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5 studies that offer fascinating conclusions about human sexuality

“My hope is that a more accurate updated understanding of human sexuality will lead us to have greater tolerance for ourselves, for each other, greater respect for unconventional relationship configurations like same-sex marriage or polyamorous unions, and that we’ll finally put to rest the idea that men have some innate instinctive right to monitor and control women’s sexual behavior,” Ryan says . “And we’ll see that it’s not only gay people that have to come out of the closet: we all have closets we have to come out of.”

Below, read up on some more lines of research that suggest out-of-the-box ideas about our sexuality.

• Question: Is bisexuality a sexual orientation, something that’s temporary or an outgrowth of the sexual fluidity we all exhibit? . Research: In a 2008 study , Lisa M. Diamond of the University of Utah presented the results of a decade-long assessment of nearly 70 women who identified as lesbian, bisexual, or sexually unlabelable. Five times over the course of the study, the women detailed their sexual identities, attractions, behaviors, and their social and familial relationships. . Results: Based on Diamond’s findings, bisexuality is not a “transitional stage that women adopt ‘on the way’ to lesbian identification” or an “experimental phase” for heterosexuals. Her results, instead, supported that, “Bisexuality may best be interpreted as a stable pattern of attraction to both sexes in which the specific balance of same-sex to other-sex desires necessarily varies according to interpersonal and situational factors,” she writes. .
• Question: Which comes first—desire or arousal? . Research: In a study from 2004, described in this New York Times article , Ellen Laan, Stephanie Both and Mark Spiering of the University of Amsterdam examined participants’ physical responses to sexual images. . Results: The research indicates that we respond physically to highly sexual visuals before our mind even engages with them. In other words, desire doesn’t precede arousal—it’s the other way around. And we aren’t even aware it’s happening. .
• Question: Do men and women respond differently to sexual images? . Research: The same New York Times article describes an Emory University study that tracked participants’ eye movements and brain activity while they looked at sexually explicit photos. . Results: Men and women didn’t have the same reactions, but they might not be the ones you’d expect. Men looked at the faces in the photographs much more than women did, and everyone quickly flipped past close-ups of genitalia. Brain activity was gender-dependent: in particular, men had a lot more activity in the amygdala than women did. .
• Question: Does geography influence the body types we idealize and are attracted to? . Research: There’s a lot written about the effects of culture and media on the bodily standards we uphold. But the International Body Project , a survey of 7,434 people worldwide, aimed to investigate whether there were more base-level factors motivating our ideal body types, too. . Results: The researchers found that places with low socioeconomic status tended to value heavier female body types, while places with high socioeconomic status tended to favor thinner bodies—possibly because body fat acts as an indicator of status when resources are scarce. And the effect of media shouldn’t be underestimated: “Our results show that body dissatisfaction and desire for thinness is commonplace in high-SES settings across world regions, highlighting the need for international attention to this problem,” the researchers write. .
• Question: Do men and women have different sex drives? . Research: A recent New York Times Magazine article describes a University of Wisconsin, Madison “ meta-analysis ” of more than 800 studies of our sexual habits conducted over 15 years. . Results: The researchers found that “the evidence for an inborn disparity in sexual motivation is debatable,” the Times Magazine piece reports. The study “suggests that the very statistics evolutionary psychologists use to prove innate difference — like number of sexual partners or rates of masturbation — are heavily influenced by culture. All scientists really know is that the disparity in desire exists, at least after a relationship has lasted a while.” Women’s desire does decrease, but not as a matter of course—as a result of monogamy in particular.

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• Published: 14 March 2024

The impact of digital media on sexuality: a descriptive and qualitative study

• Ana Filipa Beato   ORCID: orcid.org/0000-0003-3177-3578 1   na1 ,
• Patrícia M. Pascoal   ORCID: orcid.org/0000-0002-2810-4034 1 , 2   na1 &
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The beliefs about Digital Information and Communication Media (DM) impact on sexuality by people from the community are an essential field to understanding people’s sexual behaviours and their response to others’ sexuality. This cross-sectional, online, descriptive, qualitative study, developed in the context of the celebration of National Sexual Health Day in Portugal, intended to identify the reasons and the activities using DM related to sexuality and explore participant’s beliefs about the impact of DM on sexuality. In August 2021, a convenience sample of 167 people ( M  = 40.01; SD  = 14.67; range 19–75 years old) completed an online survey that was disseminated through social networks and that included two closed questions about internet use and an open question about their personal beliefs about the impact of DM on sexual health. The results showed that most participants were motivated to use DM to search for erotic content (51.5%). DMs are also regularly used for educational purposes, such as seeking information about sexual pleasure and satisfaction (46.1%). Regarding qualitative data, three themes were identified concerning the impact of DM on sexuality: YES, IT’S SEX, SO WHAT?, I’M MORE VULNERABLE NOW! and SEXUAL EXPANSION. DM is an indisputable resource in sexual health, like in other dimensions of health. Still, it may facilitate exposure to contexts of aggression with a harmful impact on mental health, especially for younger people. Taken together, our results reveal that sexuality is part of DM use, and people share beliefs that indicate they may be actively involved in diminishing its hazards and benefiting from its potential.

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Gerwin R, Kaliebe K, Daigle M. The interplay between digital media use and development. Child Adolesc Psychiatr Clin N Am. 2018. https://doi.org/10.1016/j.chc.2017.11.002 .

Irwin SON. Digital media: human–technology connection. Rowman & Littlefield. 2016.

Plantin J, Punathambekar A. Digital media infrastructures: pipes, platforms, and politics. Media Cult Soc. 2019. https://doi.org/10.1177/0163443718818376 .

Cooper A, Delmonico D, Griffin-Shelley E, Mathy R. Online sexual activity: examining potentially problematic behaviours. Sex Addict Compulsivity. 2004. https://doi.org/10.1080/10720160490882642 .

Shaughnessy K, Byers E, Walsh L. Online sexual activity experience of heterosexual students: gender similarities and differences. Arch Sex Behav. 2011. https://doi.org/10.1007/s10508-010-9629-9 .

Döring N. Internet sexualities. In: Hunsinger, J, Klastrup, L, Allen, M (eds) International Handbook of Internet Research. Springer, Dordrecht, 2009. pp 171–85. https://doi.org/10.1007/978-1-4020-9789-8_10 .

Marktest. Bareme Internet. 2020. https://www.marktest.com/wap/a/n/id~269e.aspx .

Rokach A. Sexuality and internet use: the promise and dangers in cyberspace. SciMed J. 2020. https://doi.org/10.28991/SciMedJ-2020-0203-5 .

Hassrick E, Holmes L, Sosnowy C, Walton S, Carley K. Benefits and risks: a systematic review of information and communication technology use by autistic people. Autism Adulthood. 2021;3:72–84. https://doi.org/10.1089/aut.2020.0048 .

Article   PubMed   PubMed Central   Google Scholar  

Döring N. Sex education on social media. In: Encyclopedia of Sexuality and Gender. 2021:1–12. https://doi.org/10.1007/978-3-319-59531-3_64-1 .

Griffiths M. Internet sex addiction: a review of empirical research. Addict Res Theory. 2012;20:111–24. https://doi.org/10.3109/16066359.2011.588351 .

Article   ADS   Google Scholar  

Bauermeister JA, Muessig KE, LeGrand S, Flores DD, Choi SK, Dong W, et al. HIV and sexuality stigma reduction through engagement in online forums: results from the HealthMPowerment intervention. AIDS Behav. 2019. https://doi.org/10.1007/s10461-018-2256-5 .

Zarski AC, Velten J, Knauer J, Berking M, Ebert DD. Internet- and mobile-based psychological interventions for sexual dysfunctions: a systematic review and meta-analysis. NPJ Digit Med. 2022;5:139. https://doi.org/10.1038/s41746-022-00670-1 .

Kim S, Kim S. Integrative review of sexual health information seeking behaviors among adolescents: based on qualitative research. J Korean Soc Sch Health. 2021. https://doi.org/10.15434/KSSH.2021.34.1.42 .

Article   Google Scholar  

Kirana PS, Gudeloglu A, Sansone A, Fode M, Reisman Y, Corona G, et al. E-Sexual health: a position statement of the European society for sexual medicine. J Sex Med. 2020;17:1246–53. https://doi.org/10.1016/j.jsxm.2020.03.009 .

Article   PubMed   Google Scholar  

Costa I, Manão A, Pascoal P. Clinical sexologists’ perceptions of the potentials, downfalls, and best practices for digitally delivered therapy: a lesson from lockdown due to COVID-19 in Portugal. Behav Sci. 2023;13. https://doi.org/10.3390/bs13050376 .

Fish JN, McInroy LB, Paceley MS, Williams ND, Henderson S, Levine DS, et al. “I’m kinda stuck at home with unsupportive parents right now”: LGBTQ youths’ experiences with COVID-19 and the importance of online support. J Adolesc Health. 2020. https://doi.org/10.1016/j.jadohealth.2020.06.002 .

Hiebert A, Kortes-Miller K. Finding home in online community: exploring TikTok as a support for gender and sexual minority youth throughout COVID-19. J LGBT Youth. 2023. https://doi.org/10.1080/19361653.2021.2009953 .

