolescents tend to exhibit multiple forms of delinquency.
By the 1990s, Miller and Moore (1990) reported that a number of studies have found that “early” sexual behavior is associated with a variety of “criminal” behaviors such as those described above. Some authors have overlooked the fact that these studies have found this association with delinquent behaviors only for early sexual behavior and have tended to characterize all adolescent sexual behavior as delinquent. These studies do suggest the possibility that developmental issues may be relevant to these findings.
Sexual Affect. A different approach has been taken by a group of researchers interested in examining the role of affective reactions to sexual stimulation, both as a factor that may influence sexual decisions and behavior and as an outcome of sexual experience. Sorensen (1973) reported that 71 percent of teenagers agreed with the view that using the birth-control pill indicates that a girl is planning to have sex. This has been offered as evidence that adolescents are unwilling or unable to accept responsibility for contraceptive use, and thus lack cognitive development. However, affective theorists would argue that it is just as likely that sexual guilt, fear, or embarrassment prevent such a decision.
In the early 1960s, Christensen (1962) conceptualized sexual guilt as a variable response to sexual experience. He found that adolescents are more likely to report experiencing guilt in cultures with restrictive PS norms. He called this a value-behavior discrepancy. Schwartz (1973) found that persons with high sex guilt retain less information in a birth-control lecture, especially when aroused by a sexually stimulating condition. In the Schwartz study, females retained more information than males across all conditions.
Donn Byrne and his associates have maintained that individuals can be placed on a continuum ranging from erotophilic, reacting to sexual stimuli with strongly positive emotions, to erotophobic, reacting to sexual stimuli with strongly negative emotions. Erotophobic persons have been shown to be less likely to seek contraceptive information, to have lower levels of contraceptive knowledge, and to be less likely to purchase contraceptives or use those contraceptive methods that require them to touch themselves (Byrne and Fisher 1983; Goldfarb, Gerrard, Gibbons, and Plante 1988). However, they are no less likely to retain information about contraceptives, even though they become more sexually aroused by a lecture (Goldfarb et al. 1988).
There is a need for much future research on the association between adolescent sexuality and affective variables. However, the studies just mentioned suggest that affective variables may prove to be a fruitful way of explaining adolescent sexual behavior and its consequences. This approach seems particularly suited to examining the variety of ways that adolescents behave and the diverse consequences of such behavior.
Reference Group. Yet another approach to explaining adolescent sexuality has been the attempt to identify persons or groups who have influenced teenagers. Perhaps the most developed theoretical perspective of this type is known as Reference Group Theory. There is some evidence that, as adolescents progress from age 12 to 16, they shift their primary reference-group identification from their parents to their peers. Peer orientation has been shown to be related to sexual intercourse. Moreover, association with peers who are seen as approving PS is correlated with PS permissiveness and PS behavior (Cannon and Long 1971; Clayton and Bokemeier 1980; Floyd and South 1972; Reiss 1967; Teevan 1972). Similarly, Fisher (1986) found that the correlation between the attitudes of teenagers and their parents decreased as adolescence progressed. However, females who cited their mothers as their major source of sexual information were less likely to engage in intercourse and more likely to use contraceptives when they did.
These results should not be interpreted to mean that parents or families do not or cannot exert influence on the sexuality of adolescents. There have been relatively few scientific studies of the influence of differing parental styles and the PS behavior of children. One study (Miller, McCoy, Olson, and Wallace 1986) found that adolescents were least likely to have PS or to approve of PS when their parents were moderately strict. Teenagers who described their parents as very strict or not at all strict were more likely to have had PS. This correlation also held when parents were asked to describe the rules they set for their children. There is some evidence that the age of a mother’s first intercourse is related to the age of her daughter’s first intercourse (Miller and Moore 1990). Miller and Moore (1990) also showed that girls from single-parent families tend to have sex at younger ages.
Thus, there appears to be two conflicting sets of empirical findings. One set of studies finds evidence that adolescent sexuality is most strongly related to peer influences, especially as age increases. Another set of studies provides evidence that families and parents can exert influence in various ways. Obviously, important questions remain to be resolved.
Rehearsal. A more direct perspective views adolescent sexuality as a developmental process, in which intercourse is seen as the culmination of a sequence of progressively sexual behaviors (Miller and Moore 1990; Simon et al. 1972; Weis 1983). Adolescents appear to move through a series of stages, from kissing to petting of the female’s breasts to genital petting to intercourse. There is evidence that, among white adolescents, this pattern is strongly consistent. White adolescents appear to take an average of two years to move through this sequence (Miller and Moore 1990; Weis 1983). In contrast, blacks appear to move through the stages more quickly, and there is greater variability in the actual sequence of behaviors (Miller and Moore 1990). Within this perspective, each subsequent sexual behavior can be viewed as a rehearsal for the next behavior in the sequence.
Not only is there evidence that adolescent sexual experience is acquired in a process that produces an escalating and expanding repertoire of sexual behaviors, but dating and “going steady” appear to serve as the key social contexts in which this process occurs (Clayton and Bokemeier 1980; Reiss 1967; Spanier 1975). The age of onset of dating and the frequency of dating appear to be major factors in the emergence of sexual behavior (Spanier 1975). In fact, adolescent experiences with intimate relationships (dating and “going steady”) and the sequencing of sexual behaviors have been shown to be more influential in predicting PS intercourse than general social background variables, parental conservatism or liberalism, or religiosity (Herold and Goodwin 1981; Spanier 1975).
As dating frequency and noncoital experiences increase, exposure to eroticism, sexual knowledge, and interest in sex are all likely to increase concomitantly. Male behavior appears to be more strongly related to the sequencing of behaviors. In contrast, female behavior seems to be more a result of involvement in affectionate relationships. Increased dating interaction and frequency increase sexual intimacy, since opportunities and desire increase. This process is likely to overshadow the influence of prior religious, parental, or peer influences. Thus, adolescent courtship provides the context for the general process of sexual interaction. As Reiss (1967, 1980) has noted, such adolescent courtship also serves as a rehearsal experience for adult patterns of intimate involvement. It is also possible that such adolescent rehearsal experiences are a more powerful and direct explanation of adolescent sexual behavior (Spanier 1975; Weis 1983).
Multivariate Causal Models. An important trend in American research on adolescent sexuality has been the growing recognition that several of the factors reviewed here will eventually need to be included in a sound theory of adolescent sexual development and expression. Reiss (1967) was one of the first to test competing hypotheses in an attempt to identify the strongest predictors of PS permissiveness. Since then, a number of researchers have used multivariate techniques to examine the relative strength of PS correlates (Byrne and Fisher 1983; Christopher and Cate 1988; DeLamater and MacCorquodale 1979; Herold and Goodwin 1981; Reiss et al. 1975; Udry 1990; Udry, Tolbert, and Morris 1986; Weis 1983).
A few examples should illustrate the potential usefulness of this multivariate approach. Herold and Goodwin (1981) found that the best predictors of the transition from virginity to nonvirginity for females were perceived peer experience with PS, involvement in a steady, “committed” relationship, and religiosity. In contrast, parental education, grade-point average, sex education, and dating frequency failed to enter the multivariate equation.
Udry and his associates (1990; Udry et al. 1986) have investigated the relative influence of hormonal and social variables in explaining adolescent sexual behavior. Several studies demonstrate that androgenic hormones present at puberty directly contribute to the sexual motivation and precoital sexual behavior of white males. For white males, the initiation of coitus seems to be strongly related to androgen levels. Female initiation of coitus seems, on the other hand, to be strongly related to a series of social variables, but not to any hormonal predictors. Udry has argued that these results reflect the differing social encouragement versus constraints placed on males and females respectively. Interestingly, the behavior of African-American youth does not appear to fit with these same explanations, so that the exact interaction between social factors and hormonal variables remains unclear.
Before moving to the issue of adult heterosexuality, we wish to make a few comments about the nature of intimacy in adolescent sexual relationships and the process of relationship formation. Most of the research on adolescent sexuality reviewed here has tended to focus on the specifically and explicitly sexual elements of such experiences and to ignore the broader relational aspects. In one sense, this is understandable, given the fact that Americans have generally viewed adolescent sexuality, especially its premarital forms, as a social problem. Consistent with this perspective, Americans have tended to deny the possibility that any genuine intimacy occurs in sexual experiences involving adolescents. This is unfortunate in at least two respects. First, it tends to ignore the fact that most adolescent sexual encounters in the U.S.A. occur within the context of what the participants define as a meaningful, intimate relationship. It also ignores the reality that sexual expression within loving, intimate relationships (rather than marital status) has become the dominant attitudinal standard for Americans of all ages. Second, the tendency to ignore the relational character of adolescent sexuality means that researchers have tended to overlook the reality that patterns of sexual and intimate interactions are largely learned within the context of adolescent experiences, and these are likely to be extended well into adulthood. Thus, the failure to investigate these larger relational questions probably impairs our ability to fully understand adult intimate relationships as well. This is not meant to denigrate other forms of sexual expression or to deny that other forms of expression do occur, both in adolescence and later. Rather, it is to suggest that one strong characteristic of American sexuality is the tendency to associate love and sexuality. Any attempt to understand or explain American sexual expression must acknowledge that it generally occurs within the context of ongoing, intimate relationships. This is as true for adolescents as for adults.
The separation of sexuality and relational concerns is well reflected by the emergence of two independent bodies of research within the American academy. On the one hand, there is a well-established field of research on the formation of adolescent intimate relationships, dating and courtship, and mate selection. This tradition extends back to the 1920s and has largely been explored by family sociologists. Social exchange theory has become the dominant perspective in this tradition in recent decades. Surra (1990) provides an excellent review of such research through the 1980s. However, this tradition has largely failed to consider sexuality as an issue in courtship and mate selection, although it ought to be apparent that sexual dynamics and processes are key components of adolescent attraction, dating, courtship, and mate selection. Sexuality carries the potential both for increasing intimacy between teenagers or young adults and for creating intense relationship conflict and, possibly, termination. Yet, Surra’s (1990) review is notable precisely for the fact that there is not one single citation of a study including sexuality variables. This is not an indictment of Surra per se. Her goal was to review the field of mate selection as it stood at the beginning of the 1990s. Her assessment serves to document that researchers in this area continue to ignore the role of sexuality in adolescent relationship processes after seven decades of empirical research.
This tendency to ignore sexuality within the courtship process is unfortunate, because of the growing evidence that one of the major influences on PS behavior is the intimate relationship in which most adolescent sexual activity occurs. Being involved in a loving and caring relationship increases the probability of a decision to engage in intercourse (Christopher and Cate 1985) and contributes to sustained activity once it begins (DeLamater and MacCorquodale 1979; Peplau, Rubin, and Hill 1977). In fact, most adolescent sexual experiences in the U.S.A., especially for females, occur within the context of an ongoing intimate relationship. It does appear, however, that as the general rates of PS have increased and as the average age of first intercourse have declined throughout this century, intercourse has tended to occur at earlier stages in a relationship (Bell and Chaskes 1970; Christensen and Carpenter 1962; Christensen and Gregg 1970). With respect to attitudes, Americans are more likely to approve of PS in the context of a relationship. This permissiveness-with-affection-and/or-commitment standard has increasingly become the norm for both adults and young people (Christensen and Carpenter 1962; Christensen and Gregg 1970; Reiss 1960, 1967).
A second body of research examining the formation of sexual relationships has begun to emerge in recent decades. Much of this work has been done by biologists or evolutionary social psychologists and extends a model of mammalian mating first presented by Beach (1976). We discuss it here because it also reflects the separation of the sexual and intimate domains of relationships, and because much of the pertinent human research has been done with samples of college students. Essentially, this body of work forms the foundation for what might be called female selection theory.
The traditional view had always been that males are the aggressors and initiators of sexual involvement. From this perspective, females were seen as sexual “gatekeepers.” Their role supposedly was to regulate male access by accepting or rejecting male advances (Perper 1985; Perper and Weis 1987). Beginning with Beach (1976), a growing number of researchers have provided evidence that this traditional view is highly flawed. Instead, females select desirable partners and initiate sexual interaction by proceptively signaling selected males (Fisher 1992; Givens 1978; Moore 1985; Moore and Butler 1989; Perper 1985; Perper and Weis 1987). Males, in turn, respond to these proceptive signals. Moore (1985; Moore and Butler 1989) has demonstrated that, not only do women use such signaling, but that men are more likely to “approach” women who do. Perper (1985; Perper and Weis 1987) has provided evidence that American women employ a variety of complex strategies to arouse male interest and response. Finally, Jesser (1978) has provided some evidence that males are just as likely to accept direct initiations from women as they are to respond to more covert strategies, although females tend to believe that men are “turned off” by female sexual assertiveness.
This new line of research raises fundamental questions about the roles of males and females in the formation and maintenance of sexual relationships - for both adolescents and adults. It indicates a need for research that is focused on the dynamics within and the processes of sexual relationships themselves. As just one example, Christopher and Cate (1988) found that, early in a relationship, the level of conflict was positively related to a greater likelihood of intercourse. As the relationship progressed, love and relationship satisfaction eventually became significant predictors of sexual involvement. In the case of adolescence, we need to move beyond “social bookkeeping,” counting the number of American teenagers who have PS, to examine what actually happens in their relationships with each other.
