Gender and Sexuality

The Psychology of Women and Gender: Half the Human Experience + - Nicole M. Else-Quest, Janet Shibley Hyde 2018


Gender and Sexuality

It is not coincidental that the women’s movement and the sexual revolution grew up together in the 1960s and 1970s. Historically, sex for women always meant pregnancy, which meant babies and a life devoted to motherhood. For the first time in the history of our species, because of the development of highly reliable methods of contraception, we are now able to separate sex from reproduction both in theory and in practice. In the 1970s, because of advances in contraception, women came to see themselves as free to enjoy sex without incurring a surprise pregnancy. The AIDS and herpes epidemics that began in the 1980s and 1990s have complicated the picture of sexual freedom. Nonetheless, female sexuality has been let out of the bag and shows no signs of returning.

Physiology

Much of our contemporary knowledge of female sexual physiology is due to the pioneering work of William Masters and Virginia Johnson (1966), which has been followed up by even more sophisticated research (Meston et al., 2004).

We can think of sexual response as occurring in four phases, although these stages actually flow together. The first phase is excitement. In women,1 the primary response is vasocongestion, which means that a great deal of blood flows to the blood vessels of the pelvic region. A secondary response is the contraction of various muscle fibers termed myotonia, which results, among other things, in erection of the nipples.

1 Here, again, we use women as shorthand for female-bodied persons.

Vasocongestion: An accumulation of blood in the blood vessels of a region of the body, especially the genitals; a swelling or erection results.

Myotonia: Muscle contraction.

Perhaps the most noticeable response in the excitement phase is the moistening of the vagina with lubricating fluid. This seems quite different from the most noticeable response in men, erection of the penis. In fact, the underlying physiological mechanism is the same: vasocongestion. The lubrication that appears on the walls of the vagina during sexual excitation results from fluids that have seeped from the congested blood vessels in the surrounding region, through the semipermeable membranes of the vaginal wall. The physiological underpinnings are the same in men and in women, although the observable response seems different.

In the excitement phase, a number of other changes take place, most notably in the clitoris. The clitoris, located just in front of the vagina (see Figures 12.1 and 12.2), has, like the penis, a shaft with a bulb or glans at the tip. The glans is densely packed with highly sensitive nerve endings. The clitoris is the most sexually sensitive organ in the female body. In response to further arousal, the clitoral glans swells, and the shaft increases in diameter, due to increasing vasocongestion. The clitoris is interesting because it is the only exclusively sexual organ in the human body; all the others, such as the penis, have both sexual and reproductive functions. The clitoris is purely for sexual pleasure.

The structure of the clitoris extends beyond the externally observable part (see Figure 12.3). Two crura—longer, spongy bodies—extend from the shaft and run along either side of the vagina, under the major lips (Clemente, 1987). Some refer to the entire structure as having a wishbone shape. These spongy bodies enlarge during arousal.

The vagina also responds in the excitement phase. Think of the vagina as an uninflated balloon in the unaroused state, divided into an outer third (or lower third, in a woman standing upright) and an inner two-thirds (or upper two-thirds). During the successive stages of sexual response, the inner and outer portions react in different ways. In the latter part of the excitement phase, the inner two-thirds of the vagina undergoes a dramatic expansion or ballooning (see Figure 12.4).

In the second phase of sexual response, the plateau phase, the major change is the appearance of the orgasmic platform. This refers to the outer third of the vagina, where there is a tightening of the bulbospongiosus muscle around the vaginal entrance (Figure 12.4). Whereas the upper portion of the vagina expands during excitement, the lower or outer portion narrows during the plateau phase. Therefore, if there happens to be a penis in the vagina at that point, the orgasmic platform grips it.

The other major change occurring during the plateau phase is the elevation of the clitoris. The clitoris retracts and draws into the body, but continues to respond to stimulation. A number of autonomic responses also occur, including an increase in pulse and a rise in blood pressure and in rate of breathing.

Once again, these complex changes are the result of two basic physiological processes, vasocongestion and increased myotonia or muscular tension, which occur similarly in both men and women. Readiness for orgasm occurs when these two processes have built up sufficiently.

Orgasm, the third phase of sexual response, consists of a series of rhythmic contractions of the muscles circling the vaginal entrance. Generally there is a series of 3 to 12 contractions at intervals of slightly less than a second. The onset of the subjective experience of orgasm is an initial spasm of the muscles preceding the rhythmic contractions.

Orgasm: An intense sensation that occurs at the peak of sexual arousal and is followed by the release of sexual tensions.

Figure 12.1 Female sexual and reproductive anatomy viewed from the side.

Image

Figure 12.2 The vulva, or external genitals, of the human female.

Image

Figure 12.3 Beneath the surface: structure of the clitoris.

Image

Figure 12.4 Female sexual and reproductive organs during the plateau phase of sexual response. Notice the ballooning of the upper part of the vagina, the elevation of the uterus, and the formation of the orgasmic platform.

Image

What do women’s orgasms feel like? The main feeling is an intensely pleasurable spreading sensation that begins around the clitoris and then spreads outward through the whole pelvis. There may also be sensations of falling or opening up. The woman may be able to feel the contractions of the muscles surrounding the vaginal entrance. The sensation is more intense than just a warm glow or a pleasant tingling.

In the fourth phase, or resolution phase, of sexual response, the processes of excitement are reversed. The major physiological changes are a release of muscular tensions throughout the body and a release of blood from the engorged blood vessels. In women, the breasts, which were formerly enlarged with nipples erect, return to the unaroused state. The clitoris returns to its unaroused, unretracted position and shrinks to normal size. The muscles around the vaginal entrance relax, and the ballooned upper portion of the vagina shrinks. The return of a woman to the unstimulated state may require as long as a half-hour following orgasm. If the woman reaches the plateau phase without having an orgasm, the restoration process takes longer, often as much as an hour.

Criticisms of the Masters and Johnson Model

Criticisms of Masters and Johnson’s work have been raised (e.g., Tiefer, 1991; Zilbergeld & Evans, 1980). One of the most important of these criticisms is that Masters and Johnson’s model focuses exclusively on physiological processes and ignores cognition and affect—that is, what we are thinking and feeling emotionally during sexual response. In the wake of these criticisms, researchers have proposed other models.

Alternative Models

One alternative model to address this criticism, the triphasic model, was proposed by the eminent sex therapist Helen Singer Kaplan (1979). According to her, there are three components to sexual response: sexual desire, vasocongestion, and the muscle contractions of orgasm. The vasocongestion and orgasm components are consistent with Masters and Johnson; the new component is sexual desire, which refers to an interest in or motivation to engage in sexual activity. Without this psychological component of desire, sexual activity is not apt to take place, or if it does, it is less likely to be pleasurable. The desire component is also important in understanding some sexual disorders (discussed later in this chapter).

Triphasic model: A model that there are three components to sexual response: sexual desire, vasocongestion, and myotonia.

John Bancroft, Erick Janssen, and their colleagues have introduced a dual control model of sexual response (Bancroft et al., 2009). The model proposes that two basic processes underlie human sexual response: excitation (responding with arousal to sexual stimuli) and inhibition (inhibiting sexual arousal). These researchers argue that almost all sex research has focused on the excitation component, which is true of the Masters and Johnson model. The dual control model asserts that the inhibition component is equally important to understand. Inhibition of sexual response is adaptive across species; sexual arousal can be a powerful distraction that could become disadvantageous or even dangerous in certain situations.