Grinberg N, Joseph K, Friedland L, Swire-Thompson B, Lazer D. Fake news on Twitter during the 2016 US presidential election. Science. 2019;363:374–8. https://doi.org/10.1126/science.aau2706 .

Article   ADS   CAS   PubMed   Google Scholar  

Yan P. ‘Fed with the Wrong Stuff’: information overload (?) and the everyday use of the Internet in rural and urban China. Int Commun Gaz. 2021;83:404–27. https://doi.org/10.1177/17480485211029019 .

Hadjab Boudiaf H. La religión y las nuevas tecnologías al servicio de las redes nigerianas de explotación sexual de niñas migrantes. Sociol Technosci. 2019. https://doi.org/10.24197/st.1.2019.49-685 .

Todaro E, Silvaggi M, Aversa F, Rossi V, Nimbi FM, Rossi R, et al. Are social media a problem or a tool? New strategies for sexual education. Sexologies. 2018;27:e67–70. https://doi.org/10.1016/j.sexol.2018.05.006 .

Dubin JM, Aguiar JA, Lin JS, Greenberg DR, Keeter MK, Fantus RJ, et al. The broad reach and inaccuracy of men’s health information on social media: analysis of TikTok and Instagram. Int J Impot Res. 2022. https://doi.org/10.1038/s41443-022-00645-6 .

McCashin D, Murphy C. Using TikTok for public and youth mental health – a systematic review and content analysis. Clin Child Psychol Psychiatry. 2023;28:279–306. https://doi.org/10.1177/13591045221106608 .

Soriano-Ayala E, Díaz M, Cala V. TikTok and child hypersexualization: analysis of videos and narratives of minors. Am J Sex Educ. 2022. https://doi.org/10.1080/15546128.2022.2096734 .

Zenone M, Ow N, Barbic S. TikTok and public health: a proposed research agenda. BMJ Glob Health. 2021. https://doi.org/10.1136/bmjgh-2021-007648 .

Zulli D, Zulli, DJ. Extending the internet meme: conceptualizing technological mimesis and imitation publics on the TikTok platform. New Media Soc. 2020. https://doi.org/10.1177/1461444820983603 .

Gosse C, Burkell J. Politics and porn: how news media characterises problems presented by deepfakes. Crit Stud Media Commun. 2020. https://doi.org/10.1080/15295036.2020.1832697 .

Kohut T, Fisher W, Campbell L. Perceived effects of pornography on the couple relationship: initial findings of open-ended, participant-informed, “bottom-up” research. Arch Sex Behav. 2017. https://doi.org/10.1007/s10508-016-0783-6 .

DeKeseredy WS, Hall-Sanchez A. Adult pornography and violence against women in the heartland: results from a rural southeast Ohio study. Violence Against Women. 2017;23:830–49. https://doi.org/10.1177/1077801216648795

Bridges AJ. Pornography and sexual assault. In: Handbook of Sexual Assault and Sexual Assault Prevention. 2019; https://doi.org/10.1177/1077801220971352 .

Šepec M. Revenge pornography or non-consensual dissemination of sexually explicit material as a sexual offence or as a privacy violation offence. Int J Cyber Criminol. 2019. https://doi.org/10.5281/zenodo.3707562 .

Abraham C, Sheeran P. The health belief model. In: Predicting health behaviour: research and practice with social cognition models. 2nd ed. 2015. 30–55.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211. https://doi.org/10.1016/0749-5978(91)90020-T .

Bosnjak M, Ajzen I, Schmidt P. The theory of planned behavior: selected recent advances and applications. Europe’s J Psychol. 2020;16:352–6. https://doi.org/10.5964/ejop.v16i3.3107 .

Zhao J, Song F, Ren S, Wang Y, Wang L, Liu W, et al. Predictors of condom use behaviors based on the Health Belief Model (HBM) among female sex workers: a cross-sectional study in Hubei Province, China. PLoS One. 2012. https://doi.org/10.1371/journal.pone.0049542 .

Turchik JA, Gidycz CA. Prediction of sexual risk behaviours in college students using the theory of planned behaviour: a prospective analysis. J Soc Clin Psychol. 2012;31:1–27. https://doi.org/10.1521/jscp.2012.31.1.1 .

Cornwall A, Jewkes R. What is participatory research? Soc Sci Med. 1995;41:1667–76. https://doi.org/10.1016/0277-9536(95)00127-S .

Article   CAS   PubMed   Google Scholar  

Heiphetz L, Spelke ES, Harris PL, Banaji MR. What do different beliefs tell us? An examination of factual, opinion-based, and religious beliefs. Cogn Dev. 2014;30:15–29. https://doi.org/10.1016/j.cogdev.2013.12.002 .

Braun V, Clarke V. Conceptual and design thinking for thematic analysis. Qual Psychol. 2022. https://doi.org/10.1037/qup0000196 .

Flinn C, Koretsidou C, Nearchou F. Accessing sexual health information online: content, reasons and practical barriers in emerging adults. Youth. 2023;3:107–24. https://doi.org/10.3390/youth3010007 .

von Rosen A, von Rosen F, Tinnemann P, Müller-Riemenschneider F. Sexual health and the internet: cross-sectional study of online preferences among adolescents. J Med Internet Res. 2017;19:379. https://doi.org/10.2196/jmir.7068 .

World Health Organization. Recommendations on digital interventions for health system strengthening: WHO guideline. In: Recommendations on digital interventions for health system strengthening: WHO guideline, 2019,–150.

Bőthe B, Tóth-Király I, Bella N, Potenza M, Demetrovics Z, Orosz G. Why do people watch pornography? The motivational basis of pornography use. Psychol Addict Behav. 2021;35:172–86. https://doi.org/10.1037/adb0000603 .

Dawson K, Nic Gabhainn S, Willis M, MacNeela P. Development of a measure to assess what young heterosexual adults say they learn about sex from pornography. Arch Sex Behav. 2022;51:1257–69. https://doi.org/10.1007/s10508-021-02059-9 .

Anderson M, Vogel E, Turner. ‘The virtues and downsides of online dating’. Pew Research Centre. 2020. Available at: https://www.pewresearch.org/internet/2020/02/06/the-virtues-and-downsides-of-online-dating .

Hertlein K, Chang J, VanYperen A, Fatkin K, Nakamura S. Experiences after infidelity via Internet communication: surveillance, ambivalence, and termination. Sex Relatsh Ther. 2022. https://doi.org/10.1080/14681994.2021.1907568 .

Attwood F, Barker M, Boynton P, Hancock J. Sense about sex: media, sex advice, education and learning. Sex Educ. 2015. https://doi.org/10.1080/14681811.2015.1057635 .

Hanckel B, Vivienne S, Byron P, Robards B, Churchill B. ‘That’s not necessarily for them’: LGBTIQ+ young people, social media platform affordances, and identity curation. Media Cult Soc. 2019. https://doi.org/10.1177/016344371984661 .

Collins R, Strasburger V, Brown J, Donnerstein E, Lenhart A, Ward L. Sexual media and childhood well-being and health. Pediatrics. 2017. https://doi.org/10.1542/peds.2016-1758Xsameas18 .

Wright PJ, Štulhofer A. Adolescent pornography use and the dynamics of perceived pornography realism: does seeing more make it more realistic? Comput Hum Behav. 2019;95:37–47. https://doi.org/10.1016/j.chb.2019.01.024 .

United Nations Children’s Fund. ‘Legislating for the digital age: Global guide on improving legislative frameworks to protect children from online sexual exploitation and abuse’ UNICEF, 2022. https://www.unicef.org/media/121261/file/Legislating%20for%20the%20digital%20age%20.pdf . Acessed 31 July 2023.

Litsou K, Byron P, McKee A, Ingham R. Learning from pornography: results of a mixed methods systematic review. Sex Ed. 2021. https://doi.org/10.1080/14681811.2020.1786362 .

Byers ES, Shaughnessy K. Attitudes toward online sexual activities. Cyberpsychology. 2014. https://doi.org/10.5817/CP2014-1-10 .

Döring N, Krämer N, Brand M, Krüger THC, van Oosten JMF, Vowe G. Editorial: sexual interaction in digital contexts: opportunities and risks for sexual health. Front Psychol. 2022. https://doi.org/10.3389/fpsyg.2022.872445 .

Pascoal PM, Alvarez MJ, Pereira CR, Nobre P. Development and initial validation of the beliefs about sexual functioning scale: a gender invariant measure. J Sex Med. 2017;14:613–23. https://doi.org/10.1016/j.jsxm.2017.01.021 .

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Acknowledgements

We thank Andreia Manão for her support throughout the reviewing process. We thank Marta Crawford (sex therapist) and Isabel Moreira (Deputy in the Portuguese Parliament) for their fundamental role in collaboration with Paulo Côrte-Real and Bernardo Mendonça who, together with the involvement of the Portuguese Society of Clinical Sexology led by Patrícia M. Pascoal, and the support of the World Association for Sexual Health, presided by Pedro Nobre, made the National Sexual Health Day possible in Portugal.