Strangely, there has been considerably more research on the sexual conduct of American adolescents than of adults, and much of the existing research on adults has tended to focus on sexual “problems” such as extramarital sex (ES) and sexual dysfunction (see Section 12 on sex dysfunctions and therapies). There has been little research on the patterns of sexual interactions within nonclinical marital relationships. This is striking, precisely because of the fact that marriage is the most widely accepted setting for sexual relations in the U.S.A. and because more than 90 percent of Americans do marry. Taken together, the preponderance of research on adolescent sexuality, ES, and dysfunction indicates the tendency of American sexuality professionals to focus on sexual behaviors that have been defined as social problems, rather than on “normal” sexuality.
In October 1994, a national survey of adult sexual practices was released with great media fanfare (Laumann, Gagnon, Michael, and Michaels 1994). The survey, titled the National Health and Social Life Survey (NHSLS), randomly sampled 3,432 persons, aged 18 to 50. It was touted as the most comprehensive American sex survey ever, and the first national study of adult sexuality. However, Reiss (1995) has noted that this claim is misleading, as there have been more than a dozen national surveys of a more-limited scope. Given our interest in reviewing the nature of American sexuality research, it is interesting to note that the survey was originally planned and approved as a government-sponsored project. Funding was denied for this project and a similar study of teens (the Udry study) when conservatives in the U.S. Congress objected to the studies. Conservatives argued that the government should not use taxpayer money to study private matters like oral sex - clearly rejecting the significance of the health concerns involved. The researchers found private funding instead. Also interesting is the fact that conservatives hailed the findings when the study was released (Peterson 1994).
There is little doubt that the NHSLS is the most comprehensive study of adult sexuality to date, with literally hundreds of variables assessed. Among the key findings are the following:
The NHSLS has sparked considerable controversy among sexuality professionals. Questions have been raised, primarily about the legitimacy of the prevalence estimates for such behaviors as number of sexual partners, homosexual experience, and ES. In general, the NHSLS estimates tend to be lower than those found in most prior sex research - including prior national studies (Billy, Tanfer, Grady, and Klepinger 1993). It should be noted that the NHSLS estimates are remarkably similar to Findings in a series of studies conducted by the National Opinion Research Center using similar national probability samples (Davis and Smith 1994; Greeley et al., 1990; Smith 1990, 1991). These national samples have been carefully constructed to be representative of gender, age, race, education, marital status, size of city of residence, and religion in the U.S.A. The NHSLS did obtain a 79 percent response rate, probably because participants were financially reimbursed. Few prior studies have had comparable response rates, and few have reimbursed participants. Questions about how this impacted the results are a legitimate matter for future research.
In a review of the NHSLS, Reiss (1995) credits the study for its comprehensiveness, the richness of the data generated, the theoretical nature of the investigation, and the high quality of the sampling techniques. However, he also raises several questions that may influence the validity of the findings. Here, we will focus on a few of the more serious. One concerns the fact that 21 percent of the respondents were interviewed with someone else present during the interview. As Reiss notes, a person with an intimate partner or a family member present may well have answered questions differently for obvious reasons. For example, only 5 percent of persons interviewed with another person present reported that they had two or more sexual partners in the last year. In contrast, 17 percent of those interviewed with no one else present reported two or more partners in the last year. This is a sizable difference, and it raises questions about the validity of responses to many questions in the survey. Similarly, the NHSLS asked respondents to report the number of sexual partners they have had since age 18. Most previous studies asked respondents to report their lifetime number of sexual partners. Here, one half of the sample did have sexual relations prior to age 18. This reduced estimates for lifetime number of partners. The NHSLS reported a median number of six sexual partners for men and two for women. Reiss notes that these estimates are lower than comparable studies (Billy et al., 1993), and that this reported gender difference cannot possibly be true in the real world.
To this critique, we can add that it is possible that prevalence estimates have been inflated by the volunteer bias of most sex research. There are unexamined questions about the effects of volunteer bias and response rates. Paul Gebhard (1993), a member of the original Kinsey research team, has argued that estimates of lifetime prevalence rates for homosexual behavior have been remarkably similar when adjusted for sampling weaknesses. Gebhard also criticized the NORC and NHSLS studies for failing to use trained sex researchers to conduct their interviews, and for their own sampling flaws that overrepresented rural populations. In fairness, it is appropriate to note that several of the volunteer samples overrepresent urban populations, and there is evidence that urban-rural differences in sexual attitudes remain substantial (Weis and Jurich 1985). Finally, although there is a general consensus that persons who agree to participate in sex research are more permissive and more sexually experienced, two recent studies strongly suggest that persons who decline to answer particular items in a sex survey are attempting to hide behavior in which they have engaged (Wiederman 1993; Wiederman, Weis, and Allgeier 1994).
Although these questions will require considerable future research to resolve, it should be acknowledged that the NHSLS is a major contribution to the field of sex research in the U.S.A. It is a landmark study with important new information about the sexual practices of the vast and diverse American adult population, and it will set the parameters for questions yet to be explored. Finally, it provides important data on each of the topics we will explore further in this section.
Practically every American spends at least a portion of his or her adult life unmarried. At any one point in time, more than 20 percent of the U.S. population is single, and this percentage has been increasing for several decades (Francoeur 1991; Shostak 1987). The chief reasons for this are the greater tendency to postpone marriage (median age is now in the late 20s), the increasing divorce rate (5 per 1,000 by the 1980s and fairly stable thereafter), and the increasing rate of cohabitation (which tripled since 1960), both as an alternative to marriage and as a form of courtship prior to marriage (Glick 1984; Norton and Moorman 1987; Shostak 1987). Glick (1984) has speculated that the prolongation of formal education, the increasing acceptability of premarital sexuality, the growing independence of women, and the earlier mortality of males may also be factors promoting the growth of singlehood.
Actually, the single adult population contains three groups who may share little in common: Those who have never married, those who have divorced, and those who are widowed. Persons within each group may or may not have chosen to be single, and they may or may not intend to remain single. Also, persons in each group may be living alone, may be living with roommates who are not intimate or sexual partners, or may be cohabiting with an intimate partner. By 1980, it was estimated that close to 2 percent of the adult U.S. population was cohabiting (Glick and Norton 1977; Yllo 1978). Of course, some single persons are gay or lesbian, although they are not typically included in estimates of cohabitation, even when they live with their partners.
It should be stressed that the population of single adults is a fluid one. The U.S.A. has high rates of marriage, divorce, and remarriage (Glick 1984; Norton and Moorman 1987). Most of those who are classified as having never married at any one point will eventually marry. This is especially true for the growing group who have remained unmarried well past the age of 20. Approximately three quarters of women who get divorced, and more men, eventually remarry (Glick 1984; Norton and Moorman 1987). Thus, the composition of the single population is always shifting as some marry and others divorce or are widowed. We are not aware of any research examining the impact of this shifting character on the sexual lifestyles of single persons. Some singles become involved in intimate relationships that lead to cohabitation or marriage, although we know little about whether these processes are similar to adolescent courtship. For those singles who are not involved in an ongoing intimate relationship, it is possible that finding sexual partners can be problematic.
It is popularly believed that being single in adulthood has become more acceptable in the U.S.A. today. There is, however, some evidence that married couples continue to associate primarily with other couples. Certainly, it is more acceptable to be sexually active while single today. Singles have greater social and sexual freedom than ever before to pursue a variety of lifestyles. In fact, the labeling of a category of “single adults” may serve to obscure the fact that the range of sexual and intimate lifestyle options is just as wide as for married persons.
Despite the large number of single adults in the U.S.A., there has been virtually no research on the sexual practices or attitudes of these groups. The NHSLS (Laumann et al. 1994) did distinguish between “single” and cohabiting respondents, an important distinction. As we discussed earlier, the NHSLS did find that “single” persons had sex less frequently than married persons, and that cohabiting persons had sex more often than married persons.
The Never Married. We know of no research that has focused on the population of never-married adults who are not cohabiting. Of course, this group does include persons in their early 20s who have yet to marry. A portion of that group is included in many of the studies of premarital sexuality, although that group is not isolated for separate analysis. There is virtually no scientific information on how never-married persons find or meet sexual partners, establish sexual encounters, or maintain sexual relationships.
Divorced (Postmarital Sex). Divorce has increased in the U.S.A. dramatically throughout the twentieth century (Berscheid 1983). The rate has leveled since 1980 (Current Population Reports 1985; Glick 1984; Norton and Moorman 1987; Shostak 1987). Of the roughly 40 percent of the American population that gets divorced, about 70 percent eventually remarry, often within a few years (Glick 1984; Norton and Moorman 1987).
Again, there has been little research on this group. It appears that about 80 percent of women, and nearly all men, remain sexually active following a divorce (Gebhard 1968; Hunt 1974). Most persons have sex with a new partner within the first year following a divorce (Hunt, 1974). In the 1970s, Hunt (1974) reported that divorced women averaged four sexual partners a year, and had a higher frequency of orgasm in their postmarital sex than they had had in their marriage. Men averaged nearly eight partners a year.
Again, there has been little research on the process by which divorced persons form or maintain sexual relationships. However, it is fair to suggest that, as the title of an American novel and corresponding movie implies, most divorced persons find that they must “start over.” After a period of marriage, they find themselves in the position of dating and courting again. Some have anecdotally reported that they find this anxiety-provoking, whereas others find it exhilarating.
Widowed. This process of “starting over” may be relevant to those persons who are widowed as well. Our review of the research literature identified only one study of the sexual practices of widowed persons. Nearly three decades ago, Gebhard (1968) reported that widowed persons were less likely to have sexual experiences than divorced persons. Francoeur (1991) has suggested that this may be due, in part, to a sense of loyalty to the former spouse or to perceived and real pressure from kin members.
By far, the most common adult sexual lifestyle in the U.S.A. is legal marriage, and marriage is the context for the overwhelming majority of sexual experiences in the U.S.A. In fact, marriage is the only context in which sexuality is universally approved. Despite this, researchers have investigated marital sexuality less than nonmarital forms of sexual expression. Greenblat (1983) has suggested that sex within marriage is more likely to be the object of jokes than of scientific investigation. Strong and DeVault (1994) report that only nine of 553 articles on sexuality that appeared in scholarly journals between 1987 and 1992 were devoted to marital sexuality.
This pattern of research is somewhat odd in light of the widespread belief that effective sexual functioning is indispensable to a good marriage (Frank and Anderson 1979). In this regard, it is striking that much of the research conducted on couples has utilized clients in sex therapy. Here we review works on nonclinical samples.
Sexual Frequency and Practices. Most of the research on sexual relations within marriage has assessed the frequency of sexual relations. Many of these studies have also examined how that frequency is related to marital satisfaction. Americans seem to be fascinated with comparing their own frequency to other couples. Until recently, this research was based on volunteer samples, which typically were also quite small.
Perhaps the first sex survey ever conducted in the U.S.A. was done by Clelia Duel Mosher (1980), who investigated the sexual practices and attitudes of forty-five women between 1890 and 1920. Most of these women reported that they found sex to be pleasurable and believed that it was “necessary” for both men and women. The women who were interviewed before 1900 were less likely to describe sex as important or enjoyable, and they were less likely to associate sex with the expression of love. The Mosher survey documents the first signs of a shift to a post-Victorian culture.
In a study of more than 1,000 men and women, Dickinson and Bean (1932) reported that sexual dissatisfaction was more important in explaining marital difficulties than disputes over work, money, and children. Davis (1929) drew similar conclusions in her study of 2,200 women. Sexual satisfaction within marriage had clearly become a norm in the U.S.A. by the early twentieth century. Somewhat later, Hamilton (1948) interviewed a hundred married men and women and concluded that an unsatisfactory sex life is the principal cause of marital dysfunction. Without addressing the validity of that particular claim, the Hamilton data do demonstrate that, in the small sample surveyed in the 1930s and 1940s, sex was considered to be an important part of a marriage.
The Kinsey group (1953) reported that married couples in the 1940s had sex an average of two times a week in the early years of marriage, declining to about once a week after ten years of marriage. By comparing those born before 1900 and those born after 1900, they found that the frequency of marital coitus had remained the same. However, virtually every other aspect of marital sex had changed. Couples born after 1900 engaged in more and longer foreplay, used more coital positions, were more likely to have oral sex, were more likely to use French (deep) kissing and manual caressing of genitals, and had sex more often naked.
More-recent studies have tended to fit two patterns. Small samples with volunteers have found a general average of three to four times a week in early marriage with a decline to twice a week in later years. However, studies with national samples have tended to get lower figures more like Kinsey’s (Bell and Bell 1972; Blumstein and Schwartz, 1983; Call, Sprecher, and Schwartz 1995; Hite 1976; 1983; Hunt 1974; Sarrel and Sarrel 1980; Tavris and Sadd 1974; Trussell and Westoff 1980; Udry 1980; Westoff 1974). Interestingly, married women tend to report lower frequencies than married men (Call et al. 1996).
A few researchers have asked respondents to report their ideal or preferred frequency. Hite (1976) found that one third of married women would like to have sex at least daily, another third wanted it two to five times a week, and a final third less often.
(1) Changes Throughout Marriage. The evidence of a decrease over time or length of marriage is strong and consistent (Blumstein and Schwartz 1983; Edwards and Booth 1976; Greeley 1991; Hunt 1974; Kinsey et al. 1953; Michael et al. 1994; Trussell and Westoff 1980; Westoff 1980). Longitudinal studies of the same couples over time have also documented this pattern (James 1981; Udry 1980), as have retrospective studies of couples looking back over the course of their marriage (Greenblat 1983).