Dual control model: A model that two basic processes underlie human sexual response: excitation and inhibition.

According to the dual control model, people vary widely in the strength of their tendencies toward sexual excitation and inhibition. Most people fall in the moderate range on both and function well. At the extremes, however, problems can occur. People who are very high on excitation and low on inhibition may engage in risky sexual behaviors. People who are very high on inhibition and low on excitation may be more likely to develop problems such as a disorder of sexual desire (discussed later in this chapter).

Researchers have developed scales to measure individuals’ tendencies toward sexual excitation and sexual inhibition (Graham et al., 2006). Examples of excitation items include the following:

· When I think of a very attractive person, I easily become aroused.

· When a sexually attractive stranger accidentally touches me, I easily become aroused.

The following are examples of inhibition items (female version):

· I need my clitoris to be stimulated to continue feeling aroused.

· If I am masturbating on my own and I realize someone is likely to come into the room at any moment, I will lose my sexual arousal.

The dual control model recognizes that, although excitation and inhibition both have biological bases, early learning and culture are critical factors because they determine which stimuli the individual will find exciting and which will set off sexual inhibition. Most heterosexual men in our culture, for example, have been exposed to pornography, which shapes their idea of the type of female body that should be arousing (Dines, 2010).

Wouldn’t evolution have selected purely for sexual excitation? It is the engine that drives reproduction and the passing of one’s genes to the next generation. Why would inhibition exist? According to the dual control model, inhibition is highly functional in some situations. First, sexual activity in certain situations would be downright dangerous—say, when a predator is about to attack. Second, sometimes the environment is not conducive to reproduction and it is adaptive to wait for a better day or a better season. For example, in conditions of drought and famine, women’s fertility is usually sharply reduced because any baby born would likely die, and the mother might die as well in the attempt to provide food. Inhibiting sexual response and waiting until conditions improve would be the best strategy.

Research typically shows gender differences, with men scoring somewhat higher on sexual excitation and women somewhat higher on sexual inhibition (Bancroft et al., 2009).

Clitoral and Vaginal Orgasm

Freud believed that women can experience two different kinds of orgasm: clitoral and vaginal. According to his view, little girls learn to achieve orgasm through stimulation of the clitoris during masturbation. However, in adulthood they have to learn to transfer the focus of their sexual response from the clitoris to the vagina and to orgasm from penis-in-vagina intercourse. Because some women fail to make this transfer, they can experience only clitoral orgasm and are therefore “vaginally frigid.” Freud thought that the only mature female orgasm was vaginal.

Masters and Johnson dispelled this myth by showing convincingly that, physiologically, there is only one kind of orgasm. The major response is the contraction of the orgasmic platform. That is, physiologically an orgasm is the same whether it results from clitoral stimulation or from vaginal stimulation. Some women are even able to have orgasms through breast stimulation—and the physiological response is identical to that occurring from vaginal intercourse (Masters & Johnson, 1966).

Multiple Orgasms

Traditionally, it was thought that women, like men, experience only one orgasm, followed by a refractory period of minutes or even hours when they are not capable of arousal and orgasm. Research shows that this is not true and that in fact women can have multiple orgasms. Alfred Kinsey and his colleagues (1953) discovered this more than half a century ago, reporting that 14% of the women they interviewed experienced multiple orgasms. The scientific establishment dismissed these reports as unbelievable, however.

Observations from the Masters and Johnson laboratory provided convincing evidence that women do indeed experience multiple orgasms within a short time period. Moreover, these multiple orgasms do not differ from single ones in any significant way except that there are several. They are not minor experiences.

Physiologically, after an orgasm, the vaginal region loses its engorgement of blood. However, in women, but not in men, this process is immediately reversible. That is, under continued or renewed erotic stimulation, the region again becomes engorged, the orgasmic platform appears, and another orgasm is initiated. This is the physiological mechanism that makes multiple orgasms possible in women.

Most frequently, multiple orgasms occur through masturbation rather than vaginal intercourse, because it is difficult for a man to postpone his orgasm for such long periods. As Natalie Angier (1999) put it, regarding the clitoris, penis, and multiple orgasms, “Who would want a shotgun when you can have a semiautomatic?” (p. 58).

Sexuality and Aging

It is a popular belief that a woman’s sexual desire is virtually gone by the time she is 60 or so, and perhaps ceases at menopause. Some people believe that sexual activity is a drain on their health and physical resources, and they deliberately stop all sexual activity in middle age to prevent or postpone aging. These, too, are myths that research has exploded.

A major survey of people over 50, conducted by the American Association of Retired Persons (1999), found that 24% of the women between 60 and 74 had sexual intercourse at least once a week. That declined to 7% for women over 75, but about 80% of them had no sexual partner, so the problem is mainly one of lack of a partner.

It is true that certain physiological changes occur as women age that influence sexual activity. The ovaries sharply reduce their production of estrogen at menopause, causing the vagina to lose much of its resiliency, and the amount of lubrication is substantially reduced. Use of lubricants can be helpful. Sexual functioning depends much more on the opportunity for regular, active sexual expression and physical and mental health than it does on hormone levels (Masters & Johnson, 1966).

A study of healthy women in their 60s, all with a male partner, found differences between those who were sexually active and those who were not (Bachmann & Leiblum, 1991). Those who were sexually active reported intercourse an average of five times per month. A pelvic exam by a physician who was unaware of which women were sexually active found less atrophy of the genitals in the women who were sexually active. If you don’t use it, you lose it.

The G-Spot

The G-spot (short for Gräfenberg spot, named for a German obstetrician-gynecologist who originally discovered it in 1944, although his work was overlooked) is the popularized term for the Skene’s gland or paraurethral gland. It lies between the wall of the urethra and the wall of the vagina (Zaviačič et al., 2000). Its ducts empty into the urethra, but the gland itself can be felt on the front wall of the vagina. Anatomically, it is the female prostate (see Figure 12.1). It may be that some women have a G-spot and others do not; a study using MRI scans identified a female prostate in six of the seven women studied (Wimpissinger et al., 2009).

G-spot (Gräfenberg spot): A small gland on the front wall of the vagina, emptying into the urethra, which may be responsible for female ejaculation.

There are two reasons that the G-spot is important. First, the researchers who have investigated it believe it is the source of female ejaculation (Addiego at al., 1981; Belzer, 1981; Ladas et al., 1982; Perry & Whipple, 1981). Traditionally, it was thought that men ejaculate and women don’t. However, sex researchers John Perry and Beverly Whipple (1981) discovered fluid spurting out of the urethra of some women during orgasm. According to one study, the fluid is chemically similar to the seminal fluid of men, but contains no sperm. Perry and Whipple estimated that 10% to 20% of women ejaculate during orgasm. This is an important discovery, because given the old wisdom that women don’t ejaculate, many women who did ejaculate suffered extreme embarrassment and anxiety, thinking they were urinating during sex.

There is a second reason that the G-spot might be important. Based on its discovery, Perry and Whipple theorized that there is a uterine orgasm. They believe that there are two kinds of orgasm: vulvar (the kind studied by Masters and Johnson, produced by clitoral stimulation and named for the vulva, or external genitals, of the female) and uterine (felt more deeply and produced by stimulation of the G-spot). This sounds like the old argument about clitoral versus vaginal orgasm, and certainly we should withhold judgment on the uterine orgasm until there can be independent replication by other scientists.