This work was funded by Fundação para a Ciência e Tecnologia (FCT) under HEI-Lab R&D Unit (UIDB/05380/2020, was partially funded by national funds through FCT—Fundação para a Ciência e a Tecnologia, I.P., within the scope of the project 2022.09087.PTDC, and it was partially funded by FCT – Fundação para a Ciência e a Tecnologia, I.P, through the Research Center for Psychological Science of the Faculty of Psychology, University of Lisbon (UIDB/04527/2020) that made the first review of the English language of the article possible.

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Conception and design: PMP and AFB. Acquisition of data: PMP. Analysis and interpretation of data: PMP, AFB and JR. Drafting of manuscript: PMP, AFB and JR. Critical revision of the manuscript: PMP and AFB. Data analysis: PMP, AFB and JR. Material and technical support: N/A. Supervision: PMP.

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Beato, A.F., Pascoal, P.M. & Rodrigues, J. The impact of digital media on sexuality: a descriptive and qualitative study. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00865-y

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February 14, 2024

How to Explore Your Sexuality, according to Science

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Sari van Anders: Our science, in some ways..., is…catching up with people’s existences.

Meghan McDonough: I’m Meghan McDonough, and you’re listening to Scientific American’s Science, Quickly. This is part one of a four-part Fascination on the science of pleasure. In this series, we’re asking what we can learn from those with marginalized experiences to get to the bottom of BDSM, find the female orgasm and illuminate asexuality. In this episode, we’ll discuss new ways to question your sexuality, according to science that draws from feminism and queer theory.

But first, let’s get real basic.

Stacy Watnick: Tell me, when I say the word sex or sexuality to you, what comes up?

McDonough: That’s Stacy Watnick , a clinical psychologist based in San Diego, California. She specializes in relationship issues and sexuality. She’s noticed certain patterns in her clients when she asks this question.

Watnick: First, surprise—that there’s such a range of experiences in their body and in their mind about it.... Frequently, I get some shame and discomfort. They’re not sure what words they’re supposed to use: “Are those bad words?”

A little lean forward…. they’re sort of excited and there’s some tension in wanting to tell me—or a little lean back because they’re not sure it’s safe.

McDonough: Stacy asks her clients if they’ve heard of gender and orientation. They talk about the words they know. And then she brings up the zine.

Zine is short for “magazine.” But zines are different from traditional magazines. They tend to be self-published and not typically what you’d find in an academic setting.

This particular zine invites readers on a “journey through the landscape of your sexuality.” The front cover features a drawing of five people on a path leading into the horizon. Each is holding a map labeled “SCT.” SCT stands for sexual configurations theory, a term coined by Sari van Anders , a gender, sex and sexuality researcher at Queen’s University in Ontario.

Sari van Anders: I was doing some work about multipartnering and things like polyamory..., I was at a conference where there was ... a session about asexuality.... And I started thinking about the way these two ... identities claimed by different people might come together.

McDonough: Here’s Sari, the creator of this theory. She and her team created the zine as a more accessible offshoot of her 2015 academic paper on the topic.

Van Anders: It was the most exciting piece of work I’ve ever done. I’ve never really done work where it just felt like it had to come out, and it was sort of bubbling out of me.

I think we can maximize our pleasure when we understand what it is that we’re wanting, what the options are, who we are. We can think through some things that we might never have had prompts to do before.

McDonough: Oxford Languages defines sexual orientation as “a person’s identity in relation to the gender or genders to which they are typically attracted.” Sexual configurations theory asks: What if this sort of definition is incomplete?

Sari’s theory basically complicates the idea that sexual orientation is only based on gender. She built it on the existing academic literature and on what people shared about their sexualities.

Van Anders: And it was really important to me to include not just diverse sexualities and genders and people with diverse sexualities and genders but people with marginalized experiences, and so on ...

McDonough: Such as people who are LGBTQ+, disabled, into kink or BDSM, asexual or non-monogamous.

Van Anders: Our science, in some ways, is, if anything, sort of, like, catching up with people's existences.... I think many women know that, like, not all women who are attracted to men, maybe including themselves, that means they’re attracted to, like, penises or that’s the thing only that turns them on. And, and so there’s sort of an assumption that gender/sex sexuality, or what people typically call sexual orientation, is about, like, genital match-ups, like, “I have these genitals, and I’m attracted to people who have those genitals.” But really, like, we rarely see people’s genitals until we’ve already decided we’re attracted to them, right.... Usually there’s so much else going on.

McDonough: Sari uses the term “gender/sex” to mean features that are both socialized and biological and considers it to be just one aspect of sexual orientation. 

Van Anders: You know, it’s not always bodies; there’s also ways of being in the world or clothes, appearance, presentation, the way people talk, how someone treats you. And research on attraction is pretty clear that a lot of other things are rated pretty high up, like kindness or sense of humor or things like that.

McDonough: Sari refers to this as “sexual parameter n”—all the other things that make us attracted to a person.

The way she visualizes these aspects is through cone-shaped diagrams where people can pinpoint their preferences.

Aki Gormezano: As an example, you could think about the tornado for gender/sex sexuality…. So there’s a space on top where there’s a ring going around the outside that SCT calls the binary ring.

McDonough: This is Aki Gormezano, a sexuality researcher who did his Ph.D. with Sari at Queen’s. The ring he’s describing represents what most people know as the sexuality spectrum.

Gormezano: And then there’s a whole space beyond that, falling inside of the binary ring, completing that circle, where you’re not just thinking about women and men, you’re thinking about gender/sex-diverse folks who are occupying spaces outside of that binary ring.

McDonough: This is called the “challenge area.”

Gormezano: That circle I described is on the top, but then it moves all the way down to a point forming what kind of looks like a cone. And there’s a little meter ranging from zero to 100 on the far left of that, and that’s to indicate the strength of your attractions.

McDonough: In lay terms, if gender/sex was an important part of your attraction to people, you’d mark a place higher up on the tornado. If it wasn’t, you’d mark a place farther down. There are also tornadoes for partner number—one, multiple or none—as well as for sexual parametern, representing the other factors Sari mentioned, such as kindness and sense of humor.

Gormezano: Growing up, I was, like, pretty uncritical of my sexuality for the most part… Like I identified as straight by default. And a lot of my attractions, you know, as a cis boy at the time, or, like, now a cis man, were to cis women.

McDonough: In case you don’t know, “cis” here refers to cisgender, when a person’s gender identity matches their sex assigned at birth.

Gormezano: I had a point in high school where I realized ... I did have attractions to people who were not cis girls or cis women.... I think I was just, like, confused and upset and didn’t really feel like it was something I could talk about. You know, especially as someone who played sports and was known as an athlete, where that was a big piece of my identity—like, I played soccer all the way through and still do.... I think, for me, the hardest part about realizing that I had interests and attractions that didn’t fit with being straight was that it challenged a lot of my identity around being a man or, like, wanting to be.

McDonough: Aki says that studying sexuality as an adult has helped him see that this isn’t a problem and that sexual orientation, identity and status don’t necessarily line up perfectly. Sexual configurations theory calls this “branched.”

Van Anders: Orientations have to do with, like, attractions, interests, arousals, desire [and] pleasure, and those might be different, or they might be the same. Like, you might really enjoy the thoughts or have fantasies about being with a man. And then when it comes to the actual sex you do, you find people of any gender are really enjoyable.... And status refers to, like, what you’re kind of actually doing, have done or will do..., who you’re actually with, for example.

McDonough: In a 27-country survey conducted by the market research company Ipsos in 2021, for example, 80 percent of self-identified heterosexual people reported that they were only attracted to the opposite sex, and 12 percent of them said they mostly were. Meanwhile 60 percent of self-identified lesbian and gay people said they were only attracted to the same sex, and 24 percent of them said they mostly were. These “branches” of sexuality can all be mapped on separate “tornado” diagrams. If you’re still struggling to picture them, you’re not alone. Between gender/sex, partner number, and other factors—plus identity, orientation and status—it’s a lot. But portraying sexuality as complex is also kind of the point.

McDonough (tape): To what extent do you think sexuality labels are limiting or expanding? If you could imagine your ideal world of how people conceive of sexuality, would everyone have a label?

Gormezano: I think when you just have identities and you just have labels, especially when identities and labels are really narrow..., you might not have the language to articulate the ways in which you don’t perfectly fit with that identity or label.... And I think the more people ... who are able to understand the ways in which they might branch from their label or, like, perfectly coincide with it, the more open everyone will be around, you know, just like understanding that, like, around each identity is, like, a collection of people who might vary from that in different kinds of ways.

McDonough: Stacy, the therapist we heard from earlier, commonly meets clients who are working through their sexualities.

McDonough (tape): How do you help them kind of figure that out?

Watnick: We kind of try labels on like clothes.... I’m gonna try this sort of sweater on and see: Does that feel snuggly? Do I feel comfortable? Is there, like, a resonance in my body and in my mind and my heart and my genitals, all over me, that this feels true...? And much like the sweater I put on, I don’t have to wear it all the time.... There’s a very flexible return policy on this kind of content: if they decide they don’t want it; they don’t have to keep it. But we’re trying it on. Let’s see how it feels.

McDonough: Stacy first saw Sari speak at a virtual conference during the pandemic. 

Watnick: And my whole brain lit up.

McDonough: The two of them have since formed a working group to bring sexual configurations theory into more clinical settings.