In a national study of the 1988 National Survey of Families and Households (Call et al. 1995), frequency decreases over the length of marriage were correlated with biological aging, diminished health, and habituation. In a multivariate analysis, age was most strongly related to frequency, followed by marital happiness, and factors that reduce the opportunity for sex (such as pregnancy and small children). Couples who had not cohabited prior to marriage and who were still in their first marriage had less-frequent sex than cohabitors, married persons who had cohabited prior to marriage, and those who were in their second or later marriage.
These findings are largely consistent with prior research. Decreasing frequency of marital sex has been found to relate to age-related reductions in the biological capacity for sex, including declines in male motivation and physical ability, declines in women’s testosterone levels, and increases in illness (Greenblat 1983; Hengeveld 1991; James 1983; Udry, Deven, and Coleman 1982). Negative social attitudes about sex and the elderly may also lead some to believe that their interest and capacity should decline (Masters and Johnson 1970; Riportella-Muller 1989). However, these aging factors do not explain the decline in frequency that occurs within the first several years of marriage (Jasso 1985; Kahn and Udry 1986). James (1981) found that the coital rate dropped by one half during the first year of marriage. Some have suggested that there is a honeymoon effect early in the marriage. As the honeymoon period ends, habituation occurs and frequency declines (Blumstein and Schwartz 1983; Doddridge, Schumm, and Berger 1987). Habituation may be seen as a decreased interest in sex that occurs with the increased accessibility of a regular sexual partner and the routine predictability of behavior with that partner over time (Call et al. 1995).
Other reasons that have been cited as influencing a decrease in frequency include fatigue, work demands, child care, and management of complex schedules (Michael et al. 1994).
(2) Effects of Children. A few comments on the effects of children are worth special note. There is some evidence that sexual frequency declines by the third trimester of pregnancy - prior to the actual birth of a child (Kumar, Brant, and Robson 1981). The birth of a child introduces parental roles into the marital relationship. The child increases fatigue, reduces time alone together for the couple, and decreases time in situations that are conducive to sexual encounters (Blumstein and Schwartz, 1983; Doddridge, et al. 1987; Greenblat 1983).
(3) Association with Sexual and Marital Satisfaction. A majority of Americans report that they are satisfied with their marital sex life (Hunt 1974; Lauman et al. 1994). In general, researchers have not found frequency to be related to sexual or marital satisfaction (Blumstein and Schwartz 1983; Frank, Anderson, and Rubinstein 1978). However, there is evidence that the congruence between ideal and actual frequency is related (Frank and Anderson 1979). There is some evidence that sexual problems are likely to occur fairly early in a marriage (Brayshaw 1962; Murphy et al. 1980).
Some studies have found social factors associated with relationship satisfaction. Rainwater (1964) found, in a study of couples in poverty in four different cultures, that lower-class couples were more likely to have highly gender-segregated role relationships (traditional gender roles); they were less likely to have close sexual relationships, and the wife was not likely to view sex with her husband as gratifying.
Several studies have found that sexual satisfaction is related to both sexual and nonsexual aspects of the marriage. The Kinsey group (1953) found that divorce was related to decreases in the wife’s orgasm rate. Hunt (1974) reported a strong correlation between marital closeness and sexual satisfaction. He found that the most important predictor was the extent to which couples share similar sexual desire. Thornton (1977) found that couples who spend more time having sex than they do fighting tend to have happier marriages. Sarrel and Sarrel (1980) found that couples who talk with each other about sex often, who rate their communication about sex as good, where the wife likes oral sex, and where the man believes the women’s movement has been good for women tend to have more satisfying sexual relationships.
Hite (1976) asked women to identify what aspect of their marital sex gave them the greatest satisfaction. Responses given by 20 percent or more included closeness, orgasm, coitus, and foreplay. In response to what they liked least, more than 10 percent said oral or anal sex, lack of orgasm, the “messiness” following sex, excessive or rough foreplay, and the routine nature of their activities.
In the Redbook magazine surveys (Tavris and Sadd 1975; Tavris 1978), marital satisfaction did not decline with length of marriage or age. The majority reported enjoying oral sex. Most respondents believed that good communication is an important ingredient of marital and sexual happiness. The most common complaint was that they had sex too infrequently. For women, religiosity was related to a happier sex life and marital satisfaction.
In an unusual study of a hundred mostly white and well-educated couples who were happily married (selected because none had ever had ES or been in therapy), Frank and Anderson (1979) found that 85 percent described themselves as sexually satisfied. One half of the wives reported they had difficulty becoming aroused or reaching orgasm. Roughly 10 percent of the husbands reported they had experienced erectile difficulties. One third of the couples expressed complaints about such things as anxiety, too little foreplay, and low sexual desire. There was no correlation between sexual dysfunctions and marital satisfaction, but complaints by the wife were associated with reduced marital happiness.
(4) Unexplored Issues. This review of research on marital sexuality serves to confirm the narrow range of the questions researchers have investigated. We know little about the dynamics of sexual relationships in marriage - about the ways couples interact sexually, about how they transact or negotiate sexual encounters, or about how they initiate and terminate encounters. Little is known about how sexuality in marriage is affected by power dynamics between the couple. There has been little study of sexual coercion in marriage. Perhaps it is time to end the focus on counting episodes and begin to examine what happens within marital sexual relationships.
Extramarital Sexual Relationships. Researchers have been studying ES for decades, although the range of the questions they have examined has been fairly narrow (For more-thorough reviews of ES research and nonexclusive lifestyles, see Macklin 1980; Thompson 1983; Weis 1983).
(1) ES Attitudes. One focus of concern has been the degree of normative consensus reflected by ES attitudes. A series of national surveys indicate that ES has consistently been disapproved by 75-85 percent of the adult American population (Glenn and Weaver 1979; Greeley, Michael, and Smith 1990; Reiss, Anderson, and Sponaugle 1980; Weis and Jurich 1985). Weis and Jurich (1985) found that nearly one third of residents in the twelve largest cities found ES acceptable, the only locations in the U.S.A. where as many as 20 percent approved. In small towns and rural areas, fewer than 10 percent approved. The norm of sexual exclusivity within marriage is so widespread in American culture that few question it.
Approval of ES has been found to be related to (1) being male, (2) young age, (3) being nonwhite, (4) living in a large city, (5) high levels of education, (6) low religiosity, and (7) being unmarried (Glenn and Weaver 1979; Reiss et al. 1980; Weis and Jurich 1985; Weis and Slosnerick 1981). Although a number of researchers have reported that approval of ES is related to lower levels of marital happiness, Weis and Jurich (1985) found that marital happiness was less strongly related to ES attitudes than several of these other variables.
(2) ES Incidence/Prevalence. A second major concern of researchers has been the attempt to establish estimates of the prevalence and/or incidence of ES behavior. Generally, this has taken the form of asking respondents to indicate whether or not they have ever had ES. Authors have regularly claimed that roughly one half of married persons in the U.S.A. have had at least one ES experience, citing the Kinsey research (1948, 1953) as the basis for this claim. Although the point is often ignored, the Kinsey team actually found that 33 percent of husbands and 26 percent of wives reported having ES. Because of suspicions of underreporting, they raised the estimate for male - but not female - ES to 50 percent. Several researchers have reported that the figures for husbands have remained “fairly stable” since then, but that the rate for wives has increased to approximately that of husbands (Blumstein and Schwartz 1983; Hunt 1974; Levin 1975). Researchers have reported lifetime prevalence rates from as low as 20 percent (Johnson 1970) to nearly 75 percent (Hite 1981).
Several recent studies by the National Opinion Research Center (Smith 1990; 1991; Greeley et al. 1990) have found that only 2 to 3 percent of American married men and women have ES each year. Further, they reported that 65 percent of wives and 30 percent of husbands have the same number of lifetime sexual partners as spouses. According to these researchers, the increases in premarital sex and cohabitation, the rising rate of divorce, and the later age at first marriage that have characterized the last forty years have resulted in less sexual exclusivity among the unmarried, but no such trend has occurred among married persons in the U.S.A. The Greeley group concluded that Americans are overwhelmingly “monogamous” [sic] and that rates of ES have been overestimated by previous researchers. The National Health and Social Life Survey (Laumann et al. 1994), also conducted by the NORC, found that only 35 percent of men and 20 percent of women reported ever having ES, and 94 percent had sex only with their spouse in the last year.
As we have already discussed, making comparisons between the results of the NORC national probability samples and previous studies is most difficult. Most previous studies have reported lifetime prevalence rates. The NORC studies have generally reported annual incidence rates. It seems likely that the conditions surrounding the collection of data and the greater representation of rural respondents in the NORC studies led to low estimates. On the other hand, the volunteer nature of most previous studies and their greater inclusion of urban respondents may well have led to high estimates. For the time being, we must conclude that questions about the incidence and prevalence of ES in the U.S.A. remain largely unanswered.
(3) Marital Happiness. The third major focus of ES research has been the attempt to demonstrate an association between ES behavior and marital happiness/satisfaction. By far, this has been the most frequently tested hypothesis. As a consequence, there has been little research exploring the circumstances or conditions surrounding ES behavior itself or testing alternative hypotheses. A number of researchers have found that ES behavior is significantly related to lower levels of marital happiness (Bell et al. 1975; Edwards and Booth 1976; Glass and Wright 1977; 1985; Prins, Buunk, and Van Yperen 1993; Saunders and Edwards 1984). Lower marital happiness has also been found to be related to ES attitudes (Reiss et al. 1980; Weis and Jurich 1985).
However, the association may not be as strong as these findings imply. The research by Glass and Wright (1977, 1985) suggests that the actual association between ES and marital happiness may be quite complex. In their earlier study, Glass and Wright (1977) found that husbands who had ES in the early years of marriage did have lower marital satisfaction. However, there were no differences in marital satisfaction between husbands who had never had ES and those who began ES later in their marriages. Interestingly, exactly the reverse was true for wives, There were no differences in marital satisfaction between wives who had never had ES and those who began it early in their marriages. Yet, wives who began their ES experiences later in marriage did have significantly lower marital satisfaction. In their later study, Glass and Wright (1985) found that ES was related to lower marital happiness only for wives. They concluded that male ES is likely to be more strongly associated with individual factors, rather than marital issues.
The Glass and Wright studies represent a level of complexity that has rarely been seen in ES research. Few studies have examined the possibility that marital happiness might relate to different types of ES experiences. As just one example, we can take the case of consensual ES. In one of the few comparisons of couples who had made an agreement to include ES in their marriage with couples who did not have this agreement and had a sexually exclusive relationship, there were no significant differences in marital stability, marital happiness, or level of jealousy (Rubin and Adams 1986). Similarly, Gilmartin (1978) found no differences in marital happiness between a group of couples who participated in swinging and a control group of nonswinging couples.
Moreover, Ellis (1969) has made the obvious point, substantiated by all the studies cited here, that some people who have ES also report high marital satisfaction. In fact, although the two variables have been consistently found to be significantly related, the proportion of ES variance explained by marital quality variables has tended to be rather small. This may be due, in part, to the tendency to dichotomize ES into “ever versus never” categories, thus ignoring the diversity of ES types. This treatment of ES as a simplistic construct that uniformly reflects poor marital dynamics may reduce our ability to establish better explanations of ES. For example, Weis and Jurich (1985) did report that ES attitudes and marital happiness were significantly related in a series of national probability samples, but they also found that marital happiness was more weakly related to ES attitudes than several background variables.
(4) Exploring the Diversity of ES Experience. This failure to recognize the diversity of ES experience may be the single greatest obstacle to the development of sound research and theory. ES experiences are, in fact, a class of relationship types, every bit as complex as other relationship forms. With few exceptions, American researchers have failed to recognize the historical and cross-cultural evidence that male and female ES behavior is universal, despite the strong normative traditions and sanctions against it. They have also largely ignored the cross-cultural evidence that amply demonstrates a wide variety of ES patterns and normative responses to it (Buss 1994; Fisher 1992; Ford and Beach 1951; Frayser 1985; Murdock 1949).
(5) Specific Aspects of ES. Ultimately, a full understanding of ES will require more-thorough investigation of the myriad ways in which ES experiences vary. Several factors require additional research. These include:
(6) Gender Issues. Before discussing theoretical factors for ES, we want to note that the available evidence strongly suggests that researchers explore the possibility of separate predictive models for men and women. There is evidence that men are more likely to have ES than women and to have more numerous ES encounters (Buss 1994; Glass and Wright 1985), more likely to report ES relationships with limited involvement (Glass and Wright 1985; Spanier and Margolis 1983), and tend to have more partners (Buss 1994; Thompson 1983). Men and women may also experience different outcomes. There is some evidence that women are more likely to report experiencing guilt as a result of ES (Spanier and Margolis 1983). It is possible that women, as a group, are more likely to be motivated to engage in ES activities by marital factors and may be more likely to seek intimacy as a primary goal in ES (Reibstein and Richards 1993). Several studies have found that marital variables are more strongly related to ES for women than for men (Glass and Wright 1985; Saunders and Edwards 1984). All of these findings indicate that the ES experiences of men and women may differ substantially.
(7) Building Theoretical Models. Edwards and Booth (1976) have argued that the context of marital interaction is more important than background factors in explaining the process leading to ES involvement. However, Weis and Slosnerick (1981) have maintained that individuals enter marriage with internalized scripts for sex, love, and marriage. Ultimately, the scripts of married persons stem from an interaction of marital dynamics and background factors. Each of these, in turn, is likely to be influenced by one’s position within the social structure.
As just noted, there is evidence of a significant correlation between marital happiness and both dichotomous measures of ES experience and ES attitudes, although this association has not always been a strong or robust one. In a study of ES attitudes (approval), Weis and Slosnerick (1981) isolated two orthogonal factors of justifications for ES. One was a set of motivations for ES that mentioned aspects of the marital relationship. The other was a set of individual motives for ES. Both factors were significantly related to approval of ES, but the individual motivations were more strongly related than the marital motivations.