Psychological Aspects of Gender and Sexuality

Gender Differences in Sexuality

It is a traditional stereotype in our culture that female sexuality and male sexuality are quite different. Women were reputed to be uninterested in sex and slow to arouse. Men, in contrast, were supposed to be constantly aroused. What is the scientific evidence on gender differences in sexuality?

Jennifer Petersen and Janet Hyde (2010) conducted a meta-analysis of studies reporting data on gender differences in sexuality. Two gender differences were substantial: the incidence of masturbation and attitudes about casual sex. Women are less likely to have masturbated than men are (d = 0.53), and women are less approving of sex in a casual or uncommitted relationship than men are (d = 0.45). Notice that the sizes of these gender differences, 0.53 and 0.45, are large compared with some of the other gender differences we have examined, such as gender differences in abilities (see Chapter 8).

Let’s first consider the gender difference in masturbation. Kinsey, based on his massive survey conducted in the 1940s, found that 92% of the men in his sample reported having masturbated to orgasm at least once in their lives, compared with 58% of the women (Kinsey et al., 1953). More recent surveys have found percentages very close to those (Laumann et al., 1994). That is, this gender difference doesn’t seem to have disappeared in recent years with the sexual revolution.

One question we must ask, however, is whether this is a real gender difference or just an inaccuracy resulting from the use of self-reports. In our culture, particularly in previous decades, more restrictions have been placed on female sexuality than on male sexuality. It might be that these restrictions have discouraged girls and women from ever masturbating. On the other hand, they might simply lead women not to report masturbating. That is, perhaps women do masturbate but are simply more reticent to report it on a sex survey than men are. We tend not to believe this argument. On today’s sex surveys, women report all kinds of intimate behaviors, such as fellatio and cunnilingus. More of them report having engaged in fellatio and cunnilingus than report having masturbated. It is hard to believe that these women honestly report about oral-genital sex and suddenly get bashful and lie about masturbation.

Another substantial gender difference was in attitudes about casual sex, such as sex in a “one night stand,” d = 0.45 (Petersen & Hyde, 2010). Men are more approving and women are more disapproving. In one well-sampled national study, 76% of White women, but only 53% of White men, said that they would have sex with someone only if they were in love (Mahay et al., 2001). This gender difference is consistent across U.S. ethnic groups: The comparable statistics were 77% for Black women and 43% for Black men, 78% for Mexican American women and 57% for Mexican American men. This gender difference can be a source of great conflict between women and men.

Consistent with their attitudes about casual sex, men report a larger number of sex partners than women report. Once again, though, it is important to remember that these data are based on self-reports, which can sometimes be inaccurate. It could be that men and women actually have roughly the same number of sex partners, but men exaggerate their number and/or women underreport their number.

A clever study used the bogus pipeline method to test this possibility (Alexander & Fisher, 2003; see also Jonason & Fisher, 2009). College students were brought to the lab to fill out questionnaires about their sexual attitudes and behaviors. They were randomly assigned to one of three experimental conditions. In the bogus pipeline condition, the student was hooked up to a fake polygraph (lie detector machine) and told that the machine could detect false answers. People should respond very honestly in this condition. In the anonymous condition, the student simply filled out the questionnaire anonymously, as is typical of much sex research, and placed the questionnaire in a locked box when finished. In the exposure threat condition, respondents had to hand their completed questionnaires directly to the experimenter, who was an undergraduate peer, and the experimenter sat in full view while the respondents completed their questionnaires, serving as a reminder that this other person would easily be able to see their answers. Figure 12.5 shows the results for reports of the number of sexual partners the respondent had had.

Figure 12.5 Number of sex partners reported by men and women in the bogus pipeline study.

Image

Source: Based on data from Alexander, Michele G., & Fisher, Terri D. (2003). Truth and consequences: Using the bogus pipeline to examine sex differences in self-reported sexuality. Journal of Sex Research, 40, 27—35. Figure created by Janet Hyde.

In the anonymous condition and the exposure threat condition, the usual gender difference appeared, with men reporting more partners than women did. The fascinating result is that, in the bogus pipeline condition, when people were presumably being most truthful, there was no significant gender difference in the number of sexual partners reported. The other interesting point in Figure 12.5 is that men’s reports of number of partners did not vary significantly with experimental condition. It was women’s reports that varied. The implication is that men feel free to report their number of partners regardless of whether others will find out. Women, in contrast, underreport their number when it may become known. This finding is powerful evidence of the ways in which women believe that the culture tells them to suppress their sexuality.

Another stereotype is that a gender difference exists in interest in and arousal to erotic materials, men being much more interested in and responsive to them than women are. Is there any scientific evidence that this is accurate?

The Petersen and Hyde (2010) meta-analysis found that reported use of pornography was one of the largest gender differences (d = 0.63), with men engaging in the behavior more than women. A meta-analysis of laboratory studies on gender differences in arousal to erotic materials found that men are more aroused, but the difference is not large, d = 0.31 (Murnen & Stockton, 1997). Interestingly, the difference was largest among college students (d = 0.38) but was nonexistent among adults beyond the college years (d = —0.04). This finding points to the importance of looking at changing patterns of gender differences in sexuality across the lifespan.

An interesting study by Meredith Chivers and colleagues provides insight into the responses of women and men to erotic materials (Chivers et al., 2007; for a meta-analysis of similar research, see Chivers et al., 2010). Participants were heterosexual and lesbian women, and heterosexual and gay men. They watched a series of 90-second video clips from seven stimulus categories: control (landscapes), nonhuman sexual activity (bonobos), female nonsexual activity (nude exercise), male nonsexual activity (nude exercise), female—female sexual expression, male—male sexual expression, and female—male sexual expression. The researchers not only obtained people’s self-ratings of their arousal during each segment, but also got objective measures of their physiological levels of arousal. To do this, they used two instruments: a penile strain gauge and a photoplethysmograph. The penile strain gauge is used to obtain a physiological measure of arousal in men; it is a flexible loop that fits around the base of the penis and measures its circumference. The photoplethysmograph measures physiological arousal in women; it is an acrylic cylinder that is placed just inside the vagina. Both instruments measure vasocongestion in the genitals, which is the major physiological response during sexual arousal.

Several interesting findings emerged from this study.

1. For both men and women, genital responses were strongest for partnered sexual activity.

2. Actor gender was more important for men than it was for women. That is, heterosexual men were turned on by heterosexual sex and women’s sex, and gay men were turned on by sex between men. However, for women, the gender of the actors made less of a difference. Many studies have found this effect, that women respond to a wider range of stimuli, regardless of gender.

3. The correlations between physiological measures of arousal and self-report of arousal were larger for men than for women. This means that women are sometimes unaware that they are physiologically turned on.

In sum, then, this research indicates that men and women are similar in their responses to erotic materials, except that women are less particular about the gender of the actors. The research also indicates that women can sometimes be unaware of their own physical arousal.

An additional gender difference in sexuality is found in orgasm consistency. According to one major survey, 91% of men but only 64% of women had an orgasm during their most recent sexual encounter (Herbenick et al., 2010). The gap is narrower for orgasm consistency during masturbation, but even here men seem to be more effective: 80% of men, compared with 60% of women, reported that they usually or always have an orgasm when masturbating (Laumann et al., 1994, p. 84).