Van Anders: Those of us with marginalized or minoritized or oppressed genders, sexes or sexualities are often not given the tools from science or scholarship to make sense of ourselves. And so this can be helpful in that way. But also people who are majorities..., our culture tells everyone..., you’re just a cisgender man; that’s that; there’s nothing more complex; the complexity is for, you know, the other “complicated,” quote, unquote, people. But our research finds that the majorities actually have a lot of complexity and often have had even less prompt to think about it.

McDonough (tape): I’m wondering if you’ve had any pushback from the scientific community or otherwise?

Van Anders: We get a fair bit of skepticism from academics that what people might call laypeople, just you, people on the street, could actually do SCT diagrams because they are a bit more complex than “What is your attraction...?”.... So we sometimes get people who say, “This is pretty hard” or “I’m kind of confused.” And then we’re like, “Okay, can you describe yourself?” And then we look at the dot, and it matches. So people are actually able to do it anyway.

Van Anders: And we sometimes get pushback, too, from majorities who get, like, a little bit angry, who are like, “Okay, well, here, I can locate myself, but, like, I don’t believe in all these other locations....” You know, they’re usually seeing questions that have heterosexual first if there’s a checklist. And here it’s, like, you know, if you’re interested in women, that’s just one little dot in this whole diagram, and that can be a bit disorienting for people who are used to being with the center.

McDonough: Sari thinks that accounting for this complexity is not only helpful for individuals but also for future scientific research.

Van Anders: People sometimes forget that every measure we use is sort of telling a story about what the world is.... They’re kind of almost like a sieve that you sieve the world through. And depending on what that sieve looks like—whether it’s SCT, whether it’s a one-word question with a checkbox or answer or something—is going to let kind of different kinds of things through.... What is empirical in science is to try to measure the world as it is.

For Science, Quickly, this is Meghan McDonough. Tune in next time to listen to episode two of a four-part series on the science of pleasure.

Science, Quickly is produced by Tulika Bose and Jeffery DelViscio. This episode was reported and edited by me, Meghan McDonough, with music by Dominic Smith.

Subscribe to ScientificAmerican.com for more in-depth science news.

• From Our Archives
• Sexuality & Gender Studies Now

Trends and Directions in Sexuality Research at the Start of the Twenty-First Century

To complement our “ Sexuality & Gender Studies Now ” series, we revisit this 2000 report by Diane di Mauro , then program director of the SSRC’s Sexuality Research Fellowship Program. Di Mauro summarizes the history of sexuality research in the United States and then explores how sexuality and gender research can address emerging (and still relevant) themes beyond their framing as “health” issues and in ways that engage the public and policymakers.

Sexuality researchers in the United States were not always, as one observer put it, refugees from the social sciences. At one time research in this area was almost lavishly funded. In 1921, the paucity of scientific knowledge about human sexual behavior led the National Research Council to form the Committee for Research in Problems in Sex, supported by the Rockefeller Foundation. Between 1922 and 1947, the Committee received approximately $1.5 million for the “scientific study of sexuality as a biological phenomenon distinct from the limited study of human social problems of a sexual nature.” More than $1 million was also provided in direct financing to five universities for sex research projects approved by the committee. Efforts supported during this period ranged from studies of hormones and the biology of sex to the pioneering social research of Alfred Kinsey and his collaborators. Following the controversy that erupted after the publication of the Kinsey studies in the late 1940s and early 1950s, funding of research that utilized national samples and focused directly on sexuality decreased steadily, culminating in the rejection of two largescale sexuality studies by the federal government in the early 1990s.

The lack of support for this work within the disciplines in the wake of the Kinsey uproar has had significant effects. As a cohesive field of inquiry and investigation, sexuality research has remained largely underdeveloped. Sexuality researchers have often found themselves isolated within their respective disciplines, and their work has typically been viewed as illegitimate, unimportant, or invisible, only coming to public attention during periods of controversy. Nor has there been any coordinating mechanism in the social sciences to provide financial, logistical, or political support to professionals conducting sexuality research. For generations of researchers, this situation has created enormous disincentives for entering the field. The fact that sexuality research is relevant to a variety of disciplines but prominent in none is evidenced by the lack of comprehensive, specialized training, peer support, and professional recognition for those conducting research in this area.

Nevertheless, some current developments within the field of sexuality research offer significant promise for field development. Research in family planning has in recent years moved beyond contraceptive issues to larger developmental and life-course concerns relating to sexual and reproductive health. A substantial body of research on adolescent sexuality from the 1950s to the 1990s has been accumulated in a variety of disciplines, although with little efforts to integrate these findings into policy formation.

Since the advent of the HIV/AIDS pandemic in the 1980s, most of the information about sexuality has been extrapolated from research on the transmission and prevention of the HIV virus. As a result of the epidemic, numerous high-quality research programs relevant to sexuality have been undertaken by well-recognized researchers representing a variety of disciplines including epidemiology, sociology, psychology, and medical anthropology. Several of these programs in the 1990s developed a strong interdisciplinary orientation. Such programs, both domestic and international, have included: the design, implementation, and evaluation of programs of sexual behavior change; sexuality surveys at the local and national level; HIV/AIDS prevention in various populations and fieldwork studies of sexual patterns in afflicted groups.

The field of sex therapy grew rapidly after the introduction of behavioral therapeutic approaches by Masters and Johnson and others during the 1960s and 1970s. While usually conducted by clinically-trained psychologists, social workers, and others, sexual therapy for individuals and couples has increased considerably, yet often without adequate moorings in scientific research and evaluation of treatment modalities. More recently, cognitive behavioral techniques have been applied to the treatment of sexual dysfunctions, and there have been concomitant advances in the study of physiological measures of sexual functioning and in the understanding of sexual problems, especially in those areas of hormonal development in humans and lower animals. At the same time, the field of sex therapy has become somewhat isolated from other areas in sexuality research, with little impact upon the implications of clinical work for other areas of research (e.g., experimental, developmental, survey).

Scientific advances in the treatment of intersex patients have led to a greater understanding of psychosexual differentiation through an integration of psychological, endocrinal, and genetic contributions. Clinical research in this area has led to basic behavioral studies of the formation of gender identify over the life course. Spontaneous errors of sexual differentiation in patient populations have exemplified the interplay among chromosomes, hormones, body build, sex of assignment, and a list of factors involved in the social process of childrearing. Meanwhile, the social and cultural conditions of sexual and gender development, including the rise of transgender identities, has precipitated an increased attention to the “social construction” of sexuality in the social sciences.

Over the past two decades, the second wave of the feminist movement and the gay and lesbian movement have shifted and transformed research models of and cultural thinking about issues of gender and sexuality, both in and out of the academy. Women’s studies programs have influenced conceptions of gender and sexuality within the more traditional disciplines and have increased research interest in many areas, including sexual rights/discrimination, sexual violence/harassment, and commercial sex work. Scholars in the gay and lesbian movement have influenced both gay and lesbian studies programs and the traditional disciplines by encouraging work that identifies the complex relations among social movements, community structure, personal identity, and sexual practices in the United States and abroad. These influences have been particularly evident in the discipline of history, which has produced considerable new work on the history of sexuality.

Beyond disease prevention

Despite these developments, the primary driving force currently generating sexuality research remains a preventive health agenda that defines sexuality as a social problem and behavioral risk, as in HIV/AIDS or STD transmission or teen pregnancy. This definition typically translates to a disease prevention model of sexuality encompassing medically defined categories of analysis, epidemiological assessments, and/or pharmaceutical interventions. While there can be no doubt that behavioral research is needed to help prevent social problems and/or disease, the ramifications of a limited, preventive approach are significant. First, the research questions are focused primarily on identifying high-risk sexual behaviors and/or motivating behavioral change, and second, sexuality is often conceptualized solely within a negative and problematic context.

In moving beyond the disease prevention approach, a number of priority areas for further research investigation emerge. First, there needs to be a strong commitment to examining biological and social/cultural interactions that impact sexual life. Second, intrinsic factors such as hormonal influences and genetics should be studied in a social and cultural context that reflect the complexity of human sexuality. Third, the influence of cultural differences on sexuality and sexual functioning needs to be understood through careful descriptive and contextual research. In identifying priority areas, an essential question is: On sexuality research topics and issues should investigators and funders concentrate their resources and energies to both advance the field of human sexuality research and provide findings with potential application to society? An emerging list of needed areas of research include:

• Sexuality, social inequality, and injustice is a pervasive theme underlying several needed lines of inquiry. Connected to this, what is the link between specific risk behaviors and social factors such as poverty and limited access to services that increase the rates of STDs and HIV transmission among specific ethnic groups. Some important questions here are: What impact do the social hierarchies reflecting class, race, gender, and sexual orientation have on sexuality and sexual functioning? What is the effect of being excluded from the “mainstream” community by any of those factors?
• Aging and sexuality . The public health of a sexually active aging population is affected by both HIV and other STDs, but also by issues associated primarily with aging, such as: social norms and expectations; biopsychosexual developmental changes of maturation; stigma and discrimination; presence or absence of social and psychological support; loss of relationships and obstacles to forming new, perhaps same-sex, relationships; and retirement.
• Sexuality of women . Given the recent emphasis of research on the sexuality of men in the wake of Viagra, investigations on female sexuality are needed to identify the interactions of biological factors (such as hormonal state) and psychosocial factors (such as power differentials and fear in negotiation of sexual interactions, stress, and/or positive or negative feelings about pregnancy) and their effect on women’s sexuality.
• Relationships and the importance of the dyad (either romantic or parent-child). Given that the nature of “a couple” has changed over the last several decades, research is needed to understand these changing relationships, addressing such questions as: How is the couple viewed differently by each partner within the context of gender script theory? How do people form, maintain, and dissolve relationships? What is the romantic ideology involved? Is it the same for a same-sex relationship as for an opposite sex one? What are the contributions of gender differences to these issues? What impact do these factors, in turn, have on gender violence? A major barrier to the investigation of this type of relationship has been the absence of both appropriate methodologies with which to collect data from couples and statistical models to analyze quantitative data.
• Adolescent relationships . Knowledge is particularly lacking about how adolescents go about forming partnerships, and how success in this regard can contribute to their feelings of competency. How do children conceptualize gender scripts and the development of relationships?
• The impact of same-gender relationships warrants investigation, especially in light of recent changes in public policy, e.g., the recognition of civil unions of same-sex couples in Vermont. Here, the questions are: Will the legalization of such unions have a positive outcome on sexual and mental health? What impact will it have on opposite gender, i.e., heterosexual, couples that choose to forgo marriage in favor of other partnership or family structures? What effect will other social changes, such as the recent growth of the “out culture,” have in terms of personal self-esteem and self-efficacy, sexual behaviors, and the formation of new sexual scripts?
• Norms . How and to what extent culturally-based religious and social norms influence a range of behaviors relating to sexuality over the life course would be an important line of inquiry, including sexual negotiation, gender roles and gender scripts, contraceptive use and HIV/STD protection, and same sex-behaviors and sexual identity.
• Religious beliefs and prohibitions . The impact of religious beliefs and prohibitions on sexual behaviors and the role of religious communities and religious leaders in this regard is little understood. Considering that humans now mature sexually at an earlier age and marry later than in the past, and that marriages often end in divorce leading to another period of single adulthood, an important question is: What are the ramifications of religious prohibitions against premarital sexual intercourse that allow for no discussion of protection against sexually transmitted infections or unwanted pregnancy? What is their impact on policy in this regard?
• Media, information technology, and sexuality . The advent and acceleration of communication technologies presents new research questions and challenges as the Internet becomes an increasingly significant conduit for “sex education” and the arena in which new relationships are initiated (either in actuality or in cyberspace). Research is needed to address the usefulness and impact of the media and of IT for information production and dissemination and its link to sexual socialization, behavior, and practices. Some important questions to address are: What is the role or responsibility of the media in promoting sexual health? What is the significance and importance of the internet as a new sexual conduit for men and for women? What is its significance for research design and implementation with the possibility of new methods of data collection and multisite studies?

The way in which sexuality is conceptualized has significant impact on the research undertaken, the funding available for its support and its links to advocacy, service provision, and public opinion; as well, it directs researchers to prioritize specific topics, approaches, and issues, prompting them to compete with other researchers for the small amount of funding available for work in this area.

Acceptance and legitimization of sexuality research and recognition of its potential contribution to public policy is affected by various factors including the political climate, public awareness, funding, and the participation of diverse professional organizations and networks. Currently, there remains considerable public misperception of sexuality researchers as flag bearers of the “sexual revolution,” and substantial work is needed, both within and outside of academic arenas, to promote the research and its potential impact as well as those who conduct it.

Some significant policy issues

Although the US public is generally uninformed about the value and contribution of sexuality research to discourse on important topics, there is a “silent and diffuse majority” that is receptive to information about human sexuality linked to the quality of life health status and promotion, relationships, and family well-being. Juxtaposed to this group are the relatively vocal extremists (an “intense minority,” e.g., the religious right) who have proven their skill at grassroots organization, lobbying, and interfacing with the media. Effectively able to shape public opinion, this group continues to promulgate via diverse channels that research questions about human sexuality should not be asked and that human sexuality is not a legitimate area of research inquiry, forcefully hindering support for this work.

In order to be effective communicators of their findings, researchers must tell a potentially complex story in a simple way. This is not a matter of “scaling down” research findings, but of waiting until the emerging picture is sufficiently mature to allow for the appropriate identification of a central message—a process useful to the academic and lay communities alike. Such simplicity can emphasize relevance, and in so doing, can be more compelling to the public consumer. Major tasks for researchers, then, are: to understand the social contexts within which various segments of the public interacts (e.g., religious, ethnic, cultural, and familial arenas), present compelling data to the public via diverse and customized dissemination activities, and be able to effectively address concerns raised during public discourse. Moreover, researchers need to incorporate the “concerns” of the public by making use of the data they produce in ways that the public can identify. Life or situational “stories” can have a significant effect in this regard, such as “case study” stories of couples or dyads that powerfully communicate important issues, in many instances much more effectively than current methods of dissemination based solely on reiterating statistical data.

While research dissemination of issues and data increasingly takes place in the context of community outreach and education through providers, service organizations, and advocacy groups, the media remains the most far-reaching and powerful means of public communication available to researchers—for the dissemination of their work, to convey credibility on sexuality research, to change public opinion and, ultimately, to affect public policy. And yet, this arena remains a woefully underused mechanism for most researchers who are typically trained not to engage in public discourse and shudder at the prospect of working with the mass media (knowing that the experience is often one in which they are unexpectedly “set up” in a false debate, misquoted in print, or rushed through radio or television interviews with loss of the crucial context of their messages).

The sexuality research field in the United States has not, and currently is not viewed, as an effective force in policy development and implementation, and an important factor in this regard is the lack of effective leadership in the field. Moreover, sexuality researchers have little participation in the political arena so visibly dominated by conservative organizations, effectively able to bring their ideological views, unsubstantiated by research, to bear on legislators or other policymakers. Yet the political arena can present positive opportunities of which the research community must take advantage. An example of this is the forthcoming Surgeon General’s report, Sexual Health and Responsible Sexual Behavior (January 2001), which provides a comprehensive definition both of individual sexual health and a sexually-healthy society, supports training for all professionals whose work relates to sexuality and a comprehensive sexuality research agenda and promotes research evaluation/ dissemination to practitioners, policymakers and educators. The planned, extensive distribution of this report to individuals and organizations at the community level nationwide will significantly encourage a more constructive public discourse about sexuality. Researchers should be ready to clarify and discuss the implications of the report, thus not only providing this essential public service but in so doing, publicly demonstrating the significance and relevance of the work.

In order to ensure the effective translation of research into applied work relevant to the general public, communities, NGOs, and individual practitioners, sexuality researchers must be able to play a more active role in the development and implementation of policy. The creation of both a national commission of research experts and a coalition of research and policy organizations would exert a much-needed leadership in that it could periodically issue data-based recommendations and/or executive summaries concerning sexuality research, education and funding, testify before legislative and other policymaking groups, and monitor media coverage of emerging policies. Policy training workshops provide important formalized opportunities for accumulating skill in providing quick, accurate responses to public policy changes, and to effectively disseminate research findings relevant to sexuality in general and sexual health in particular. Policy forum series in which sexuality researchers, politicians, government representatives, and policy planners participate would provide an opportunity to exchange ideas and dialogue on relevant health issues. These forums would include politicians, legislators, and journalists and could occur in the form of breakfast meetings or monthly working groups. In this exchange, researchers would have the opportunity to educate politicians about the significant and potential impact of current research findings (including public health and mental health consequences) and in turn, policymakers can apprise researchers of ways in which they can become a part of the policy development process. They may be able to move toward working alliance of mutual respect and understanding.

This article is based in large part on the discussion at several meetings, in particular a roundtable on the trends and future directions of sexuality research and training held at the Council offices on June 1–2, 2000.

This archive piece was originally published as “ Current Trends and Future Directions in Sexuality Research .”

Diane di Mauro has worked over 20 years in the field of human sexuality, specializing in the areas of sexuality research and education. She served as the director of the SSRC’s Sexuality Research Program (SRFP), which was active from 1996 to 2005. Di Mauro is the author of Sexuality Research in the United States: An Assessment of the Social and Behavioral Sciences (SSRC, 1995.)

This essay originally appeared in Items & Issues Vol. 2, No. 3–4 in the fall of 2000. Visit our archives to view the original as it first appeared in the print editions of Items .

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Children and young people’s views on learning about sex, sexuality and relationships: literature review

Exploring how children gain knowledge and seek support.

Young people receive messages about relationships, sex and sexuality throughout all aspects of their lives. What they learn in school is important, however, lived experience, relationships, social media, and social norms also have an impact.

To find out what research tells us about young people's experiences of learning about relationships, sex and sexuality we reviewed the published literature.

We identified 172 journal articles and reports, all of which drew on the direct views of children for inclusion in our study. We looked at:

• how and where 11- to 25-year-olds learn about relationships, sex and sexuality
• children’s views of the relationships and sex education (RSE) they currently receive or have previously received
• differences in children’s experiences based on their personal characteristics (e.g. sexuality, gender identity, age).