These findings suggest two possible paths for future research that seeks to elaborate the complex nature of the association between ES and marital satisfaction. One is to contrast the types of ES experiences that persons with individual versus marital motivations tend to have and to explore how these relate to marital satisfaction and, perhaps, to outcomes of ES relationships. The other is to separate happily and unhappily married persons and to investigate the types of ES experiences and outcomes for each group. It seems reasonable to expect that the two groups might well pursue different kinds of ES experiences under different circumstances, with different outcomes.
A second theoretical factor may be background variables. A number of researchers have reported that premarital sexual attitudes and behavior are related to ES attitudes and behavior, several arguing that it is the best predictor of ES involvement (Bukstel et al. 1978; Christensen 1962, 1973; Glenn and Weaver 1979; Medora and Burton 1981; Reiss et al. 1980; Singh et al. 1976; Thompson 1983; Weis and Jurich 1985; Weis and Slosnerick 1981). ES variables have been found to correlate with premarital sexual permissiveness, number of premarital sexual partners, and early premarital sexual experience (low age). Weis and Jurich (1985) found premarital sexual permissiveness was the strongest and most consistent predictor of ES attitudes in a series of regression analyses with national probability samples throughout the 1970s.
Several questions remain to be explored. Do these Findings suggest that there is something particular about premarital sexual interactions with partners that is associated with ES, or are measures of premarital sex merely indicative of a broader interest in and history of sexual pleasure in various forms? Which of these will prove to be more useful in explaining various types of ES activities? For example, Joan Dixon (1984) found that female swingers tend to have early and continuing histories of heterosexual involvement, but that they also tend to have early and continuing histories of masturbation and high current sexual frequencies with partners. Gilmartin (1978) also found that swingers tend to have early heterosexual experiences and high sexual frequencies with their spouses. One might conceivably argue that such persons like sex, and ES is an extension of a broader orientation to pleasure.
A third factor has been suggested by Cazenave (1979), who has criticized work in the area of alternative lifestyles for its emphasis on ideological preference and its failure to explore how structural variables (such as age, gender, and race) may impose external constraints. In fact, there is evidence that ES behavior and ES permissiveness (attitudes) are related to (1) young age, (2) being nonwhite, (3) low education for behavior and high education for attitudes, (4) low religiosity, and (5) residence in a large city (Fisher 1992; Greeley et al. 1990; Smith 1990, 1991). Several of these associations may, in fact, be quite complex. For example, the Kinsey group (1948, 1953) found that blue-collar males tend to have ES in their 20s and their behavior diminishes by their 40s. White-collar males with college educations tended to have little ES in their 20s. This rate gradually increased to an average of once a week by age 50. In contrast, female ES peaked in the late 30s and early 40s. Finally, there is a need for research that explores the role of such American social trends as the increasing age at first marriage, the growing divorce rate, the unbalanced gender ratio, and greater mobility and travel in ES behavior.
(8) Unexplored Issues. There has been little research to this point on the process of ES relationships. For example, there has been little investigation of how opportunities for ES involvement occur in a culture with strong prohibitions against ES. Cross-sex friendships and interactions have been frequently cited as creating the opportunity for ES (Johnson 1970; Saunders and Edwards 1984; Weis and Slosnerick 1981), although this has not been empirically tested. The matter is somewhat complicated by the evidence that friendships outside of marriage are associated with higher levels of marital satisfaction (Weis and Slosnerick 1981). Wellman (1985, 1992) has documented how the friendship networks of men have shifted from public spaces (bars, cafés, and clubs) to private homes. This has led to a narrowing of the concept of friendship to emotional support and companionship. Husbands’ and wives’ networks are now both based in private, domestic space, and many wives actively maintain their husbands’ ties to friends and kin. Men get much of their emotional support from women, as well as men, and women get almost all of their support from women. Wellman argues that marriage may impose constraints on men’s ability to spend time and be intimate with other men or women. Whether this is related to ES remains to be explored.
Similarly, little is known about the outcomes of ES involvement. Generally, it is assumed that ES relationships are short in duration, exploitive in character, and tragic in outcome. For example, it is generally assumed that ES and cross-sex friendships will be a source of jealousy in a marriage. Although there is a growing body of evidence about jealousy, little research has specifically investigated jealousy in the context of ES (Bringle, 1991; Bringle & Boebinger, 1990; Buunk, 1981; 1982; Denfeld, 1974; Jenks, 1985).
Alternatives to Traditional Marriage. Although most ES is secretive, some couples do pursue lifestyles that permit ES (Blumstein and Schwartz 1983; Thompson 1983; Weis 1983). There is some evidence that consensual ES is unrelated to marital satisfaction (Gilmartin 1978; Ramey 1976; Rubin and Adams 1986; Wachowiak and Bragg 1980), suggesting there might be different outcomes for the consensual and nonconsensual forms of ES.
A number of models for consensual ES have been proposed, particularly during the 1970s. These include swinging (recreational and shared ES) (Bartell 1971; Gilmartin 1978; Jenks 1985), comarital sex (Smith and Smith 1974), open marriage (O’Neill and O’Neill 1972), intimate friendship networks (ES within context of friendship) (Francoeur and Francoeur 1974; Ramey 1976), and group marriage (Constantine and Constantine 1973; Rimmer 1966). Certainly, there are differences among these various nonexclusive lifestyles. We do not have the space to review fully the distinctions among them here (see Libby and Whitehurst 1977; Weis 1983). What unites them for the discussion here is that they all represent a consensual agreement to allow multilateral sexual involvement. As such, ES is assigned a different set of meanings from betrayal.
Consensual agreements can vary in terms of the degree of sexual involvement desired, the degree of intimate involvement desired, the degree of openness with the spouse, and the amount of time spent with the ES partner (Sprenkle and Weis 1978). Buunk (1980) studied the strategies couples employ in establishing ground rules for sexually open marriages. The five most common were: (1) primary value placed on maintaining the marriage, (2) limiting the intensity of ES involvements, (3) keeping the spouse fully informed of ES relationships, (4) approving ES only if it involves mate exchange, and (5) tolerating ES if it is invisible to the spouse. It would be useful to see research on the association between the types of strategies employed and outcomes of ES.
Interestingly, husbands tend to initiate swinging (Bartell 1971; Weis 1983). There is some evidence that most couples swing for a few years, rather than pursuing it for a lifetime (Weis 1983). Dropouts from swinging report problems with jealousy, guilt, emotional attachment, and perceived threat to the marriage (Denfeld 1974). As far as we know, there have been no studies comparing dropouts and those who enjoy and continue swinging.
The Constantine study (1973) is virtually the only source of data on group marriage in contemporary America. They report that the typical relationship includes four adults. Most enter a group with their spouses, and if the group dissolves, most of the original pair bonds survive. In fact, the original pair bonds retain some primacy after the formation of the group, and this may be a factor working against the success of the group. Jealousy between male partners appears to be a common problem.
Studies of marital models that permit ES have tended to employ small, volunteer samples with no control or contrast groups for comparison. There is no basis for a firm estimate of the incidence or prevalence of such alternative lifestyles, although Blumstein and Schwartz (1983) suggested that as many as one of seven marriages in the U.S.A. may have some agreement allowing ES. Despite the vast attention given to these alternative lifestyles in the 1970s, and despite the more recent claims that Americans are “returning to traditional models of monogamous marriage,” there is no scientific basis for concluding that these patterns increased in popularity earlier or that they have become less common in the 1980s and 1990s.
Government Policies Affecting Sexuality and Disability. Over the past twenty years, pivotal legislation has been enacted in the United States that enables people with disabilities to gain their rightful place as equal members of American society. These changes have been led by spirited people with disabilities and their advocates. The Rehabilitation Act of 1973, the 1975 Education for All Handicapped Children Act (Public Law 94-142), and the Americans with Disabilities Act passed in 1990 have all added opportunities for inclusion and integration into the community for people of all abilities. With inclusion and integration have come greater opportunities for social interaction and sexual expression. The same spirit that has raised disability-rights issues to a national priority is now demanding that people with disabilities be recognized as sexual beings with a right to sexual education, sexual health care, and sexual expression afforded under the law.
Demands for the sexual rights of people with disabilities have resulted in a resurgence of research interest in the area of sexuality and disability in the 1990s. Notably, the National Center for Medical Rehabilitation Research (NCMRR) of the National Institute of Child Health and Human Development under the National Institutes of Health has identified sexuality as a priority issue that impacts the quality of life of people with disabilities. It subsequently issued a Request for Applications on Reproductive Function in People with Physical Disabilities in February of 1992. The purpose of the request was to develop new knowledge in the areas of reproductive physiology, anatomy, and behavior that are common to people with disabilities with the goal of restoring, improving, or enhancing reproductive function lost as a consequence of injury, disease, or congenital disorder. The request for applications included a specific objective to characterize the effect of impairments of sexual function on psychosocial adaptation, emotional state, and establishment of intimate relationships. Special focus was placed on research with women and minorities who have disabilities. NCMRR has funded six studies on sexuality and disability over the last three years. Two of the studies were with women who have spinal cord injury, and a third was a study of women with a variety of disabilities.
Consumers with Disabilities Leading the Way. Research, education, and advocacy efforts in the area of sexuality and disability are being led by people with disabilities (consumers). A review of the most recent annotated bibliography on sexuality and disability published by the Sexuality Information and Education Council of the United States (SIECUS, 1995) reveals a growing number of books, newsletters, special issues of publications, and curricula on sexuality and disability written by people with disabilities. In addition, national consumer-based organizations like the National Spinal Cord Injury Association, the National Multiple Sclerosis Foundation, and the Arthritis Foundation are beginning to publish self-help brochures on the specific effects of particular disabilities on sexuality. Most recently, self-help groups have been appearing on the Internet, computer bulletin-board services, and commercial computer services like American Online.
Health-Care Professionals Involved in Sexuality and Disability. In addition to the work by people with disabilities and nonprofessional advocates, health-care professionals are also taking an increased interest in sexuality and disability. The American Association of Physical Medicine and Rehabilitation has a Sexuality Task Force; the American Association of Sexuality Educators, Counselors, and Therapists has a special-interest group that focuses on educating medical and allied help professionals in the area of sexuality and disability; the Society for the Scientific Study of Sexuality includes presentations and workshops in the area of sexuality and disability for its members; and Planned Parenthood agencies around the country have increased education and services in the area of sexual health care to people with disabilities. More rehabilitation hospitals are including “privacy” rooms to give patients an opportunity to experiment sexually while still in the hospital, and many are adding specialty programs in the area of fertility and erectile function for men, obstetric and gynecological care for women, and parenting for both men and women with disabilities.
Portrayals of Sexuality and Disability in the Popular Media. The portrayal of people with disabilities as sexual beings has improved over time in the popular media. Movies that include a focus on the sexuality and relationships of people with disabilities, such as Forest Gump, Passion Fish, Water Dance, Regarding Henry, My Left Foot, Children of a Lesser God, and Born on the Fourth of July have dealt with the issue of sexuality and disability with varying degrees of sensitivity, and have enjoyed success at both the box office and in video stores. TV shows have also included people with disabilities and sexuality themes. One show, LA Law, where one of the stars portrayed a person with a developmental disability who had a sexual relationship with another person with a developmental disability, was honored by the Coalition of Sexuality and Disability for the positive portrayal of sexuality and disability in the media. There has also been an increase in TV commercials that include people with disabilities in relationships or with children. Popular magazines ranging from Bride to Penthouse and Playboy are also beginning to include feature articles on sexuality and disability. Efforts to portray people with disabilities as part of everyday life in the media are slowly helping to explode the myth that people with disabilities are asexual.
Problems, Controversies, and Hurdles. Two of the most serious sexual problems facing people with disabilities are (1) the high rate of sexual abuse, exploitation, and unwanted sexual activity, especially among women with physical disabilities and all people with developmental disabilities, and (2) the risk of STDs, including HIV, among people with cognitive impairments who are sexually active. Two leading areas of controversy are (1) the issue of what constitutes informed consent for sexual activity in people with serious cognitive impairments, and (2) the area of reproductive rights, eugenics, abortion, and prenatal testing for disabilities. As far as hurdles, there is still a need for greater access to information and educational material that affirms the sexuality of people of all abilities, including people with early- and late-onset disabilities, physical, sensory, and mental disabilities, and disabilities that hinder learning. Despite the positive current trends in sexuality and disability, we still have a long way to go in increasing the number of sexuality education and training programs for teachers, health-care workers, and family members to help them understand and support the normal sexual development and behavior of persons with disabilities. A goal is that all social agencies and health-care delivery systems develop policies and procedures that will insure sexual-health services and benefits are provided on an equal basis to all persons without discrimination because of disability.
In 1860, over half of the American population was under 20 years of age and only 13 percent over age 45. In 1990, less than a third were under age 20 and 21 percent were over age 45. The so-called Baby Boomers born between 1945 and 1965 are now in their middle years. With the birthrate less than 15 per 1,000, America has become a graying society.
Although Americans over age 50 are the fastest-growing segment of our population, research on their lifestyles and patterns of intimacy has been almost exclusively limited to studies of the chronically ill, the socially isolated, and the poor. Edward Brecher (1984) was one of the First to study older healthy Americans. His sample of 4,246 persons between ages 40 and 92 was largely white and affluent, although he did include a low-income group. His overall conclusion was that the sexual interests and activities of older persons are the best-kept secrets in America. Although there is a common belief that the elderly are no longer interested in sexual intimacy, older persons were just as affected as young people by the social turmoil and changing attitudes of the 1960s and 1970s.