Sexual Development

Sexual development in childhood and adolescence involves a complex interplay between the developing body, early experiences with masturbation, and messages from the media, parents, and peers (Hyde & DeLamater, 2017).

The earliest sexual experiences many people have are in masturbation. But as we have seen, the data indicate that substantial numbers of girls and women never masturbate, and many of those who do, do so later in life than boys and men do. This may have important consequences in other areas of sexuality as well. As one sex educator said, “I talk to so many girls where the first person to actually touch their clitoris is somebody else” (Orenstein, 2016, p. 205).

Childhood and adolescent experiences with masturbation are important early sources of learning about sexuality (Kaestle & Allen, 2011). Through these experiences we learn how our bodies respond to sexual stimulation and what the most effective techniques for stimulating our own bodies are. This learning is important to our experience of adult, two-person sex. Perhaps the women who do not masturbate, and who are thus deprived of this early learning experience, are the same ones who do not have orgasms in sexual intercourse. This is exactly what Kinsey’s data suggested: 31% of the women who had never masturbated to orgasm before marriage had not had an orgasm by the end of their first year of marriage, compared with only 13% to 16% of the women who had masturbated (Kinsey et al., 1953, p. 407). Girls’ lack of experience with masturbation in adolescence, then, may be related to their problems with having orgasms during heterosexual intercourse. And research with adult women shows that masturbation can be a source of feelings of sexual empowerment (Bowman, 2014).

Boys and girls seem to learn about masturbation in different ways. Most boys report having heard about it before trying it themselves, and a substantial number observe others doing it. Most girls, in contrast, learn to masturbate by accidental discovery of the possibility. Both boys and girls may learn about it from the media (Kaestle & Allen, 2011). And there seems to be a real double standard (see below), in which masturbation is more taboo for girls than it is for boys. As a result of these different experiences, it appears that most boys have learned to associate the genital organs with pleasure by the time of puberty, whereas many girls have not.

An illustration of the way in which masturbation can expand female sexuality is given by what one young woman student wrote in an essay:

At twelve years old, I discovered masturbation. . . . I was almost relieved to have, quite by accident, discovered the practice. This actually was one of the nicest discoveries that I’ve ever made. I feel totally comfortable with this and have actually discussed it with some of my friends. One of my favorite theories centers around this. When men have asked me to have intercourse with them and I felt that I was basically going to only serve the purpose of being an instrument to produce their orgasm, I usually tell them that I’m sure that they’d “have a better time by themselves.” Masturbation does produce a better, more controlled, orgasm for me. I’m not saying that it’s better than sexual contact with a man for me but I do think it’s more satisfying than waking up next to someone I don’t care about and feel comfortable with. I’m surprised that according to Kinsey, only 58 percent of women masturbate at some time in their lives. I thought everyone did. It’s very creative for me. I’ve tried several techniques and it certainly helps me in my sexual experiences. I know a great deal about my sexual responses and I think that in knowing myself, some of it relates to men and their sexual responses.

Experiences with masturbation—or lack of such experiences—then, may be very important in shaping female sexuality and making it different from male sexuality.

Of course, socialization forces on girls’ developing sexuality are also important. Our culture has traditionally placed tighter restrictions on women’s sexuality than it has on men’s, and vestiges of these restrictions linger today. These restrictions have acted as a damper on female sexuality, and thus they may help to explain why some women do not masturbate or do not have orgasms. In an essay, one woman student recalled one of her childhood socialization experiences:

A big part of my childhood was Catholic grammar school. The principal and teachers were nuns of the old school. . . . I remember one day the principal called all of the girls (third grade to eighth) to the auditorium. “I can’t blame the boys for lifting your skirts to see your underwear,” she scolded, “you girls wear your skirts so short it is temptation beyond their control.” I had no idea what she was talking about, but throughout school the length of our skirts was of utmost importance. Nice girls did not show their legs.

The differences in restrictions on female and male sexuality are encoded in the double standard (Crawford & Popp, 2003; Fasula et al., 2014). The double standard says, essentially, that the same sexual behavior is evaluated differently depending on whether a man or a woman engages in it (see Chapter 2). An example is casual sex, which can be a status symbol for a man but a sign of being a slut for a woman (Bogle, 2008). The media play a role in subtly maintaining the double standard. One analysis of teen girl magazines, for example, found that negative consequences of sex were associated more often with girls than with boys (Joshi et al., 2011).

Double standard: The evaluation of male behavior and female behavior according to different standards, including tolerance of male promiscuity and disapproval of female promiscuity; used specifically to refer to holding more conservative, restrictive attitudes toward female sexuality.

Sexuality is an area of ambivalence for girls and women (Orenstein, 2016; Tolman, 2002). This ambivalence results from the kind of mixed messages that they get from society. Beginning in adolescence, they are told that popularity is important for them, and being sexy—being “hot”—increases one’s popularity. But actually engaging in intercourse, especially with many partners, can lead to a loss of status. The ambivalence-producing message is “Be sexy but don’t be sexual.”

This ambivalence is writ large with media celebrities. In 2013, Miley Cyrus “twerked” (a kind of dancing with suggestive hip thrusts) on stage in a televised performance and generated enormous media coverage. For her, was that performance a display of empowerment and agency? Or was she the victim of powerful media herself? One might make either argument from a feminist point of view.

Adolescent Girls, Desire, and First Intercourse

Most discussions of teenage girls’ sexuality focus on topics such as teen pregnancy and date rape—that is, on the negatives. Missing from such discussions is any recognition that adolescent girls may actually experience sexual desire. Psychologist Michele Fine (1988) has called this the “missing discourse of desire.”

A study of 11th-grade girls, some urban and some suburban, representing multiple ethnic groups, gives us insight into these girls’ experience of sexual desire (Tolman, 2002). This study is part of a broader trend among researchers to see adolescents’ sexual experiences as a normative part of development (Tolman & McClelland, 2011). About two-thirds of the sample said that they felt desire. As they described it, the desire had a power, intensity, and urgency. It was grounded in the body, challenging beliefs that girls’ sexuality is purely relational. At the same time, the girls questioned their entitlement to their own sexual feelings.

Differences emerged between the urban and suburban girls in how they responded to feelings of desire. The urban girls expressed agency (feelings of confidence) with a goal of self-protection. They exercised self-control and caution about their body’s feelings, recognizing their own vulnerability to AIDS, pregnancy, and getting a bad reputation. The suburban girls, in contrast, expressed agency with a goal of pleasure. They were curious about sex and were less restrained by feelings of vulnerability, although cultural messages about appropriate female sexuality still exerted controls. One suburban girl expressed her complicated feelings:

I don’t like to think of myself as feeling really sexual. . . . I don’t like to think of myself as being like someone who needs to have their desires fulfilled. . . . I mean I understand that it’s wrong and that everybody has needs, but I just feel like self-conscious when I think about it, and I don’t feel self-conscious when I say that we do these things, but I feel self-conscious about saying I need this kind of a thing. (quoted in Tolman & Szalacha, 1999, p. 16)

A content analysis of teen magazines for girls in the United States (Seventeen, CosmoGirl!, and Teen) gives us some insight into the cultural factors that create these dilemmas of desire for adolescent girls (Joshi et al., 2011). Boys’ sexual desire received more attention than girls’ sexual desire, whereas sexual risks and negative consequences were portrayed more often for girls than for boys. The researchers also conducted the same analysis for comparable magazines in the Netherlands, with some differences in results. For example, in the Dutch magazines, sexual desire was portrayed as much for girls as for boys. Compared with the United States, Dutch culture is more open about sexuality and has more of a commitment to gender equality.