Our literature review highlights the need for adults to better understand children's different experiences and will inform the NSPCC’s research, service development, policy influencing, and communications.

Authors: Vicki Hollis, Rachel Margolis, Mike Williams, Zoe Swaine, Flavia Russo, Madeleine Baldwin, Chloe Gill   Published: 2022  

Key findings

Children learn about relationships, sex and sexuality intentionally and unintentionally inside and outside of school.

Wider society, peers, friends and family all influence children. They also learn through social media, pornography, and other online sources. Parents can sometimes face challenges in having conversations about sex and healthy relationships with their children.

Children’s formal in-school relationships and sex education (RSE) doesn’t match their lived experience

Most RSE assumes children are heterosexual and does not consider LGBTQ+ experiences. Children think that information is provided too late on topics such as periods, consent and recognising sexual abuse and grooming.

Children want school-based RSE to be more regular, interactive, skills-based, inclusive, and positively framed

Suggestions include:

• interactive classes
• specially trained members of staff in schools to help children with concerns around sex and relationships
• discussing real-life issues
• taking a life-skills approach that doesn’t focus on abstinence
• learning from people who have personal experience of a topic.

School culture is also important for helping children establish what is and isn’t acceptable regarding relationships, sex and sexuality

Children have described how they would like to see the whole-school environment reflect an ethos of respect and care for all students.

Please cite as: Hollis, V. et al (2022) Children and young people's views on learning about relationships, sex, and sexuality: a narrative review of UK literature. London: NSPCC.   

Related resources

Training, lesson plans, a whole-school approach framework and a dedicated helpline to support secondary school teachers and leaders embed sex and relationships education across their whole school.

Relationships and sex education teaching resources to help you plan health, relationships and sex education that protects young people and promotes healthy wellbeing.

Explains why LGBTQ+ children might be at greater risk of some types of abuse and shares best practice for professionals on supporting and protecting them.

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Unveiling 'Ronda Girls of Pateros': Marielle Marcaida's Impact as a UW Libraries Research Communication and Equity Fellow

Marielle Marcaida, a PhD student in Gender, Women & Sexuality Studies, was recently honored as one of this year's UW Libraries Research Communication and Equity Fellows during a reception held on Thursday, May 9.

The UW Libraries Research Communication and Equity Fellowship , designed for Black, Indigenous, and People of Color (BIPOC) graduate students, requires Fellows to create and exhibit a physical artifact visually communicating their research. This opportunity not only raises the visibility of their work on campus but also helps them develop skills for communicating research in public formats.

At the reception, Marielle unveiled her project titled "Ronda Girls of Pateros." This project explores the human rights activism of mothers of drug war victims under the Duterte administration’s “war on drugs” in the Philippines. Through a digital booklet, Marielle intricately delves into the often-overlooked narratives and experiences of women affected by this controversial campaign, highlighting their resilience and grassroots initiatives like the Ronda ng Kababaihan (Patrol of Women) in Pateros City.

The artifacts from all 2024 Fellows, including Marielle's project, are currently on display in the UW Libraries Research Commons and are also available online .

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17th Annual Johns Hopkins Center for Women's Health, Sex, and Gender Research Spring Symposium

Department & Center Events

The Johns Hopkins Center for Women's Health, Sex, & Gender Research is proud to present, along with the Johns Hopkins Women's Wellness and Healthy Aging Program , a joint symposium on "Advancing Sex and Gender Research on Menopause & Healthy Aging," with a keynote presented by JoAnn Pinkerton , a professor of obstetrics and gynecology and division director of midlife health in the University of Virginia Health System.

Registration is required

Please register in advance

The symposium will begin with a poster session. Registrations for presentations related to "Sex and Gender Research Through the Life Course" are due Friday, May 24.

For questions, please email Patrick Shea at [email protected] , Brittany Seibert at [email protected] , or Maclaine Parish at [email protected] .

Please join us for the 17th Annual Johns Hopkins Center for Women's Health, Sex, and Gender Research Spring Symposium! The Johns Hopkins Center for Women's Health, Sex, & Gender Research is proud to present, along with the Johns Hopkins Women's Wellness and Healthy Aging Program, a joint symposium: Advancing Sex and Gender Research on Menopause & Healthy Aging ,  with a keynote presented by JoAnn Pinkerton, MD, FACOG, NCMP, Professor of Obstetrics and Gynecology, Division Director of Midlife Health, University of Virginia Health System.

The Symposium will take place on Friday, May 31st from 8:30am - 12:00pm in Feinstone Hall (BSPH Room E2030). This will be an in-person event and will not be livestreamed.  Please register to attend at the link below:

Register: https://forms.office.com/r/zmE1dkdwME  

The Symposium will feature a poster session, for which we are now calling for Poster Registrations for Presentations on Sex & Gender Research Through the Lifecourse. Deadline for Poster Registration Submission: Friday, May 24th 2024.

If you have any questions, please reach out to Patrick Shea ( [email protected] ), Brittany Seibert ( [email protected] ), or Maclaine Parish ( [email protected] ).

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Women’s Sexuality: Behaviors, Responses, and Individual Differences

Classic and contemporary approaches to the assessment of female sexuality are discussed. General approaches, assessment strategies, and models of female sexuality are organized within the conceptual domains of sexual behaviors, sexual responses (desire, excitement, orgasm, and resolution), and individual differences, including general and sex-specific personality models. Where applicable, important trends and relationships are highlighted in the literature with both existing reports and previously unpublished data. The present conceptual overview highlights areas in sexual assessment and model building that are in need of further research and theoretical clarification.

Research in female sexuality is fractionated. Significant contributions in specific areas, such as assessment, treatment, or understanding sexual phenomena have not necessarily led to offshoot contributions in related areas. Mirroring the field of human sexuality, the study of women’s sexuality has lacked an overarching conceptual basis with which to compare, evaluate, and guide ongoing research; hence, to significantly advance sexual science, it has been suggested that we must develop comprehensive theories and constructs that describe, explain, and predict sexual phenomena ( Abramson, 1990 ). The present contribution discusses issues in the assessment of female sexuality from the organizational framework of concepts rather than measures. Here, we provide information on classic and contemporary approaches, and the discussion is framed within the conceptual domains of sexual behaviors, sexual responses (i.e., the sexual response cycle), and individual differences.

An unprecedented number of sexual behavior studies have been conducted in response to the HIV–AIDS crisis (see Catania, Gibson, Chitwood, & Coates, 1990 , for a review). However, research on the assessment of female sexual behavior, exclusive of behaviors that lead to increased HIV risk, remains limited (but see sex survey of Laumann et al. from the University of Chicago; Laumann, Gagnon, Michael, & Michaels, 1994 ). The coverage is most complete for heterosexual behaviors. This is not an intentional bias, and we acknowledge the dearth of data on sexuality topics for lesbians.

We regard a sexual response cycle conceptualization, specifically desire, excitement, orgasm, and resolution, as an important second component in a working model of female sexuality. Although there are significant and important interrelationships among the phases, there are sufficient data to suggest that each has unique aspects, too. The separate elaboration of the phases may also clarify the female sexual dysfunctions, as the majority of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994 ) diagnoses are now conceptualized according to phasic disruption. As we consider assessment of each phase, we consider four “channels” for assessment: physiological, cognitive, affective, and behavioral.

The resurgence in personality research in the past decade (see Goldberg, 1993 , for an interesting historical discussion) and our own line of cognitive research compels us to examine the role of individual differences in women’s sexuality. Here we discuss the contemporary organization of personality structure, the Big Five model, as well as sexually relevant personality factors, such as sexual self-schema.

Sexual Behavior

In the United States, the first large-scale study of sexual behavior was that by Kinsey and his colleagues ( Kinsey, Pomeroy, & Martin, 1948 ; Kinsey, Pomeroy, Martin, & Gebhard, 1953 ). Their efforts, however, were predated by Terman’s ( Terman, Buttenwieser, Ferguson, Johnson, & Wilson, 1938 ) more focused analysis of sexual behaviors, practices, and preferences in the context of marriage. Terman was specifically interested in the role of a couple’s sexual relationship in their marital adjustment and headed one of the first research groups to study in detail such aspects as the frequency of intercourse, relative “passionateness” of the spouses, refusal of intercourse, orgasm, duration of intercourse, the wife’s response to first intercourse, contraceptive practices, the wife’s desire, and each individual’s sexual complaints about the other. In the Kinsey interviews, conducted with thousands of women and men, the focus was similar, yet with a life-span orientation. They included the following: preadolescent heterosexual and homosexual play; masturbation; nocturnal sex emissions and dreams; heterosexual petting; premarital, marital, and extramarital coitus; intercourse with prostitutes (for men only); homosexual contacts; animal contacts; and, finally, the total sexual outlet, defined as the sum of the various activities which culminated in orgasm. Other topics that are now recognized as important to sexual development (and perhaps the subsequent occurrence of sexual dysfunctions), such as incest and other traumatic sexual experiences, received less coverage.