Brecher found that healthy, older person today are “enormously different from the older person of forty or fifty years ago,” and very much interested in intimacy and sexual relations. Not one of Brecher’s 4,246 respondents was sexually inactive, although masturbation was the most common sexual outlet. Forty-four percent rated their sexual satisfaction as most enjoyable; less than 1 percent rated their sexual activity as not enjoyable (Table 4). Poor health was a major determinant in hindering older persons from maintaining an active sexual life.
Table 4
Sexual Activity Among 4,246 Americans, Ages 45 to 92, in the Brecher 1984 Survey
|
|
Age Group |
||
|
50s |
60s |
70+ |
|
|
Women |
|||
|
Orgasms while asleep or awakening |
26% |
24% |
17% |
|
Women who masturbate |
47% |
37% |
33% |
|
Masturbation frequency for women who masturbate |
0.7/week |
0.6/week |
0.7/week |
|
Wives having sex with husband |
88% |
76% |
65% |
|
Frequency of marital sex |
1.3/week |
1.0/week |
0.7/week |
|
Men |
|||
|
Orgasms while asleep or awakening |
25% |
21% |
17% |
|
Men who masturbate |
66% |
50% |
43% |
|
Masturbation frequency for men who masturbate |
1.2/week |
0.8/week |
0.7/week |
|
Men having sex with wife |
87% |
78% |
59% |
|
Frequency of marital sex |
1.3/week |
1.0/week |
0.6/week |
About half of these couples reported engaging in oral-genital sex and did not limit their sexual activities to nighttime. Most of the men and women were usually orgasmic. About one in fifteen had participated in group sex after age 50. One in five couples had engaged in extramarital sex; 1 percent of couples had a mutually accepted “open marriage.” Forty percent of older single women reported a relationship with a married man. A third thought it was acceptable for an older man or woman to have a much younger lover.
In another study of healthy, upper-middle-class men and women, ages 80 to 102 living in residential retirement communities, 14 percent of the men and 29 percent of the women were still married. Sexual touching and caressing, followed by masturbation and then intercourse were the most common sexual activities. Of these outlets, only touching and caressing declined with age, a decline more evident in men than in women. Those who had been sexually active earlier in life tended to remain sexually active in their 80s and 90s, although the frequency of sexual intercourse was sometimes limited by their current physical health and by social circumstances including the lack of an available partner (Bretschneider and McCoy 1988).
The Starr-Weiner Report on Sex and Sexuality in the Mature Years (1981) examined the sexual lives and attitudes of 800 persons, aged 60 to 91, from four regions of the country. When the sexual activities of these 60- to 90-year-olds were compared with the 40-year-olds Kinsey studied thirty-five years earlier, there was no significant decline when opportunities for sexual activity existed. “Sex remains pretty much the same unless some outside event intrudes, such as a health problem, the loss of a spouse, impotence, or boredom.” A reliable predictor of the sexually active life of older persons is their acceptance or rejection of the social stereotype of the dependent, sickly older person. Older persons who maintain an active participation in life in general tend to be more sexually active in their later years.
Starr and Weiner also identified two major problems with no easy remedy. First is the tendency for older men to become asexual when they encounter an occasional erection or orgasmic problem. Instead of exploring noncoital pleasuring, many older men simply give up all interest in sex. The second problem is the ever-growing number of older women who are without sexual partners and, thus, deprived, against their will, of sexual intimacy and pleasure. (See Section 6B below on sexuality among older homosexual men and women.)
Throughout this section, we have noted the tendency of sexuality researchers in the U.S.A. to focus on the incidence and/or frequency of sexual behaviors in various lifestyles. There has been little corresponding research on the process of sexual relationships or the dynamics within them. This is precisely the same point we made in summarizing the section on adolescent sexuality. Suffice it to say that American researchers need to move beyond asking how many people “do it” and how often they “do it” to more fully investigate the contexts surrounding adult sexual lifestyles, and to identify the social, psychological, and biological factors associated with sexual practice.
To this point, we have examined the general socio-historical context of sexuality in the U.S.A. and reviewed evidence concerning what may be called mainstream sexual behaviors, in the sense that a majority of Americans engage in these activities. Our review of autoerotic behaviors and the development of heterosexual patterns throughout the life cycle may be seen in this light. We did occasionally mention less-common patterns. For example, the review of childhood sexuality did note that homosexual activities do occur in childhood, and research that examined the development of homosexual behavior was briefly discussed. However, the focus of the chapter so far has clearly been on mainstream, and essentially heterosexual, patterns.
Our review will now shift to an examination of a variety of sexual patterns that are less common, as this has also been a prime concern of sexuality professionals in the U.S.A. We hope that the reader will note that many of the general themes we have stressed so far - change and diversity, for example - are applicable to these patterns as well. In reviewing heterosexual lifestyle patterns, we stressed that researchers have tended to focus on the incidence or frequency of sexual behaviors and less likely to investigate relationship dynamics or theoretical explanations of behavior. These same trends also tend to characterize the study of less-conventional sexual behavior.
Although research on childhood sexual activity in the United States is limited, what little we know (and can remember on a personal level) indicates that a great deal of same-gender sex play takes place among children, usually of an exploratory nature. Occasionally a lesbian, gay, or bisexual adult will recall such childhood activity as being different from exploratory activity with someone of the other gender, and therefore indicative of an early awareness of orientation. But it appears that, for the majority of people, childhood sexual play, while it includes same-gender activity, has little implication for adult orientation.
Some research shows a relationship for males between cross-gender behavior as a child (known as “sissy” behavior) and homoeroticism as an adult, but that relationship has not been shown to be causal and may be more a result of the patriarchal homophobic character of the culture than any innate biological characteristic of the child. This is more apparent when one compares the research on females who engage in cross-gender role behavior as a child (known as “tomboy” behavior), wherein the same relationship is not present. Even the labels for the person engaging in cross-gender role behavior carry different connotations in the culture. For a boy, being called “sissy” is considerably more detrimental to healthy development than is being called “tomboy” for a girl (Green 1987).
When the American child is developing a lesbian, gay, or bisexual identity, the heterosexism and homophobia of the culture dictates that this is not an acceptable orientation, and it becomes difficult at best for the child to develop into an adolescent or adult with a positive self-image. Lesbian and gay youth, particularly those from small communities, seldom receive support from their peers or from the sex education and family life courses in their school. Books that could be supportive, such as Leslea Newman’s Heather Has Two Mommies (1989), or Gloria Goes to Gay Pride (1991), are usually banned from school curricula or simply not considered appropriate for children, even though they were written specifically for all children to read. Counselors and teachers generally assume that all of their students are heterosexually oriented, even though some students in any school will have a same-gender orientation.
As children grow into adolescents and attempt to deal constructively with the tensions and uncertainties of adolescence, gay, lesbian, and bisexual teenagers have to confront the question of the gender of the person to whom they find themselves sexually attracted. Do they surrender to peer and cultural pressure and date only members of the other gender? Do they tell a best friend of their orientation and risk losing that friend or being ostracized or physically attacked? Should they get sexually involved with someone of the other gender to attempt to prove that they really are “straight”? Just what do they do when they find themselves sexually attracted to someone of the same gender? Fortunately, the number and quality of resources that lesbian and gay teens can use are increasing, both on national and local levels. During the late 1980s and early 1990s, many books, pamphlets, and other resources have been published, providing practical guidelines and insights into what lesbian and gay youth should know about dating, living together, and coping in a hostile world.
However, the resources that are available for them are usually available only through homophile groups and a few commercial bookstores, and are generally not available through school libraries or other youth agencies. For example, the Boy Scouts organization has been explicitly noninclusive for both homosexual youth members and adult leaders. In rare cases, such as in New York City, a special high school has been established for gay and lesbian youth who are unable to cope with the discrimination that they face in a regular school setting. This discrimination comes from other students, as well as teachers, administrators, and counselors, making it difficult for these students to obtain an education.
Although this discrimination is still rampant in elementary and secondary schools, it is lessening somewhat in colleges and universities. Most American public and large private colleges and universities recognize and fund student organizations such as a Gay and Lesbian Alliance (GALA) or a Lesbian and Gay Organization (LAGO). Several chapters of gay fraternities and lesbian sororities have been organized. However, even where such organizations exist, many lesbian and gay collegians avoid them or keep their membership quiet. Even at religiously based institutions of higher education, there are differences with respect to the acceptance of these organizations. As late as 1995, one university, the Roman Catholic-affiliated Notre Dame, refused to allow any homophile organizations, and even denied the availability of counseling-center-sponsored group-support activities for lesbians, gays, and bisexuals. At the same time, a large Jewish orthodox-affiliated university, Yeshiva, provides numerous opportunities and funding for gay and lesbian organizations at both the graduate and undergraduate levels.
Even though information on issues confronting lesbian, gay, and bisexual adolescents may be available in printed form, the difficulty in gaining access to such materials, the anti-homoeroticism that is rampant in the media, the negative stereotypes that are still being touted as representative of all who are homoerotic, and the silence on ambieroticism or bisexuality all combine to make life unnecessarily difficult for the adolescent lesbian, gay, or bisexual person in this country. One result is that almost one third of adolescent suicides are related to the issue of homoeroticism. The data on attempted suicide among adolescents are also informative. About 10 percent of heterosexual male and female adolescents attempt suicide, while twice as many lesbian adolescents and three to four times as many gay adolescents attempt suicide (Youth Suicide National Center Report, 1989). The lack of support and acceptance of these young people is undoubtedly a factor in this difference.
The question of gender orientation and the definition of orientation is complex and confusing for both sexuality researchers and the layperson alike. Several researchers have concluded, after extensive study, that there is no clinical description that can be applied to the label “homosexual” - that there is virtually no single phenomenon that can be labeled “homosexuality” and then described in clinical terms. Yet, some theorists have suggested models to define and categorize. When researchers then indicate that they are using a specific model, usually there is no internal consistency. Take, for example, the Kinsey continuum of orientation. After interviewing 5,300 men and 5,940 women in the 1940s, Kinsey and associates developed a continuous scale based on the ratio of sexual fantasies and physical contacts with one’s own gender and with the other gender. Along this continuum are seven points, labeled from 0 to 6, with a “Kinsey 0” being a person whose behavior and fantasies have always involved persons of the other gender, and a “Kinsey 6” being a person whose behavior and fantasies have always involved persons of their own gender.
Even where researchers have indicated their use of the Kinsey scale, the actual definitions of research subjects have varied significantly from the original and also varied from study to study. In some instances, fantasy data are not available and consequently not considered; in other instances, behavior alone is the criteria for being placed in a “Kinsey” category, with no recognition of the difference in subjective experience of the sexual activity. In other studies, subjects are placed on the continuum solely according to the gender of the partner with whom they are living.
There are other models available that begin to reflect some of the complexities of gender orientation. Moses and Hawkins (1982; 1986) indicated that the minimum data necessary for identifying orientation in subjects were an assessment of the gender of emotional relationship partners, the gender of sexual attraction partners, and the gender of partners in sexual fantasy content, and that all three of these should be considered from a past and a present perspective, implying that although orientation may be consistent throughout one’s life, it is not necessarily so. It is seen as a potentially dynamic characteristic.
An even more complex model was developed by Fred Klein, a physician and gender-orientation researcher. Klein indicated that an assessment of orientation needed to consider seven criteria over three time periods, resulting in a Sexual Orientations Grid of 21 cells. The criteria are: (1) sexual attraction; (2) sexual behavior; (3) sexual fantasies; (4) emotional/affectional relationship preference; (5) social relationship preference; (6) lifestyle; and (7) self-identification, with each of these criteria being assessed over three time periods: the past, the present, and the future ideal. This was the first model to present the notion that one’s self-label might be an important facet of one’s orientation, and the time factor was an acknowledgment of the potentially dynamic character of orientation. Research subjects can rate themselves on these criteria using a three-by-seven grid and the Kinsey ratings, summing the ratings, and then dividing by 21 to produce a position on a scale identified popularly as “The Kinsey Scale” (Klein 1978; Klein, Sepekoff, and Wolf, 1985). Although the initial response to Klein’s model was that it was more comprehensive and realistic, its complexities have kept most researchers from using or disseminating it widely. It has thus remained unfamiliar to many.
Several studies in the past decade have attempted to identify biological determinants for adult homoeroticism from a heterosexist theoretical base, in which heterosexual behavior is viewed as the basic, natural human behavior, and anything else is deviant. There is usually little recognition of definitional complexity or the possibility of precursors rather than determinants. Subjects are typically placed in the dichotomous classification so prevalent in the culture - that one is either gay or straight, homosexual or heterosexual - with no recognition of the Kinsey continuum, and especially no recognition of Klein’s model. Researchers have purported to examine twins, siblings, adopted children, and brains of people who are homosexual and those who are not.