These national variations, too, provide evidence that cultural factors play a major role in the socialization of girls’ sexuality.

Many girls have their first experience of heterosexual intercourse during high school or the early college years. Girls tend to experience less pleasure at first intercourse than boys do. In a large sample of college students, women reported significantly less pleasure (d = 1.08) and significantly more guilt (d = —.55) about first intercourse than men did (Sprecher, 2014). On a pleasure scale ranging from 1 (not at all) to 7 (a great deal), women gave an average rating of only 3.01 for first intercourse. Despite, or perhaps because of, our culture’s romanticized version of first intercourse, adolescent girls typically find it disappointing. Nonetheless, they persist.

Hooking Up

The dating scene and casual sex now have more options—and more terminology. Hooking up is a poorly defined term—which is part of its problem—but it generally means any kind of casual sexual contact, ranging from making out to intercourse, between two people who are strangers or only casually acquainted, with no strings attached, that is, with no commitment to a future relationship (Bogle, 2008).

Hooking up: Casual sexual contact between two people, ranging from making out to intercourse.

Sociologist Kathleen Bogle (2008) conducted a qualitative study of hooking up on college campuses, interviewing students and recent alumni from two eastern U.S. universities. According to her findings, college campuses provide an ideal environment for hookup culture to flourish. There is plenty of access to same-age peers. In recent years, students have come to believe that college is a time to party and no one seems to be in a hurry to marry. Developmental psychologists note that the period of adolescence has become extended. College students do not view themselves as adults—adulthood comes a few years after college. For many, real dating and building a long-term relationship does not begin until after college.

Bogle found that a sexual double standard exists in hookup culture. Despite sexual liberation and women’s participation in hookups, women cannot have too many partners, and those who do can be ostracized and labeled “sluts.” For men, there are no rules. As the college years progress, women increasingly want a relationship because it is one way to avoid being labeled a slut, but men have less motivation to begin a relationship. Even in this very contemporary form of sexual expression, a double standard still exists.

Other studies have also found evidence of a double standard, as well as gendered power dynamics, in hookups. In one, women were more likely than men to feel judged for hooking up (Kettrey, 2016). Feeling judged was related to a sense of lack of power in the interaction. And lack of power meant that a woman might perform a sexual act just to please the man or give in to pressure for intercourse.

The Sexuality of Transgender Persons

The sexuality of transgender persons is a complex topic. Some experts like to categorize transgender people as either heterosexual or homosexual (Blanchard, 1985). The terminology is complicated, though. Let’s say we have a trans woman, whose natal gender was male and whose identity is as a woman. Is she heterosexual because she prefers female sexual partners and her natal gender was male? Or is she heterosexual because her identity is woman and she prefers male sexual partners? And why do we have to use a binary categorization of sexual orientation anyhow? To this is added the complexity of whether the person is undergoing hormonal treatments and possibly surgical interventions. Importantly, sexuality is so fundamentally about the body. Yet for so many trans persons, the body is the problem, because the sex of the body does not align with the person’s gender identity.

In one qualitative study, 25 trans men were interviewed about their sexuality (Williams et al., 2013). The men ranged in age from 20 to 65 and were ethnically diverse. All but one of them were taking testosterone. Most had had top surgery (see Chapter 11). Only two of them had had bottom surgery. For most of the men, the testosterone treatments had a big effect, both physically and psychologically. The clitoris grew considerably for them so that they could consider it more as a penis. And they developed a sense of sexual urgency that is so associated with masculinity in our culture. As one man said, “I had a pea-sized clit before I started T (testosterone) and it grew 10-fold, and now I have a dick that’s the size of a gherkin” (Williams et al., 2013, p. 726). Another man said that his sexuality had “gone through the roof. I never had an orgasm before. . . . Now I jack off two to four times a day” (Williams et al., 2013, p. 728). Yet some regretted their loss of multiple orgasms. And for those who had not had bottom surgery, the vagina could seem like an unwelcome reminder of their female body.

The researchers also found generational shifts in patterns of identity development. For the older generation of trans men, many had decided first that they were lesbian. That was an available category and identity at that time. Trans was not. Only later did they conclude that they were trans. In more recent generations, the trans identity develops earlier and first, because it is now better known to the general public.

The same research team also interviewed 25 trans women (Williams et al., 2016). Almost all of the women were on estrogen, and the majority had had cosmetic surgery so as to appear more feminine. The majority had not had bottom surgery, though. The cosmetic surgery was successful to varying degrees, depending on how masculine the person’s body type was to begin with (e.g., whether they had very broad shoulders). For most of the women, it was very important to feel sexually attractive and feminine. When they were asked what the most serious problem was for a trans person in a love relationship, the most common response was that it was being truly accepted for who they are.

The Intersection of Gender and Race in Sexuality

The topic of the intersection of gender, race, and sexuality is a large and complex one that could easily fill several books. Many historical issues are involved. For example, during the period of slavery in the United States, White masters assumed that they had the right to sexual intercourse with African American slave women. In sharp contrast, the reverse—an African American slave man having sex with a White woman—was not only forbidden but grounds for death.

Here we will focus on contemporary data collected by social scientists that allow us to compare the sexual behavior of girls and women of various ethnic groups. Some of these data are summarized in Table 12.1. The data show evidence of both differences and similarities. Among 15- to 19-year-olds, Whites, African Americans, and Latinx are about equally likely to have had heterosexual intercourse. Yet the sequence of sexual behaviors can vary by ethnic group. For example, Whites are the most likely to have oral sex before first vaginal intercourse, and African Americans are the least likely. When asked about their feelings about the first time they had sex, nearly half of both Whites and Latinx really wanted it to happen, but the percentage was much smaller for African Americans. Also striking in Table 12.1 is the fact that data on these questions were not available for Asian Americans in these well-sampled, large studies. Clearly, we need much more research on the sexuality of Asian Americans.

Earlier in the chapter we noted that girls tend to begin masturbating at later ages than boys do. When the data are broken down by ethnicity, however, it becomes clear that this statement is true for Whites but not for African Americans. On average, Black women begin masturbating at an earlier age than Black men do and considerably earlier than White women do (Belcastro, 1985). This finding is a good reminder that we shouldn’t look simply at gender differences, but should remember the intersection of gender and ethnicity.

The media portray women’s sexuality differently depending on their ethnicity. In magazine advertisements, White women’s sexuality is portrayed as submissive and dependent on men, whereas Black women’s sexuality is portrayed as independent and dominant (Baker, 2005). Asian American women have been stereotyped in the media as exotic sex toys (Reid & Bing, 2000). American Indian women and their sexuality are essentially invisible, except for some representations in the magazine Latin Girl (Sanchez-Hucles et al., 2005).

Image

Sources:

Martinez et al. (2011);

Copen et al. (2012).

NA = not available in that study.