In addition to the significant public attention that the Kinsey volumes received, it is clear that their behavior chronicle interview is one of the few examples of a method affecting the nature of sex research for decades. It was mirrored, for example, in the late 1950s to the early 1970s with investigators including Podell and Perkins (1957) , Brady and Levitt (1965) , and Zuckerman (1973) publishing listings of heterosexual behaviors for men and women. The scales consisted of 12 to 20 items and included experiences that ranged from kissing to intercourse or mutual oral stimulation. Undergraduates were typically the research participants—an unusually relevant group because one aspect of these studies was to provide an ordinal (Guttman) scaling of the items. These data suggest, in part, a hierarchical or chronological ordering of sexual experiences. This is nicely illustrated by Peter Bentler’s (1968) 21-item experience scale. Years later, this method continues to appear in assessment and therapy arenas. For example, omnibus sexual functioning inventories, such as the Sexual Interaction Inventory by LoPiccolo and Steger (1974) , include the same hierarchical listing of sexual behaviors for each of its 11 scales. Such orderings also provide an empirical basis for generic hierarchy construction in systematic desensitization therapy studies (see Andersen, 1983 , for a review).

To illustrate scales of this sort, we provide data in Table 1 for the 24 items from the Sexual Experience Scale of the Derogatis Sexual Functioning Inventory (DSFI; Derogatis & Melisaratos, 1979 ). Rather than use the Derogatis yes–no format for scoring, we asked 172 undergraduate women (mean age, 19.3 years) to complete two versions of the scale. On the first assessment (previous scoring), they indicated whether they had ever experienced the activity. We have used such a scoring as an indicator of a woman’s sexual history, as scores would range from 0 to 24 and quantify the range of heterosexual behaviors that had been experienced in one’s lifetime (e.g., Andersen & Jochimsen, 1985 ). As indicated in the far left column of Table 1 , a hierarchical ordering of the items can be determined. In large part, comparison of the ordering with the much earlier Bentler data (1968) is similar, with the addition of the items masturbation, anal intercourse, and anal stimulation on the low-frequency end of the listing. Also of note is male-initiated or male-dominated versions of many of the items preceding the female counterpart items (e.g., intercourse with male “on top,” 71%, vs. intercourse with female “on top,” 68%; oral stimulation of one’s genitals by partner, 72%, vs. oral stimulation of partner’s genitals, 70%). These trends are consistent with gender differences found in the frequency of oral sex, as reported in the most recent comprehensive sex survey (e.g., 77% of men vs. 68% of women reported engaging in active oral sex at least once in their lifetime; Laumann, Gagnon, Michael, & Michaels, 1994 ). On the second assessment, women indicated their frequency of behaviors in the past 30 days on a scale ranging from 0 (activity did not occur) to 9 (activity occurred two or more times per day) for each item. As might be expected, data for the present scoring reflect the previous scoring hierarchical ordering. We have also found that use of frequency rating scales rather than dichotomous presence–absence scoring provides greater sensitivity when the purpose is to assess behavior change or group differences (see Andersen & Broffitt, 1988 , for a discussion).

Sexual Experience Scale for Previous and Current Scoring for College-Age Women (N= 172)

Note. For the previous scoring, items were scored 0 (never experienced in my lifetime) and 1 (experienced at least once in my lifetime). Values are percentages of women in the sample who endorsed each item as having been experienced at least once. For the current scoring, the following scale was used for the frequency of each behavior in the past 30 days: 0 = this activity did not occur, 1 = activity occured once, 2 = activity occurred twice, 3 = activity occurred three times, 4 = activity occurred four times, 5 = activity occurred five times, 6 = once a week, 1 = two to six times a week, 8 = once a day, and 9 = two or more times a day. SES = Sexual Experience Scale.

Despite the usefulness of such scales, questions have been raised about the reliability and validity of any method that uses self-reports of sexual behavior. Rather than discuss them here, we refer the reader to reviews of these issues (e.g., Catania, Gibson, Chitwood, & Coates, 1990 ; Morokoff, 1986 ). Methodologic problems notwithstanding, further research efforts are needed to clarify which variables constitute the domain of women’s sexual behavior. The behavior listings noted earlier may provide a useful starting point. For example, in an earlier report we provided a factor-analytic study of the Sexual Experience Scale from the DSFI ( Andersen & Broffitt, 1988 ). Responses were obtained from nonstudent, “older” women (mean age, 41 years; range, 21 to 65 years). Women rated each item in a yes–no format, indicating whether the activity had occurred in the previous 3 months. A five-factor principle components solution that accounted for 82% of the variance was selected as the best fit for the data. Inspection of the factor loadings indicated that the items fell into the following subgroups: (a) masturbation (7% of the variance); (b) arousing activities, the majority of which occurring while clothed, including kissing with tongue contact, erotic embraces, breast fondling, and undressing (22% of the variance); (c) intimate activities, the majority of which occurring while unclothed, including kissing of breasts and other parts of the body and manual and oral genital stimulation (23% of the variance); (d) intercourse position items (13% of the variance); and (e) anal stimulation and anal intercourse (16% of the variance). We have since replicated this factor solution with the sample of 172 undergraduate women who provided the data in Table 1 . Data from the previous scoring was submitted to a principal-axis factor analysis with an oblique Harris-Kaiser rotation. The solutions are identical with one exception: items from groupings (b) and (c) combine to form a single factor, with the oral-genital stimulation items forming a second, separate factor.

As any factor solution is dependent on the items represented, these are unique to the items included by Derogatis and the participants in the samples described. However, if comparison is made between these Derogatis items and those in the scales noted earlier, one finds significant overlap, 100% with the Zuckerman (1973) and 86% with the Bentler (1968) measures, for example, and often the exact wordings for the items are used. The notable additions by Derogatis to the earlier behavioral scales were items assessing masturbation and anal stimulation. In summary, these analyses suggest that behavioral listing measures may provide a reasonable sampling of the sexual behavior domain for adult heterosexual women. Furthermore, careful selection of rating scales for such listings may provide useful indicators for women’s heterosexual behavior repertoires and estimates of current sexual activity.

Sexual Response Cycle

As noted by Rosen and Beck, there is “a fundamental assumption underlying most conceptualizations of sexual response [and that is that] sexual arousal processes are likely to follow a predictable sequence of events, and that a cyclical pattern of physiological responding can potentially be identified” (1988, p. 25). However, there has been disagreement about the number and importance of each phase. Although popularized by Masters and Johnson (1966) , the concept of stages of sexual engagement has early origins. As summarized in Table 2 , the number of stages has ranged from two to four. The phases of desire, plateau, and resolution are inconsistently represented, whereas a two-dimensional model of arousal–excitement process and an orgasm or orgasm–immediate postorgasm phase has been consistent. Historically, researchers have focused on understanding excitement (or sexual arousal), but more recently there has been similar emphases on defining the psychological and behavioral boundaries of sexual desire.

Historical Models of the Sexual Response Cycle

We combed the literature to find assessment strategies for these four dimensions, yet there are few that follow this comprehensive conceptualization. In fact, Masters and Johnson’s (1966) widely publicized findings appear to have had minimal impact when it comes to assessing sexual responding in clinical samples. Even their own assessment strategy—a lengthy oral interview described in the 1970 book—has little continuity with the 1966 model. In articles and chapters by researchers, a functional analysis of the antecedents, problem behaviors, and consequences of the particular sexual difficulty is most common. Although the latter is very useful, one may not necessarily obtain information about all phases of the sexual response cycle. Whereas our efforts have concentrated on such a measure (e.g., Andersen, Anderson, & deProsse, 1989 ), others have either developed phase-specific measures or multidimensional inventories (e.g., body image, sexual satisfaction, sexual roles, etc.; Derogatis & Melisaratos, 1979 ; LoPiccolo & Steger, 1974 ).

Sexual Desire

A decade after Masters and Johnson’s (1966) formulation proposing sexual excitement as the first phase of the response cycle, Kaplan (1979) and Lief (1977) asserted an expanded model that began with sexual desire, and the term inhibited sexual desire was coined for individuals who chronically failed to initiate or respond to sexual cues ( Lief, 1977 ). What is sexual desire? Current theories range from purely dynamic models to ones that emphasize biologic factors. Kaplan (1979) , in her influential volume, Disorders of Sexual Desire, reiterated the psychoanalytic position of libido as an innate emotional force that would be expressed in either sexual or nonsexual outlets. It would follow, then, that any inhibition of desire would be due to the unconscious repression or conscious suppression of urges for sexual contact. In either case, such defenses would arise from intrapsychic conflicts surrounding sexuality.

There are interactional models of desire and ones that emphasize other, nondynamic, psychological processes (see also a discussion by Beck, 1995 ). Levine (1992) , for example, highlights the role of sexual drive, seen as a biologically based source, and the individual’s behavioral and cognitive efforts to seek sexual stimulation. In contrast, Singer and Toates (1987) offer a central-nervous-system-mediated motivational model. They propose that sexual motivation, like hunger or thirst, emerges from an interaction of external incentives (i.e., a sexual stimulus) and internal states (e.g., sexual deprivation). Leiblum and Rosen (1988) note both intrapsychic and interpersonal aspects, but they define sexual desire functionally (i.e., desire is both a setting event and a consequence of sexual activity. Finally, Hatfield relies on her rich conceptualization of passionate love for the context of sexual desire; she sees sexual desire as a psychological longing for sexual union that is tied to sexual satisfaction and interpersonal relationship satisfaction (i.e., love) for the partner ( Hatfield & Rapson, 1987 ; Traupman, Eckels, & Hatfield, 1982 ).