For example, Simon LeVay (1991) reported finding a portion of the hypothalamus that was smaller in homosexual men than in heterosexual men and was equal in size to that portion in heterosexual women. There were no lesbian brains identified as such in this study. The “finding” was quickly seized by the popular media and soon became what is called “common knowledge.” There were many problems with the study, but these were generally ignored, even in the scientific press. The definitional problem, whereby subjects were classified according to whether they were known to be gay or not (obviously all subjects were no longer living, so no information could be garnered from the subjects), has been ignored. The size of the sample (nineteen men previously identified as gay, sixteen men identified as not known to be gay and, therefore, heterosexual; one man known to be identified as bisexual and included in the study as such; and six women, all classified as heterosexual) has also generally been ignored. The fact that the size of another part of the hypothalamus in the women’s brains did not coincide with other research on women’s brains was ignored in discussions, and the possibility that what was found may have had something to do with body build and general physical characteristics rather than directly with sexual orientation was also never discussed. The overly simplistic design was convenient, because including even a few of the other variables, such as body build or sexual history, would mean that the sample size would have to be considerably larger to enable any conclusions to be drawn.
Dean Hamer and his research team (1993) have reported the discovery of a genetic region, the Xq28 region on the X chromosome, that is claimed to be associated with male homosexuality in about three quarters of gay men and inherited on the maternal side of the family. Similar research on lesbian women does not show similar findings. There is also no attempt in all of this research to explain the “exceptions” that are reported. If there is a “gay” gene, then why is it that all men who are gay do not show it? Most biologically focused studies suffer from similar problems, first with the issue of definition, then with the exclusion or nonsimilarity of research on women who are attracted to women, and finally with assumptions, conclusions, and discussions of results that assume the “natural” state of the human being is exclusively heterosexual.
Although the question of a biological basis for homoeroticism has, in recent years, seen increased interest and attention, such research consistently does not consider the complexities of orientation, such as emotional attraction, behavior, and other criteria that constitute sexual orientation in Klein’s model. Most of the classification methods for identifying orientation of subjects in these studies are overly simplified. Although there may be biological precursors to orientation, no well-designed, appropriately controlled study has been done to support that conclusion.
One positive side effect of the popular interpretation of research into possible biological roots of homoerotic orientation has been in easing the acceptance of gay and lesbian persons by some churches. One can paraphrase a common response among some mainstream Protestant church people and leaders: “If homosexual orientations are not a freely chosen preference but in some way rooted in prenatal genetic, hormonal, and/or neural templates, then God and nature made them this way, and we and the church must accept that reality.”
The research on bisexuality or ambieroticism is even more scant. It is very difficult to do research on bisexuality if one cannot define it, and there is no simple, dichotomous cultural model as is available with research on homosexuality. In a 1994 book, Dual Attraction, Weinberg, Williams, and Pryor report that using the Kinsey scale with sexual behaviors, sexual feeling, and romantic feelings, they identified five different types of bisexuals in their study of 435 men and 338 women:
Additionally, it is only in the recent past that models for development of a bisexual identity have been proposed, and further research into ambieroticism, such as was begun by Fred Klein, has moved very slowly. The heterosexist nature of the culture, combined with the indigenous psychological and sociological perspectives of many researchers, has precluded the acceptance of a somewhat radical notion that the basic state of the human sexual orientation is ambierotic and mutable, with exclusive heterosexual or exclusive homosexual behavior being equally deviant from the biological norm. Further research on bisexuality appears to be moving in that direction. (See Section C below for more on bisexuality.)
In much of the public discussion of homoeroticism, there is a preoccupation with the general question, “How many are there?” The answer to this question carries political and economic implications, and there is a need to understand the extent of the economic power and political power that this group wields. For example, is the culture required, in policy decisions, to provide for this group, or is it such a small number that policymakers are not required to respond to identified needs of this population? Commerce is in a strategic position to profit from this population, and economically driven decisions in the marketplace are taking these numbers into serious account. For example, in 1994, advertisements focusing directly on lesbian women and gay men as consumers were introduced in popular television and print media, and more mainstream commercial advertisements were being placed in homoerotically focused magazines, such as The Advocate, and in programs for fund-raising benefits for homoerotic communities.
Another area where numbers are considered in policy decisions is the increasing recognition and development of domes tic-partner benefits, such as health insurance and death benefits. This began in the early 1990s when some employers became aware that lesbians, gay men, and bisexuals comprise enough of the work force to have an effect on productivity and efficiency, and that accommodating their needs is beneficial to the company so that it can have and keep well-qualified people.
Ignoring the basic fact that there is no definition of what “a homosexual” or “a bisexual” person is, until the mid-1990s the most-often cited figure for incidence of homosexuality came from the research of Kinsey and associates carried out in the 1940s. These data have been used to estimate the number of homoerotic people in the population without any indication of the simplistic nature of the definition. The commonly cited figure that 10 percent of American men are homosexual is a combination of Kinsey’s finding that 4 percent of his sample were exclusively homosexual (Kinsey 6) and 6 percent were predominantly homosexual (Kinsey 5) (Kinsey et al. 1948). His data on homosexual activity in women indicated approximately 9 percent were either exclusively or predominantly homosexual (Kinsey 5 or 6) (Kinsey et al. 1953).
Laumann et al. (1994) found that almost 3 percent of their subjects were homosexual. Although these two sets of figures may, at first, seem at odds, the 1994 figure had a 1 percent error rate, and the Kinsey figure for exclusive homosexuality was 4 percent, so the two major studies do not differ greatly. There were some other problems with the 1994 study, such as the use of females as interviewers and the tendency of males in this culture to deny homosexual activity, even in anonymous questionnaires, but especially in face-to-face contact with anyone else; however, even with those design problems, the numbers are similar (Schmalz 1993).
In 1973, the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. This was a major turning point, both in the United States and worldwide, in the clinical acceptance of homosexuality. Homosexuality was no longer to be viewed as an illness. The impact within psychology and psychiatry was profound, and has influenced many aspects of society. The basis for this change was the scientific conclusion that, among individuals who were not in clinical treatment, it was impossible to distinguish heterosexual and homosexual persons. Evelyn Hooker first arrived at this conclusion in 1957 with the first controlled study to include a comparison on a non-clinical sample of heterosexual and homosexual men.
Since then, research designs employing the principle that such non-clinical participants exist have resulted in many studies confirming that, in itself, homosexuality is not an illness. The illness model of homosexuality that had existed as the basis for so much discrimination is no longer supported by the psychiatric and psychological establishments. In 1973, the Comprehensive Textbook of Psychiatry was revised to state: “many homosexuals, both male and female, function responsibly and honorably, often in positions of high trust, and live emotionally stable, mature, and well adjusted lives, psychodynamically indistinguishable from well-adjusted heterosexuals, except for their alternative sexual preferences.”
This has led clinicians to change their point of reference regarding homosexuals, from a pathological frame to a counseling frame, from looking at persons as sick to looking at how persons may maximize their human potential in society. Since then, many studies and books have examined aspects of the development of gay men and lesbian women, looking at identity development (social, sexual, and psychological), family issues, relationship issues, work and career development, and other dimensions of identity and lifestyle. There now exists a large body of American literature, in both the professional and general press aimed at maximizing the health and wholeness of gay men and lesbians.
Still, gay and lesbian individuals often have difficulty with their own self-acceptance and the process of deciding just how to live as gay or lesbian persons. Mental-health professionals who specialize in working with gay and lesbian clients offer individual and group counseling throughout the U.S.A. Various organizations also routinely offer support groups for a wide range of concerns. In addition, counseling is now available to the family members and friends of gay and lesbian persons who have difficulty in accepting the homosexuality of their loved ones.
In examining the legal status of lesbians, gays, and bisexuals, one needs a rudimentary understanding of the legal system in the United States. There are levels of jurisdiction throughout the country; each jurisdiction, from local villages, to city, county, state, and the federal governments, has its own legal codes. In addition, the military has its own legal code. The issue of rights for lesbians and gays has been raised at all levels of jurisdiction. Supposedly, all of these laws are subject to the provisions of the Constitution of the United States, which provides consistency. Each state has its own state constitution, which is also to be consistent with the federal Constitution, as are the governing documents of cities and local communities.
Generally, lesbian women and gay men have no protection against discrimination based on orientation or the perception of orientation, and in 1995, only nine states had laws including sexual orientation as a minority protected from discrimination. Historically, attempts to obtain protection have followed the patterns of other oppressed groups in the United States. First, there were attempts to gain protection against discrimination in public accommodations and employment. More recently, this has expanded to include equal treatment with regard to employment-related benefits accorded to married heterosexual relationships. Examples include the benefits accrued to persons by their legally married status (as of 1995 same-gender partners are not allowed to marry legally in any state in the U.S.), as well as benefits in relation to parental status (such as adoption or custody issues), and bereavement leave with respect to family members.
Opposition to these attempts to expand discrimination protection either takes the stance that homosexual activity is immoral and, therefore, not deserving of consideration for equal protection, or suggests that lesbian women and gay men are seeking “special treatment.” There is even an argument put forth that suggests that lesbian women and gay men are not an oppressed minority and should not be treated as such. Where legal protections have been instituted, it has usually been based on the need for equal treatment.
In the past decade, some local jurisdictions have passed laws recognizing the civil rights of same-gender couple relationships and of homoerotic individuals. Similarly, many corporations, of all sizes, have granted gay and lesbian couples the same benefits as heterosexual couples. For example, in Dallas, Texas, a major corporation threatened not to locate a new corporate facility in that city if the corporation’s policy on domestic partnership benefits for same-gendered couples was declared illegal by virtue of the city’s discriminatory laws. The economic impact of this decision caused the city government to rescind the law.
In May 1993, a court case highlighted a conflict between the antidiscrimination clause in the Constitution of the State of Hawaii and that state’s ban on the recognition of same-gender unions. The state’s Supreme Court asked the state to prove its “compelling interest” for continuing the discrimination or to end it. Lawyers generally admit that it will be very difficult to prove a “compelling interest,” and if it cannot be done, the state will be forced to grant legal recognition of same-gender partnerships. Currently, all fifty states grant reciprocal recognition of the legality of heterosexual marriage, but if Hawaii legalizes homosexual marriages, the other forty-nine states will have to decide whether to continue that reciprocity. In early 1995, several states sought to pass legislation that would limit their reciprocity to heterosexual marriage, in the event that Hawaii recognized same-gender marriages (Rotello 1996; Eskridge 1996; Sullivan 1996).
Lesbians and gays are also treated differently with respect to serving in the United States armed forces. For many years, they were specifically excluded in official policy, yet were differentially managed in individual cases. For example, when the war in Kuwait broke out, some lesbians and gays who were scheduled for separation from the service were required to serve until the end of the conflict. In another instance, an enlisted man, Perry Watkins, repeatedly told the military that he was gay, but they kept reenlisting him until someone finally decided that he should be separated from the service, and the legal process to do so was instituted (Shilts, 1993).
In 1994, the military instituted a policy called “Don’t ask, Don’t tell,” in which recruits were no longer to be asked if they had “homosexual tendencies,” but were also forbidden from telling anyone if they were homoerotic. Prior to this, the official policy being enforced was one in which activity was not a requirement for dismissal; simply acknowledging one’s homoerotic orientation was enough to cause separation from the service. For example, Joseph Stephan, a midshipman at the United States Naval Academy, was only three months from graduation when he was asked if he was a homosexual. He indicated that he was, but never was asked, nor did he ever acknowledge any homosexual activity. He was separated from the navy and was denied his bachelor’s degree from the Naval Academy (Rotello 1996; Eskridge 1996; Shilts 1993; Sullivan 1996).
Lesbians and gays have to pay special attention to wills, as biological families have successfully contested wills that left nothing to the blood relatives and everything to the person’s life partner. This situation has led to the development of agencies and books focusing specifically on estate planning for lesbian and gay couples and individuals.
The legal issues for bisexuals generally focus on that part of their lives that includes someone of the same gender, so it is the homoerotic aspect of their ambieroticism that suffers from the lack of legal protection. Additionally, there is no legal option for triangular relationships that provides legitimacy, so if a bisexual person has a primary relationship simultaneously with a man and a woman, that relationship cannot be legitimized as a marriage.
With the removal of homosexuality from the category of mental illness in 1973, the major foundation for legal discrimination against homosexuality was removed. As a result, religious intolerance of homosexuality, which had always been present, took on a more significant role in the debate on homosexuality within American social and political dialogue. Those who believe homosexuality to be immoral on religious grounds have since become more vocal in their quest to have their particular moral positions on homosexuality and other religious and moral issues inserted into the nation’s laws (see also Section 2 of this chapter).
At the same time as Americans witnessed the radical change in the clinical view of homosexuality and the emergence of the gay-liberation movement, religious bodies in the U.S. were challenged on their stances with regard to homosexuality. Within Christian and Jewish sects, the debate generally has centered on the interpretation of sacred Biblical texts (Boswell 1980; Countryman 1988; Curran 1993; Francoeur in Gramick and Furey 1988; Gold 1992; Kosnick et al. 1977; Helminiak 1994; McNeill 1976; Presbyterian Church 1991; Thayer et al. 1987). The central locus of the debate is concerned with certain Old Testament texts, particularly the story of Sodom and Gomorrah, and the New Testament comments of the Apostle Paul in 1 Corinthians 6:9 and I Timothy 1:9-10 (Helminiak 1994), which appear to condemn homosexuality. In actuality, the debate is waged on the basis of how ancient texts are interpreted and used for modern guidance. Many “fundamentalist” and traditional sects accept the ancient texts for their literal meaning and condemn all homosexual expression (Presbyterian Church, Part 2, 1991). These sects, however, generally do not address the extent to which they completely ignore many other Biblical texts and do not use them for modern guidance. Other, liberal, bodies interpret the ancient texts in their historical context in the light of current biological and psychological knowledge about the origins and nature of homosexual and other orientations. These bodies, particularly liberal reformed - and to some extent conservative - Judaism, the Episcopal Church, and the United Church of Christ, frequently welcome homosexual men and women to membership, and even to the ministry (Heyward 1989; Presbyterian Church 1991; Thayer 1987). Within the Catholic Church in America, there is a quite-visible split that, on the grassroots level, constitutes a silent schism on the issue of homosexuality. On the pastoral level, many, perhaps a majority of the clergy, accept the tolerant and liberal position expressed by the Catholic Theological Society of America (Kosnick et al. 1977), and quietly ignore the dogmatic condemnation of homosexuality by the Vatican (Curran 1993; Francoeur in Gramick and Furey 1988; McNeill 1976).