Sexual socialization by the family can also vary by ethnic group. Asian American women, for example, report that sexuality is a taboo topic of discussion within the family (Kim, 2009). Nonetheless, Asian American parents implicitly convey their attitudes and expectations, which are conservative and restrictive about sexuality. One woman, commenting about her mother, said,

She’s very, very hush hush about it. . . . I have mostly Asian friends and we all don’t know. . . . Our moms and our parents, we just grew up never hearing. . . . I have never heard the word “sex” come out of my mom’s mouth (Amanda, Korean American, age 19). (quoted in Kim, 2009, p. 339)

There was also evidence of a double standard in fathers’ treatment of daughters compared with sons. As one woman said,

My dad always implies to me things that I should do and I shouldn’t do. Like, I shouldn’t have a boyfriend and things like that. But when he talks about my brother, he’s like, “I’m going to buy your brother a car. I’m going to give him all this money to go on dates.”. . . I’ve told him, “You treat us differently.” And he’s like, “Yeah.” He admits it. . . . He thinks it’s appropriate (Naomi, Filipina American, age 19). (quoted in Kim, 2009, p. 342)

Sexual Disorders and Therapy

The term sexual disorder (or sexual dysfunction) refers to various disturbances or impairments of sexual functions, such as inability to have an orgasm (orgasmic disorder) or premature ejaculation. Here we will look at some specific examples of sexual disorders in women. The disorders are grouped into the categories of desire disorders, arousal disorders, orgasmic disorders, and pain disorders.

Sexual disorder: A problem with sexual responding that causes a person mental distress; examples are erection problems in men and orgasm problems in women.

Desire Disorders

Sexual desire, or libido, refers to a set of feelings that lead the individual to seek out sexual activity or to be pleasurably receptive to it. When sexual desire is inhibited, so that the individual is not interested in sexual activity, the disorder is termed low sexual desire, or hypoactive sexual desire (Basson et al., 2004). The defining characteristic is lack of interest in sex or sharply reduced interest, or a lack of responsive desire. Many people’s desire occurs before sexual activity begins and leads them to initiate sex, whereas in other cases they begin to feel desire as sexual activity starts; this latter pattern is called responsive desire. Responsive desire is particularly common in women.

Hypoactive sexual desire: A sexual disorder in which there is a lack of interest in sexual activity; also termed inhibited sexual desire or low sexual desire.

Roughly 10% to 15% of women report no sexual desire, with the percentage increasing as women age (West et al., 2004). Men, too, experience lack of desire; it is just less common in men than it is in women.

As with other dysfunctions, disorders of sexual desire entail complex problems of definition. There are many circumstances when it is perfectly normal for a person’s desire to be inhibited. For example, one cannot be expected to find every potential partner attractive. Sex therapist Helen Singer Kaplan (1979) recounted an example of a couple consisting of a shy, petite woman and an extremely obese (350 pounds, 5 feet 3 inches tall), unkempt man. He complained of her lack of desire, but one can understand her feelings and would certainly hesitate to classify her as having a sexual disorder. One cannot expect to respond sexually at all times, in all places, with all persons.

It is also true that an individual’s absolute level of sexual desire is often not the problem; rather, the problem is a discrepancy of sexual desire between the partners (Zilbergeld & Ellison, 1980). That is, if one partner wants sex less frequently than the other partner wants it, there is a conflict.

Discrepancy of sexual desire: A sexual disorder in which the partners have considerably different levels of sexual desire.

In the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association (2013) did some odd things in regard to gender and sexual disorders. The prime example is hypoactive sexual desire disorder. In the DSM-5, it is split into two disorders, male hypoactive sexual desire disorder and female sexual interest/arousal disorder. Why is it that hypoactive sexual desire disorder had to be split into male and female versions? And what does that do for trans individuals? Moreover, why should desire (called interest in DSM-5) be merged with arousal for women (Balon & Clayton, 2014; Basson, 2014)? Those favoring this new category say that it is appropriate because interest or desire problems so frequently co-occur with arousal problems in women. The new classification system reinforces the gender binary in striking ways.

The following have been implicated as determinants of low sexual desire: hormones, antidepressant medications, psychological factors (particularly anxiety and/or depression), cognitive factors (not having learned to perceive one’s arousal accurately or having limited expectations for one’s own ability to be aroused), and sexual trauma such as sexual abuse in childhood (Ashton, 2007; Pridal & LoPiccolo, 2000).

A closely related phenomenon is asexuality, which today is an available sexual identity with an Internet presence. Asexuality is usually defined as a lack of interest in or desire for sex or as a lifelong lack of sexual attraction (Brotto & Yule, 2011; Prause & Graham, 2007). Research with asexual people shows that the defining feature is low sexual desire. Still, it’s important to note that asexuality is not a sexual disorder.

Asexuality: A lack of interest in or desire for sex.

Arousal Disorders

Sex therapists do not use the term frigidity because it has a variety of imprecise, negative connotations.

Female sexual arousal disorder refers to a lack of response to sexual stimulation, including a lack of lubrication (Graham, 2010). The disorder involves both the subjective, psychological component and a physiological element. Some cases are defined by the woman’s own subjective sense that she does not feel aroused despite good stimulation, and others are defined by difficulties with vaginal lubrication.

Female sexual arousal disorder: A lack of response to sexual stimulation, including a lack of lubrication.

Difficulties with arousal and lubrication are common, reported by roughly 10% of women (Mitchell et al., 2013). These problems become particularly frequent among women during and after menopause. As estrogen levels decline, vaginal lubrication decreases. The use of lubricants is an easy way to deal with this problem. The absence of subjective feelings of arousal is more complex to treat.

Orgasmic Disorders

Orgasmic disorder (also termed anorgasmia, orgasmic dysfunction, female orgasmic disorder, or inhibited female orgasm) is the condition of being unable to have an orgasm. In lifelong orgasmic disorder the woman has never experienced an orgasm. In situational orgasmic disorder, the woman has orgasms in some situations, but not in others. Clearly, in this case there is no organic (physical) impairment of orgasm, because the woman is capable of experiencing it. One example of situational orgasmic disorder is the case of women who are able to have orgasms through masturbation but not through penis-in-vagina intercourse. This pattern is so common, however, that it probably shouldn’t be classified as a disorder (Hyde & DeLamater, 2017).

Anorgasmia: The inability to have an orgasm; also called orgasmic disorder.

Orgasmic disorders in general are common among women. Roughly 20% of women report difficulties with anorgasmia (West et al., 2004).

Pain Disorders

Painful intercourse, or dyspareunia, can trigger other problems with sexual functioning (Farmer & Meston, 2007). Too often, a woman’s complaints of pain are dismissed, particularly if the physician cannot find an obvious physical problem. However, this is a serious condition and should be treated as such. When pain is felt in the vagina, it may be due to failure to lubricate, to infection, to special sensitivity of the vagina (such as to the contraceptives being used), or to changes in the vagina due to age. Pain may also be felt in the region of the vaginal entrance and clitoris or deep in the pelvis. In this latter case, the causes may be infection or tearing of the ligaments supporting the uterus, particularly following childbirth.

Dyspareunia: Painful intercourse.

Vaginismus involves a tightening or spasm of the outer third of the vagina, possibly to such an extent that the opening of the vagina is closed and intercourse becomes impossible (Basson et al., 2001; Leiblum, 2000). Factors in the woman’s history that seem to cause this condition include family background in which sex was considered dirty and sinful, a previous sexual assault, and long experience of painful intercourse due to a physical problem.

Vaginismus: A strong, spastic contraction of the muscles around the vagina, perhaps closing off the vagina and making intercourse impossible.