Among American religious bodies, the major continuing issues regarding homosexuality center on welcome, support, and affirmation of members within congregations and on the presence of openly gay and lesbian persons in religious leadership. Recently, support for gay and lesbian members has often led to performing “holy unions” for gay and lesbian partners. Given that the legal option of marriage has not been available, religious bodies have been the logical place for couples to seek such recognition and support. Many congregations have offered these services to both their members and to gay and lesbian persons in their communities. Although there are gays and lesbians in leadership in some religious bodies, they are few and often do not receive the support of predominantly heterosexual congregations. The one religious place where gay and lesbian persons have found a guaranteed welcome has been in the special ministries that exist for gay and lesbian persons. This includes a variety of individual denominations and individual congregations with a special outreach to gay and lesbian persons.
The growing visibility of homosexuals in American society and the scrutiny of the press probing the private lives of public figures have led some politicians to acknowledge publicly their homoerotic orientation. In 1980, Robert E. Bauman, a leading conservative Republican Congressman from Maryland, lost his bid for reelection after revealing his homoerotic orientation. About the same time, Congressman Gerry E. Studds from Massachusetts revealed his homoeroticism and he served in the House of Representatives until 1996. Elaine Noble was the first openly lesbian legislator in the state of Massachusetts. On the federal level, Representative Barney Frank, also from Massachusetts, disclosed his homoerotic orientation in 1987, and also continues to serve. In 1994, President Bill Clinton named Roberta Achtenberg as his highest-ranking lesbian appointee, and she was confirmed by the Congress as assistant secretary for fair housing and equal opportunity in the Department of Housing and Urban Development. In 1995, she announced that she was leaving that post to run for mayor of San Francisco.
Thanks to the political and educational activism of a wide variety of gay and lesbian individuals and groups, American society is becoming increasingly sensitized to the prevailing discrimination of heterosexism and homophobia. On the negative side, there has been an apparent increase in violence against people perceived to be homosexual. Studies have indicated increases in the reporting of violent crimes that are based on the perceived homosexuality of the victim, and students have reported witnessing harassment of students and teachers thought to be homosexual. In some instances, the growing hostility is purported to be linked with fear and anxiety about AIDS, but lesbian and gay leaders suggest that this is simply a convenient new excuse to further hate and discrimination. Lesbians, gays, and bisexuals see themselves as the last large minority that is not legally protected from discrimination, and thus, as a group, they fulfill the need of some people to find scapegoats for whatever social ills occur. The other negative aspect of this increased visibility is that it causes the opposition to become aggressive. Observing the progress made by lesbians and gays in attempting to obtain equal rights, those opposed have taken a proactive approach in attempting to limit the rights and opportunities for lesbians and gays to enjoy a full and unrestricted life. This has taken many forms, including the development and dissemination of a video filled with partial truths and false information designed to arouse fear of and hatred toward homoerotic individuals and groups. There have also been referendums on ballots to deny homosexuals equal protection. While some of these have been passed in several jurisdictions, some of them have subsequently been declared unconstitutional by state and federal courts. That has not deterred others from developing similar referendums. In September 1996, Congress voted to deny Federal benefits to married people of the same sex and to permit states to ignore such marriages sanctioned in other states. A separate bill that would have banned for the first time discrimination against homosexuals in the workplace was defeated by a single vote.
On the positive side, openly gay or lesbian people have been elected to almost every level of government, with the exception of the executive branch of the state and federal governments (governors and the president and vice president). Voters in several jurisdictions have enacted legislation to protect the civil rights of lesbians and gays. The amount of literature and published research on lesbian and gay issues has increased exponentially in recent years, and the arts have moved to include lesbian, gay, and bisexual subjects in other than classically stereotypic and tragic roles. Research and commentary regarding gay, lesbian, and bisexual issues in the academic disciplines has become acceptable, and the result has been a concomitant exponential increase in published works in all the academic disciplines. There are even a few departments in universities specifically devoted to studies of lesbian, gay, and bisexual issues. In all the arts and literature, there are more and more instances of openly lesbian and gay themes, stories, and characters. And there are more openly gay, lesbian, and bisexual people in professional and amateur sports (such as Martina Navratilova in tennis, and Greg Louganis, the Olympic multiple-gold-medal diver), and in commerce (billionaire David Geffan).
Some people who are known privately but widely to be lesbian or gay are challenged by the gay and lesbian communities to be open. On occasion they are “outed,” that is, they are publicly announced to be lesbian or gay. Whether this is appropriate and ethical, given the extent of the homophobia in the culture, is a question. Originally, this practice was instituted only in cases where a person was widely known to be homoerotic and was not only keeping that information secret, but also was engaging in antihomosexual activity, such as gay public officials supporting antigay, antilesbian legislation. It later developed into a more-general application of “outing,” which many have questioned and challenged.
One of the major problems for lesbian, gay, and bisexual adolescents is the lack of positive role models available in the homophobic, heterosexist culture. This lack contributes to the lowered self-esteem of lesbian and gay youth. The increased visibility of lesbian women and gay men throughout all levels of the society means that younger lesbians and gays are able to see others of identical orientation who have succeeded in whatever their chosen career. This has a positive effect on ego and the development of self-image.
Gay and lesbian people have been at the forefront of defining operative, nontraditional, nonbiological family concepts. Although this may have grown from the difficulties of association with biological families and the impracticality of the “heterosexual husband-wife with children” relationship model, it has resulted in the active development and maintenance of alternative family structures of great depth and commitment that have subsequently provided an alternative model for the heterosexual society. This includes not only nonmarital couples and their children, but also committed long-standing friendship circles that constitute a chosen extended family, a set of associations often with stronger bonds than those that may exist through the unchosen avenue of blood relatives.
The depth and extent of these intentional relationships have become dramatically evident in the caring provided to those within such networks in the HIV/AIDS epidemic. The depth and extent of this caring has provided incontrovertible evidence of the wholesomeness and loving nature of these associations, and has significantly challenged the remainder of society.
The social, familial, and internalized heterosexist homophobia sometimes creates a situation in which the lesbian or gay man sees heterosexual marriage as the only public option for life. They may or may not include secret homosexual activity while married. With the increased visibility of lesbians, gays, and bisexuals, this pattern of behavior is less likely to occur without conscious awareness and dissonance on the part of both marital partners. Sometimes, but rarely, the only way a gay man or lesbian can cope successfully with the social pressures is to find a homoerotic person of the other gender to agree to a “marriage of convenience,” in which they might live as roommates and have separate sexual lives.
Some lesbians and gay men choose to have children. Women have the option of childbearing through the medically established procedure of donor insemination available in this country, or they can, and sometimes do, seek and find a man who will biologically impregnate them. Men obviously do not have this option. Therefore, the issues for lesbians who want a child are different from those for a gay man who wants one. In keeping with the resourcefulness and creativity of many lesbians and gay men, there are many patterns that have been developed to achieve biological parenthood.
Support organizations for the heterosexual relatives of homoerotic individuals have formed and become available. Most notable is the organization Parents and Friends of Lesbians and Gays, (PFLAG), with headquarters in Washington, D.C. and groups throughout the United States. Where there are lesbian and gay community centers, usually one finds programs for children of lesbian and gay parents, such as The Center Kids, a program at the Lesbian and Gay Community Center in New York City. These centers also usually have support groups and education sessions for the biological families of lesbians and gays, as well as for the chosen families.
American lesbian women and gay men have many of the same health issues as their heteroerotic counterparts, but there are some issues that are unique, including the fact that the assumption of heterosexuality for individuals in the culture in general continues into the sphere of the health-care consumer. When the health-care professional is taking a history and asks, “Are you married or single or divorced?” there is little room for the lesbian or gay individual to indicate that she or he is in a long-term relationship with another person. And if the person is bisexually active, the answer to that question could be very misleading to the professional who should be concerned with whatever may impact the patient’s health.
Lesbian women and gay men also have to interact with hospitals and other health-care facilities that often do not recognize the rights of a nonmarital partner to determine the course of treatment or to visit in an intensive-care unit unless they have obtained either a power of attorney or have officially been designated as a “health-care proxy.”
Although lesbians have the lowest rates of sexually transmitted diseases of any orientation group, they also have some special concerns that would not apply to heteroerotic women, but would apply to bisexual women. Those issues are related to the fact that this person is sexually active with another woman. There is some debate concerning whether lesbians who are not sexually active with a man should have a Pap smear as often as a woman who is sexually active with a man. Additionally, if a patient tells the health-care professional that she is a lesbian, the assumption is then made that she is not being sexually active with a man. This assumption should always be checked, because it is not necessarily true. A comprehensive sex history is needed to avoid incorrect assumptions, but is seldom done.
Gay men, on the other hand, have a high rate of sexually transmitted diseases. Prior to the 1980s, there was no major push for these men to wear condoms to prevent STDs, because most of the diseases could be cured by medical intervention. However, with the advent of HIV/AIDS, that situation changed, and the increased use of condoms in this population has significantly decreased the incidence of other STDs. The high frequency of sexual activity in many gay men means that their health care needs include concerns for the many diseases that can be transmitted sexually - and a comprehensive sex history is mandatory if the professional is to provide appropriate health care.
In the early 1980s, what we now know as AIDS was called GRID, Gay Related Immunodeficiency Disease, and it was believed that gay men were the only people who had it. While that has changed, the largest percentage of cases of AIDS in the United States continues to be among gay men, and part of gay-male identity is now referenced to HIV status, i.e., whether he is HIV-positive or HIV-negative. There is some concern about the effect that this has on one’s psychological health, with some people questioning the acceptance of that reference to “Gay Related” when the infectious potential of HIV is not influenced by a person’s sexual orientation.
Additionally, gay men have been likened in a psychological manner to Vietnam veterans in that both have experienced the death of many people with whom close bonds had been established. There has been a suggestion that many gay men, particularly in the regions of the country that are hardest hit by the HIV/AIDS epidemic, are suffering from post-traumatic stress disorder, and are in need of psychological treatment. Those lesbians who are very involved in the care of and are friends of HIV-positive gay men, are also experiencing trauma associated with multiple bereavement.
Another group that is receiving little attention in this epidemic are those gay men who are HIV-negative, who have lost partners to AIDS, and who are having to deal with survivor guilt and associated issues. Many of these men must also cope with the very strong feelings of pleasure that were associated with sexual activity before HIV became a threat. These men are at great risk for HIV infection; yet in the mid-1990s, the public-health focus has turned to women and children at risk, generally ignoring gay men.
Very little is known about sexuality and aging among the estimated 3.5 million American men and women over age 60 who are homosexual. For gay men and lesbians, aging can create unique conflicts and problems. The death of a partner in a long-term relationship may bring out homophobic reactions among family members that lead these relatives to ignore the bereaved partner or contest a will and estate. Gay men and lesbians who decide to acknowledge their orientation after years of passing as heterosexual face the possibility of quite different outcomes when loved ones, children, and grandchildren, learn of their relative’s sexual orientation. Gay men, who are fearful that their orientation will be discovered as it becomes evident they are not going to marry, may adopt a loner life with relatively little sexual and social intimacy. Lesbian couples have to cope with two female incomes, which would usually be lower than most dual-career gay male or heterosexual couples (Friend 1987).
By necessity, gay men and lesbians develop skills in coping and crisis management, which give them an advantage in the aging process. More-flexible gender roles may allow older homosexuals to take aging more in stride and develop ways of taking care of themselves that seem comfortable and appropriate. “These skills may not be developed to the same degree among heterosexual men or women, who may be used to having or expecting a wife or husband to look after them” (Friend 1987, 311). Gay people tend to plan ahead for their own independence and security, whereas heterosexuals are more likely to assume that their children will take care of them in their old age. Homosexual men and women have significantly more close friends who serve as a “surrogate family” than do heterosexuals. In larger urban areas, organizations like Senior Action in a Gay Environment (SAGE) provide a variety of social and support services for older homosexuals.
Gay Men, Lesbian Women, and Bisexuals - Comparisons
Because gay men are socialized as males and generally perceive themselves as males, their socialization process is somewhat different from that of lesbian women, who are socialized as females and generally perceive themselves as being female. This means that, from a general perspective, just as there are differences in male and female socialization, there are differences between lesbians and gay men, as well as differences among them. For example, in general analyses of gay and lesbian relationships, one difference often noted between the two is the role of sexual activity and sexual exclusivity. Generally, lesbian relationships are sexually exclusive and gay male relationships are not. This appears to be especially true of long-term relationships, and can be explained by the differences in socialization of women and men around sexual activity issues.
When gay men and lesbian women join together to form groups working toward a common goal, sometimes there are issues of power differentials and attitudes toward sexual activity that prevent the original goals from being reached by dividing the group along gender lines. Again, this can be explained by the differential socialization process.
It was not until the late 1980s that people identified as bisexual were welcomed into what were previously lesbian and gay organizations, and they are still viewed with caution in many circles. Bisexuals are sometimes accused by heterosexual people of being gay or lesbian and are labeled homophobic and fake by some homoerotic people. There are few bisexual support groups, most of them in large cities. The United States is only just beginning to attempt to understand the bisexual phenomenon.