Behavioral Therapy for Sexual Disorders

Masters and Johnson pioneered modern sex therapy (Masters & Johnson, 1970; for a critique, see Zilbergeld & Evans, 1980). Their approach can be seen basically as behavior therapy, grounded in learning theory, although they themselves did not frame it that way.

The major objective in therapy is abolishing goal-directed sexual performance. Most people think that certain things should be achieved during sexual activity—for example, that the woman should achieve or attain orgasm. This emphasis on achieving leads to a fear of failure, which spells disaster for sexual enjoyment. The therapist therefore tries to remove the individual from a spectator role in sex—observing their own actions, evaluating their success. Instead, the emphasis is on the enjoyment of all sensual pleasures. Clients use a series of sensate focus exercises in which they learn to touch and to respond to touch. They are also taught to express sexual needs to their partners, which people generally are reluctant to do. For instance, the woman is taught to tell her partner in which regions of her body she enjoys being touched most and how firm or light the touch should be. Beyond this basic instruction, which includes lessons in sexual anatomy and physiology, the therapist simply allows natural sexual response to emerge. Sexual pleasure is natural; sexual response is natural. After removing artificial impediments to sexual response, most people quickly begin joyful, “successful” participation in sex.

Focus 12.1 Women’s Sexual Problems: A New View

Feminist psychologist and sex therapist Leonore Tiefer, together with a large group of experts, has proposed a new view of women’s sexual problems (Kaschak & Tiefer, 2001; Tiefer, 2001). Tiefer argues that the classification of sexual problems has, for decades, been based on men’s problems and the increasing medicalization of their problems encouraged by drug companies that have made billions on Viagra. A new view is needed, Tiefer argues, that focuses on women’s sexual experiences. The new view proposes four broad categories for women’s sexual problems:

1. Sexual problems due to sociocultural, political, or economic factors. These include ignorance and anxiety about sexuality resulting from inadequate sexuality education. In the absence of education, women may lack information about the biology of sexual functioning. And in the absence of information about the impact of gender roles, women may experience sexual avoidance or distress because they feel they cannot meet cultural standards of ideal female sexuality.

2. Sexual problems relating to partner and relationship. These include discrepancies in desire or in preferred behaviors between the partners, distress about sexuality because of dislike or fear of the partner, and problems created by poor communication about sex.

3. Sexual problems due to psychological factors. These include sexual aversion and inhibition of sexual pleasure due to past experiences of physical, sexual, or emotional abuse; problems associated with attachment issues; and depression and anxiety.

4. Sexual problems due to medical factors. These include pain or lack of response during sex that is not due to any of the factors listed above. Problems in this category can result from specific medical conditions such as diabetes, or they may involve side effects of medications.

This classification scheme starting from women’s point of view is strikingly different from the traditional one reflected in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5). What would happen if we now imposed these categories on men’s sexual experience?

Source: Tiefer (2001). Reprinted with permission of the Society for the Scientific Study of Sexuality.

Many sex therapists require that both partners participate in therapy. Masters and Johnson maintained that there is no such thing as an uninvolved partner in cases of sexual disorders, even if only one person displays overt symptoms. For instance, a woman who does not experience orgasm is anxious and wonders whether there is anything wrong with her or whether she is unattractive to her partner. The partner, at the same time, may wonder why they are failing to stimulate her to orgasm. Both partners are deeply involved.

Masters and Johnson evaluated the success of their therapy, both during the 2-week therapy session and in follow-up studies 5 years after couples left the clinic. Their research indicated that therapy was successful in approximately 75% of the cases (although their results have been disputed; see Zilbergeld & Evans, 1980).

Today many sex therapists use a combination of the behavioral exercises pioneered by Masters and Johnson and cognitive therapy (Heiman, 2002). This is termed cognitive-behavioral therapy. The cognitive approach involves restructuring negative thoughts about sexuality to make them positive.

Additional Therapies for Women’s Sexual Disorders

The prevalence of women who have problems having orgasms, particularly in heterosexual intercourse, is so high that it seems that this pattern is well within the range of normal female sexual response. It is questionable whether it should be called a disorder, except insofar as it causes unhappiness for the woman. With the growing awareness of the frequency of this problem have come a number of self-help sex therapy books for women, one of the best being Emily Nagoski’s (2015) Come as You Are. Reading and working through the exercises in these self-help books actually has a fancy name—bibliotherapy—and it has been demonstrated to produce significant gains in women’s frequency of orgasm (Van Lankveld, 1998).

A common recommendation from Nagoski and other therapists (LoPiccolo & Stock, 1986; Meston et al., 2004) is that preorgasmic women practice masturbation to increase their capacity for orgasm. The idea is that women must first explore their own bodies and learn how to bring themselves to orgasm before they can expect to have orgasms in heterosexual intercourse. As noted earlier in this chapter, many women have not had this kind of practice, and sex therapists recommend that they get it.

Kegel exercises or pubococcygeal muscle exercises are also recommended (Kegel, 1952). The pubococcygeal (PC) muscle runs along the sides of the entrance to the vagina. Exercising this muscle increases women’s sexual pleasure by increasing the sensitivity of the vaginal area. This exercise is particularly helpful to women who have had the PC muscle stretched in childbirth or who simply have poor tone in it. The woman is instructed first to find the PC muscle by sitting on a toilet with her legs spread apart, urinating, and stopping the flow of urine voluntarily. The muscle that stops the flow is the PC muscle. After that, the woman is told to contract the muscle 10 times during each of six sessions per day. Gradually she can work up to more.

Kegel exercises: Exercises to strengthen the muscles surrounding the vagina; also called pubococcygeal muscle exercises.

Feminist Sex Therapy

Sex therapist Leonore Tiefer has pioneered models of feminist sex therapy (Tiefer, 1996, 2001). Tiefer questions the medicalization of sexual disorders that results from therapists using the DSM “diagnoses” (for further discussion of the DSM, see Chapter 15). She argues that these diagnoses are based on Masters and Johnson’s exclusively physiological model of sexual response and that they oversimplify sexuality and ignore the social context of sexuality and sex problems (see Focus 12.1). The advent of Viagra has only increased the medicalization of sex problems, and the search for a “female Viagra” channels the medicalization toward women’s problems.

Tiefer recommends that feminist sex therapy for women include the following components:

1. Education about feminism and women’s issues: This can be liberating as a woman realizes that her individual problem is common and often rooted in the culture’s negative attitudes about sexuality and women.

2. Anatomy and physiology education: Because sexuality education in the United States—whether from parents or schools—is so inadequate, many women have fundamental misunderstandings about their sexual anatomy and its functioning. Education can be a simple solution in many cases.

3. Assertiveness training: Women need to learn to be assertive in asking a partner for what they need in a sexual interaction, just as in other areas of life.

4. Body image reclamation: Women need to make a substantial shift away from seeing their bodies as objects to be evaluated (as we saw in the discussion of objectified body consciousness in Chapter 2) to seeing their bodies as sources of sensations and competencies.

5. Masturbation education: As noted earlier, many women do not masturbate and some do not even know about masturbation. Masturbation education has proven to be successful in sex therapy for women. From a feminist point of view, it can be seen as empowering women.

Where’s the Female Viagra?

Men have Viagra for their erections. Why isn’t there a pill for women’s sexual problems? Is this another case of gender bias in the medical establishment? It turns out to be a complicated story.