The ambivalence about bisexuality is reflected in the history of the concept. For several years after the terms homosexuality and heterosexuality were coined in the late 1800s, bisexuality was largely ignored by the physicians and sex researchers who had newly medicalized sex. Sigmund Freud, with his theory of sexual development borrowed from Darwinian evolutionary models, helped to change that. By the 1920s, when Wilhelm Stekel wrote Bi-Sexual Love, the erotic capacity to desire both males and females could be envisioned as universal, if likely to be outgrown by adulthood. Havelock Ellis, by contrast, viewed bisexuality as a distinct sexual-orientation category, comparable to both homo- and heterosexuality.
Alfred Kinsey (1948, 1953) conceptualized bisexuality not in evolutionary terms, as the Freudians tended to do, but in simple behavioral terms. In his sexual-orientation scale, bisexuality was represented on a continuum between exclusive heterosexuality (the 0 end of Kinsey’s scale) and exclusive homosexuality (at 6), with a Kinsey 3 equally attracted to or having had sexual experience with males and females.
Since most humans experience their erotic desires and relationships in a social context, many (perhaps most) bisexuals have more sexual experience with one or the other gender, depending upon whether their social affiliations tend to be mostly heterosexual or homosexual. Indeed, researchers have noted that many people who have displayed “bisexual” behavior over the lifespan - that is, people who have had sexual experience with both males and females - tend to identify sexually according to the gender of their current partner (Blumstein and Schwartz 1983). This is reported as especially true of women. When the current partner is female, women are more likely to identify themselves as lesbian, and when the current partner is male, as heterosexual. Factors such as political or social affiliation can also lead an individual to - or away from - a bisexual identity.
One common stereotype about bisexuals suggests a person is not “really” bisexual unless he or she is a Kinsey 3. This is related to the presumption that the individual is “really” homosexual but hiding behind a heterosexual relationship. The notion that all, or most, people are “really” homosexual or heterosexual has been termed “monosexuality.” Monosexuals are individuals who desire members of only one gender, whereas bisexuals desire both. The term was apparently first used to describe hetero- and homosexuals by Stekel (1922). Today this term has gained new currency in the American bisexual community as bisexuals seek to understand and combat the sources of stereotyping and social opprobrium they term “biphobia” (Hutchins and Kaahumanu 1991). Expressions of biphobia encompass caustic dismissals, such as Bergler’s (1956) “Nobody can dance at two different weddings at the same time”; difficult relations between bisexual women and some lesbians (Weise 1992); and media-fed concerns that bisexual men are “spreading AIDS” into the heterosexual population. (The latter concern ignores the possibility that bisexual men can be as responsible about safe-sex practices as anyone else, that heterosexuals may also contract HIV from other heterosexuals, and that bisexual men may choose to live monogamous lives with female - or male - partners.)
Until recently, American bisexuals had few sources of support for their sexuality unless they derived it from the gay community - which has been far from uniformly supportive. In fact, it should be noted that many gays deny the reality and/or possibility of bisexuality. In the 1970s, a few support groups for bisexuals were formed; the best known of these was San Francisco’s Bisexual Center. By the late 1980s, groups and organizations had emerged that aimed specifically to develop a supportive bisexual community; at the time of this writing, these are extensively networked and are producing their own publications and conferences.
Due to insufficient support, the influence of negative and alienating stereotypes, and the apparent fact that many bisexuals have lived as lesbians, gay men, or heterosexuals, it has been difficult to estimate what percentage of the population is, or has been, bisexual. It is probable that many more people have bisexual histories than would answer affirmatively to a survey researcher asking “Are you bisexual?” Too, many researchers have conflated or collapsed homosexuality and bisexuality (for a recent example, see Laumann et al. 1994), a further indication that many still consider one a variant of the other.
To stress the multidimensional nature of sexuality, Fred Klein (1985) developed his Sexual Orientation Grid, which expands Kinsey’s concept of the continuum. He considers not only experience and desire, but also dreams, fantasies, social networks, relationships, ideal sexual orientation, and other variables. Additionally, Klein breaks the scale into temporal units (adolescence; early adulthood; present) so it can better reflect changes in behavior and sexual identity over the lifespan. Coleman (1987) has also developed a scale that takes factors like these into account and that serves as a clinical interview tool. Researchers using these scales, as well as Kinsey’s, find that, although some display continuity of sexual identity over the lifespan, other individuals change identity over time. Many rate themselves near the middle of the Kinsey scale when asked their ideal, but report their relationships fall closer to one or the other end.
That behavior and identity are not fixed (and are sometimes not even consonant) is of special interest and relevance to researchers of bisexuality. The differences between homosexual and heterosexual may be less important and intriguing than those between monosexual and bisexual. Why, for example, is a prospective partner’s gender of primary importance to some (monosexuals) and not to others (many bisexuals)? Other researchers note that bisexuality assumes different forms in different cultures, subcultures, and individuals. Klein (1978) suggests four primary types: (1) sequential (in which an individual will alternately partner or engage in sex with only men, then only women); (2) concurrent (in which an individual partners and/or engages in sex with both genders during the same period of time); (3) historical (bisexual behavior in an individual’s past, especially adolescence); and (4) transitional (through which a heterosexual moves toward homosexuality or a homosexual moves toward heterosexuality).
Other American researchers have concentrated not on the taxonomy of bisexuality, but on the development and adjustment of bisexuals in day-today life. Some of this research has been incidental to studies done on gay and lesbian or heterosexual populations; other researchers have looked at self-identified bisexual populations. Just as estimates on the percentage of bisexuals in the population are inconclusive, so is information about what percentage of people who have a history of sexual experience with both genders defines themselves as bisexual. What differentiates those who do from those who do not is still a matter of speculation, although research into the formation of bisexual identity suggests that, at least for them, identity formation is more open-ended than linear.
A common monosexual accusation is that bisexuals are “confused.” Although this may be descriptive of some bisexuals before they find the label with which to self-identify, and some may also experience ongoing distress or uncertainty due to the dearth of societal validation (Weinberg and Williams 1994), some research has indicated that self-identified bisexuals are high in self-esteem, self-confidence, and independence of social norms (Rubenstein 1982; Twining 1983).
Much more attention has been given to bisexuals, especially males, who are heterosexually married than to those whose primary relationships are homosexual. These marriages are most successful when the partners communicate openly, the spouse is aware and accepting of the bisexual partner’s sexuality, and both partners are committed to the relationship. Especially as the bisexual community brings self-identified bisexual people together, more bisexuals are choosing to partner with other bisexuals. These relationships may be monogamous, open, polyamorous, or - much more rarely - triadic.
Bisexuals bringing issues related to their sexual identities into therapy may seek help in interpreting their attractions to both genders; other issues are isolation and alienation, fears about coming out or about nonvoluntary disclosure of their sexuality, and relationship concerns.
What bisexual community spokespeople call “bisexual invisibility” hinders many individuals from easily resolving their concerns about adopting a non-normative sexual identity. Many do not know about the existence of a community of peers. While some individuals move towards a bisexual identity after considering themselves heterosexual, others have previously been gay- or lesbian-identified. As such, diversity in the bisexual community is broad, and will undoubtedly become broader as more people gain access to its institutions.
[On March 12, 1993, the “Op-Ed” page of The New York Times carried a full-page reflection on “How Many Sexes Are There?” The March/April issue of The Sciences, published by the New York Academy of Sciences, featured an article on “The Five Sexes: Why Male and Female Are Not Enough.” These articles, by biologist Anne Fausto-Sterling, are evidence of a trend in changing definitions of gender roles over the past decade that is echoed in the appearance in 1995 of Hermaphrodites with Attitudes, a newsletter published by cross-gendered persons who endorse Fausto-Sterling’s call for the medical profession to recognize gender diversity and cease using surgery and gender reassignment to force true hermaphrodites (“herms”), female pseudohermaphrodites (“ferms”), and male pseudohermaphrodites (“merms”) into the dichotomous mold of male or female. (Editor)]
American society, with its cultural diversity, has long assumed that one’s gender perception, role, and presentation are all a function of biological anatomy, as visually ascertained at birth. This biocentric viewpoint served as the basis for looking at sexual and gender variations for both sexologists and therapists. Until the mid-1970s, many sexual and gender options were seen and diagnosed as deviations of the male/female gender dichotomy and/or as types of sexual dysfunction. Gender options, as style modes of clothing and accouterment, gender shifts, and transsexualism were viewed as diseases [sic] of the psyche. Those who chose such options were considered “gender-conflicted” and were treated on the basis of known medical or psychological modalities (Pauly 1994).
Factors contributing to the current trend of changing gender roles include the rise and powerful articulation of feminism among both women and men; the knowledge explosion in molecular biology, specifically genetics and endocrinology, artistic diversity in both the visual arts and music with their individual styles and presentations (with cinema, television, and music increasingly dealing with gender and cross-gender issues), the emergence of an articulate, vocative, and visible gay-lesbian-cross-gender “community,” and the influence of computer technology and its application in almost all sectors of American life. The impact of these factors on the daily lives of Americans - how they think, how they feel both about themselves as well as society, and how they act and present themselves to each other - has been awesome.
In this social context, there is a powerful drive to question the biocentric notion about gender being a derivative of the biomorphic nature of Homo sapiens, i.e., two sexes implies only two gender forms. This challenge to gender rigidity, in roles and presentations, is seen in many areas of American social and economic life. Women as bus drivers and heavy-equipment operators and men as nurses and secretaries represent only one aspect of the varied paradigm shift occurring in America in the nature of gender identity and its concomitant behaviors. Instead of a two-sexes/two-genders model, one needs a model of two or more sexes and many genders. This gives rise to a sociocentric view of gender, in which one can think of gender in terms of three basic parameters: perception (Jungian constructs of anima/animus), social role (cuing, interactions, and gender-role inventories), and presentation (modes of presenting one’s self, for whom, when, motivations, etc.). A person is then seen as a composite of these three parameters, with the gender composite time-dependent and always subject to some change in one or more component over the lifespan.
The shift from focusing on individual gender conflict to looking at facets of gender diversity is evident in the “gender rainbow” paradigm suggested by gender counselors Leah Schaefer and Constance Wheeler, June Reinisch’s concept of “gender flavors,” and James Weinrich’s model of “gender landscapes” (Francoeur 1991, 100-101). In these paradigms, the notion of conflict is broadened to include gender explorations and gender clarifications and how an individual can access these avenues in their search for personal growth in a tolerant and more nurturant society. Armed with this sociocentric model of gender, one can study CD/CG (cross-dressing/cross-gender) behaviors and conflicts with a more-sensitive approach to the issues and problems of gender expression in an ethnoculturally diverse American society.
Traditionally, the terms “transvestite” (TV) and “transsexual” (TS) have been used to label individuals, mostly males, who wear apparel usually associated with the other sex, or who want to cross a gender boundary and seek anatomical congruity with the other sex. These terms are too inclusive and stigmatize the person, who may be on a gender exploration, or who sees personal gender expression as only one piece in their total personality matrix. To deal with this limitation, the following new glossary has been proposed, with the terms serving as “mileposts” on the road to gender “happiness:”
The term “transgender” indicates that a person is crossing gender boundaries usually associated with traditional gender traits of one or the other sex. Transgender, transgendered, and transgenderist are also used to indicate transcending - rising above - traditional gender forms and expressions, a usage that has gained popularity both within the paraculture, as well as in the health-care and academic professions.
The term “transsexualism” was coined by D. O. Cauldwell, an American sexologist, and popularized by Harry Benjamin in the 1950s and 1960s. Research on this phenomenon was facilitated in 1980 when the concepts of transsexualism and gender disorders were recognized in the American Psychiatric Association’s Diagnostic and Statistical Manual III. In 1988, transsexualism was defined by the DSM-III-R as having the following diagnostic criteria:
DSM-IV has replaced the term “transsexual” with the generic term “gender disorder.”
Transsexualism is estimated to affect at least 1 in 50,000 individuals over the age of 15 years, with a 1:1 male-to-female ratio. The greater visibility of male-to-female transsexuals may reflect a more-negative bias toward male homosexuality or a lack of available female-to-male treatment in a society. Whatever the real incidence, this disorder carries more social significance and impact than the actual prevalence might suggest because of the questions raised for anyone who watches and listens to transsexuals (and transvestites) in their frequent appearances on television talk shows (Pauly 1994, 591).
An individual’s perception of his or her own body, and the way she or he feels about these perceptions, are important in the clinical diagnosis of gender disorders. In 1975, Lindgren and Pauly introduced a Body Image Scale, a thirty-item list of body parts, for which the individual is asked to rate her or his feelings on a five-point scale ranging from (1) very satisfied to (5) very dissatisfied. This scale is useful in following the progress and evaluating the success of sex-reassignment treatment.
Evaluating the outcome of sex-reassignment surgery is complicated and difficult. The most recent evaluation leaves little question that the vast majority of post-operative transsexuals claim satisfaction and would pursue the same course if they had to do it again. Post-operative satisfaction ranged from 71.4 percent to 87.8 percent for post-operative male-to-female transsexuals, with only 8.1 percent to 10.3 percent expressing dissatisfaction. Among female-to-male transsexuals surveyed, 80.7 percent to 89.5 percent were satisfied with their outcome, compared with only 6.0 percent to 9.7 percent who are not satisfied. The difference between male-to-female and female-to-male satisfaction was not statistically significant (Pauly 1994, 597).
The publicit