The drug company Pfizer, which produced Viagra, hoped that it would also work for women. After many failed clinical trials, Pfizer announced in 2004 that it would give up on testing Viagra for women (Harris, 2004). The problem is that Viagra is good at producing erections, but women’s sexual problem is not lack of erections—it’s lack of desire and difficulty with orgasms.

In another attempt at a female Viagra, the German pharmaceutical company Boehringer developed the drug flibanserin (trade name Addyi). It had originally been developed to be an antidepressant, but it didn’t work very well. Its effect is to reduce levels of the neurotransmitter serotonin and increase levels of dopamine and norepinephrine. To use terms from the dual control model (discussed earlier in this chapter), serotonin seems to have an inhibitory effect on sexual desire, and dopamine and norepinephrine seem to have excitatory effects. All of that sounds good in theory, but in 2010 the U.S. Food and Drug Administration (FDA) refused to approve flibanserin, based on clinical trials that showed no actual increase in sexual desire in women taking it, compared with controls. Boehringer decided not to pursue it further.

In 2014, the plot thickened (Moynihan, 2014). The drug was bought by a new company, Sprout Pharmaceuticals. A feminist campaign materialized, pressuring the FDA to approve flibanserin because of the need for a “pink Viagra” and arguing that the FDA was discriminating against women by not approving it. As it turned out, the “feminist” campaign was actually created and funded by Sprout. And flibanserin still didn’t work. But the FDA approved it in 2015 because of the pink Viagra campaign. This whole episode is a salient example of the co-optation of the women’s movement by big business, in this case, Big Pharma.

Gender Similarities

In previous chapters we stressed gender similarities in psychological processes. There are also great gender similarities in sexuality. In earlier generations, at the time of the Kinsey research, there were marked gender differences in several aspects of sexuality. However, more recent research shows that these differences are greatly decreased, or even absent, now.

For example, according to Kinsey’s data collected in the 1940s, 71% of men but only 33% of women had premarital intercourse by age 25 (Kinsey et al., 1953). There was, at that time, a marked gender difference in premarital sexual activity. By the 1990s, though, 78% of men and 70% of women had engaged in premarital sexual intercourse (Laumann et al., 1994), representing a clear trend toward gender similarities. In the meta-analysis discussed earlier in this chapter, a number of variables showed no gender difference, including incidence of same-gender sexual behavior and attitudes about masturbation (Petersen & Hyde, 2010). Although there are some large gender differences in sexuality (incidence of masturbation, use of pornography, and attitudes about casual sex), there are many gender similarities.

Experience the Research: Gender Differences in Sexuality

Administer the questionnaire below to 10 students: 5 cis women and 5 cis men. If you are able to recruit some trans folks or non-binary people, their responses will be interesting, too. Because the information you will collect is sensitive, be sure to explain to each participant that the answers will be anonymous. You must devise some method to ensure anonymity, such as having respondents mail the questionnaire back to you, or having them place it into a large brown envelope that already contains others’ questionnaires. If you have only one trans person in your sample, how can you guarantee their anonymity? Assure your respondents that the questionnaire will take less than 5 minutes to complete.

SEXUALITY QUESTIONNAIRE

1. Age: _____

2. Gender: ___ Woman ___ Man ___ Trans woman ___ Trans man ___ Nonbinary Other: Specify __________________________

3. Ethnic heritage (check the one that applies):

___ Black/African American

___ Hispanic/Latinx

___ Asian American

___ American Indian

___ White (not Hispanic)

___ Biracial or multiracial

For each of the questions below, circle the letter that best reflects your response. Remember that your answers will be kept completely anonymous.

4. What is your attitude about a heterosexual couple engaging in sexual intercourse when they are engaged?

1. Strongly disapprove

2. Disapprove somewhat

3. Neutral

4. Approve somewhat

5. Strongly approve

5. What is your attitude about a heterosexual couple engaging in sexual intercourse when they are only casually acquainted (i.e., a “one-night stand” or hookup)?

1. Strongly disapprove

2. Disapprove somewhat

3. Neutral

4. Approve somewhat

5. Strongly approve

6. Have you ever masturbated to orgasm?

1. Yes (Go to question 7)

2. No (Skip question 7 and go to question 8)

7. In the past month how many times did you masturbate to orgasm? Number: _____

8. Have you ever engaged in heterosexual intercourse?

1. Yes (Go to question 9)

2. No (Skip question 9 and go to question 10)

9. With how many different partners have you engaged in heterosexual intercourse?

Number: ____

10. Have you ever engaged in sex to orgasm with someone of your own gender?

1. Yes

2. No

Chapter Summary

Physiologically, sexual response involves vasocongestion and myotonia, as people pass through four stages of response: excitement, plateau, orgasm, and resolution. This analysis results from the research of Masters and Johnson, which has been criticized for omitting psychological aspects of sexuality. Alternative models have been proposed, including Kaplan’s triphasic model, which adds sexual desire, and the dual control model, which emphasizes processes of sexual excitation and inhibition.

Contemporary sex research challenges Freud’s assertion that women can have either clitoral or vaginal orgasms. Research also lends support to the contention that some women possess a G-spot, which may be responsible for ejaculation in some women.

According to meta-analysis, there are moderate-sized gender differences in the incidence of masturbation, attitudes about casual sex, and use of pornography. There is also a gender difference in reported number of sex partners, although the bogus pipeline study questions whether that is a true difference or just a bias in reporting.

Across child and adolescent development, girls are less likely to masturbate than boys are. That means that girls get less experience with their body’s sexual response. To that is added the double standard and forces of socialization that also discourage girls’ sexual responding. Despite this, research shows that adolescent girls do experience sexual desire. First intercourse is a significant event, but girls experience substantially less pleasure in it than boys do. Hooking up is a contemporary form of sexual interaction, yet even here, a double standard is found.

The sexuality of transgender persons is a new topic for research. The issues are poignant, because sexuality is so much about the body, and yet for transgender people, the body can be exactly the problem, because it does not align with the person’s gender identity. Trans men tend to be pleased with the effects of testosterone administration, which can enlarge the size of the clitoris and increase sexual desire. For trans women, issues often center on feeling feminine and sexually attractive.

In considering the intersection of gender and ethnicity in sexuality, research shows some similarities for women of different ethnic groups, but also some differences.

Sexual disorders for women include hypoactive sexual desire, female sexual arousal disorder, anorgasmia, dyspareunia, and vaginismus. Therapy for sexual disorders includes behavior therapy, bibliotherapy, and directed masturbation. Feminist sex therapy has also been developed.

Even though gender differences in sexuality are often emphasized, there are many gender similarities.

Suggestions for Further Reading

Dines, Gail. (2010). Pornland: How porn has hijacked our sexuality. Boston, MA: Beacon Press. Dines presents a feminist analysis of contemporary pornography and how it has distorted both male and female sexuality.

Hyde, Janet S., & DeLamater, John D. (2017). Understanding human sexuality (13th ed.). New York, NY: McGraw-Hill. Clearly, we have a prejudice in favor of this book, but we would like to recommend it if you want more information on sexuality than we could provide in one brief chapter here.

Nagoski, Emily. (2015). Come as you are. New York, NY: Simon & Schuster. This is a great book on sexual techniques and how to think about one’s own sexuality in healthy ways, with all of the information based solidly in science.