Biologic models of sexual desire are controversial and currently emphasize hormonal mechanisms. Data are most consistent for the necessary (but not sufficient) role of androgens, probably testosterone. For this model, the majority of supporting data comes from men (e.g., O’Carroll, Shapiro, & Bancroft, 1985 ). Bancroft (1988) proposes that the occurrence of spontaneous erections during sleep are the behavioral manifestations of the androgen-based neurophysiological substrate of sexual desire; in contrast, erections with fantasy or erotic visual cues are seen as evidence for androgen-independent responses.

Hormone–sexual behavior relationships for women are less clear, although estrogen, progesterone, and androgen (testosterone) have been studied. Regarding estrogen effects, it is clear that some amount of estrogen is necessary for normal vaginal lubrication, and receipt of estrogen replacement therapy after menopause may reduce the problematic symptoms (e.g., lack of lubrication, atrophic vaginitis) and allow sexual activity or functioning to proceed unimpaired ( Walling, Andersen, & Johnson, 1990 ). In contrast, progesterone may actually have an inhibitory effect ( Bancroft, 1988 ). Finally, testosterone may have direct effects on sexual functioning; both Bancroft and Wu (1983) and Schreiner-Engel, Schiavi, Smith, and White (1982) have found positive relationships between testosterone levels and frequency of masturbation and vaginal responses to erotic stimuli. In studies of women for whom estrogen therapy was not effective for postmenopausal symptoms, testosterone administration improved sexual desire and related outcomes ( Burger et al., 1984 ; Studd et al., 1977 ). Perhaps the most direct data on this topic are by Alexander and Sherwin (1993) . In studying 19 oral contraceptive users, they reported that plasma levels of free testosterone was correlated with self-report measures of sexual desire, sexual thoughts, and anticipation of sexual activity. However, an interesting and more direct test of the hypothesis that testosterone is related to sexual cognitions was disconfirmed; using a selective attention (dichotic listening) task, Alexander and Sherwin found no relationship between levels of free testosterone and an attentional bias for sexual stimuli. Finally, a clinical study by Schreiner-Engel, Schiavi, White, and Ghizzani (1989) is relevant. They compared 17 women who met Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM–HI–R; American Psychiatric Association, 1987 ) criteria for loss of desire with 13 healthy, sexually active women. Blood samples were drawn every 3–4 days for one menstrual cycle and were analyzed for testosterone, estradiol, progesterone, prolactin, and luteinizing hormone. No differences between the groups were found, and subgroup analyses (e.g., comparison of women with lifelong absence of desire vs. those with acquired loss of desire) were also disconfirming. At present, it is unclear whether physiologic measures, and hormonal assays in particular, are useful physiologic indicators of sexual desire.

Considering the other channels for assessment, cognitions have been emphasized. For example, in DSM definitions (both DSM–III–R and the fourth edition [DSM–IV; American Psychiatric Association, 1994 ]), there is little suggestion of the theoretical models discussed earlier or of any specific physiologic or affective markers (other than generic psychologic distress). Instead, a circular statement (i.e., that hypoactive desire is deficient desire) is linked to a cognitive symptom—the absence of sexual fantasy. Correlational data suggest that, in general, individuals distressed about their sexual functioning report fewer spontaneous sexual fantasies, a higher likelihood that sexual fantasy will generate concomitant feelings of sexual guilt, and that they may prematurely terminate their fantasizing ( Zimmer, Borchardt, & Fischle, 1983 ). A comparison of women diagnosed with inhibited sexual desire and nondysfunctional women has revealed that women with desire problems fantasized less during a variety of sexual activities, including foreplay, coitus, and masturbation ( Nutter & Condron, 1983 ). Epidemiologic data indicate that women use sexual fantasies to increase sexual desire and facilitate orgasm ( Lunde, Larsen, Fog, & Garde, 1991 ). Not surprisingly, fantasy does play an important role in sex therapies (e.g, directed masturbation, systematic desensitization). Although these lines of data suggest some importance to the role of fantasy, there are not data at present suggesting that the absence of fantasy is pathognomic for low sexual desire.

Data comparing the frequency of internally generated thoughts (fantasies) and externally prompted thoughts (sexual urges) among young heterosexual men and women indicate that men report a greater frequency of urges than do women (4.5/day vs. 2.0/day), although the frequency of fantasies were similar (2.5/day; Jones & Barlow, 1990 ). Related data from Laumann, Gagnon, Michael, and Michaels (1994) indicate a normal distribution in the frequency of autoerotic activities (e.g., fantasy, masturbation, use of erotica) among women, with an elevated flat distribution for men. This indicates that, on average, men have higher rates of autoerotic activities and that there is less variance among men; for women, this indicates that, on average, women have generally lower rates but there are more individual differences among women in the frequency of autoerotic activity. Regarding the specific content of women’s fantasies, the data of Ellis and Symons (1990) suggest that touching, partner responses, and emotional responses may be important, in contrast to the characterization of men’s fantasies, which emphasizes visual imagery of the sexual partner or the sexual act.

There are self-report measures of sexual fantasy. Wilson’s (1988) 40-item measure includes four topical areas: exploratory (e.g., group sex, swapping items), intimate (e.g., heterosexual behaviors), impersonal (e.g., sex with strangers), and sadomasochistic fantasy topics (e.g., forced sex, whipping). Correlation analyses reveal that higher self-reported levels of sex drive are correlated with more frequent sexual fantasies, particularly intimate fantasies for women (e.g., r = .49 for women vs. .05 for men). There is also a 20-item fantasy scale on the DSFI; however, there are few psychometric data on this scale. Snell and Papini (1989 ; see also Snell, Fisher, & Schuh, 1992 ) have developed a measure of sexual preoccupation, or the tendency to think about sex to an “excessive degree.” This is a 10-item subscale from the Sexuality Scale on which an individual endorses frequent thoughts, fantasies, and daydreams about sex (e.g., “I think about sex a great deal of the time,” “I hardly ever fantasize about having sex”). Internal consistency of the measure is high (.88–.91) and 4-week test–retest is adequate (.70–.76). There are few convergent and discriminant data, but they are supportive. The measure is positively correlated but not overlapping with Byrne’s (1983) measure of erotophilia (.32) and negatively correlated with measures of sexual anxiety (−.36) and sexual guilt (−.22). Measures such as these may be useful to assess sexual cognitions. Other techniques exist (see Cacioppo & Petty, 1981 , for thought listing procedures) yet have not been used in sexuality research, despite their usefulness in the areas of social cognition and cognitive therapy research. When such measures are not used, researchers often use proxy variables. One strategy has been to have participants rate their sexual desire and then correlate these data with other indicators, such as sexual arousal or behavior (e.g., Beck, Bozman, & Qualtrough, 1991 ).

Provided below are symptom descriptions of individuals complaining of low desire. These may provide useful phenomenologic information for future assessment research. Specifically, we note the following.

• Individuals with low desire report that they are generally uninterested in sexual activity. Such an attitude can be manifest behaviorally by never initiating sexual contact, avoiding sexual contexts, or refusing a partner’s initiations. These behaviors are presumably not due to strong negative responses to interpersonal or genital contact, an important point to consider when ruling out alternatives, specifically a sexual aversion disorder (see Discussion; for an early example of the absence of distinction, see McCarthy, 1984 ). Instead, individuals with low desire disorder are thought to be indifferent or neutral toward sexual activity. Sexual urges seem not to occur.
• Individuals with low desire may report no sexual cognitions—fantasies or other pleasant, arousing sexual thoughts and mental images.
• In terms of self-descriptions, individuals with low desire may have an asexual self-view.
• Disruption in the frequency, focus, intensity, or duration of sexual activity may occur, and secondary disruption of sub sequent response cycle phases may occur.

Sexual Excitement

Either physical or psychologic sexual stimulation can initiate sexual excitement. The bodily changes with sexual excitement are considerable. The general physiologic responses are widespread vasocongestion, either superficial or deep, and myotonia, with either voluntary or involuntary muscle contractions. Other changes include increases in heart rate and blood pressure and deeper, more rapid respiration. For women, sexual excitement is also characterized by the appearance of vaginal lubrication, produced by vasocongestion in the vaginal walls, leading to transudation of fluid. Other changes include a slight enlargement of the clitoris and uterus with engorgement. The uterus also rises in position with the vagina expanding and ballooning out. Maximal vasocongestion of the vagina produces a congested orgasmic platform in the lower one third of the vaginal barrel. As discussed later, individuals may not be aware of the physiologic sensations of arousal; even if they are, their affects may or may not be convergent. Thus, in the following discussion, we consider both positive affects, such as arousal, and negative affects, such as anxiety, which may relate to sexual excitement. Consideration of negative affects is relevant as some (e.g., anxiety) are key in theoretical models of sexual excitement difficulties or dysfunctions.

Arousal and other positive emotions

Studies have addressed the physiological and affective aspects of arousal. Although the aforementioned description notes vasocongestion and lubrication as the predominant bodily responses, psychophysiological research has consisted largely of measures of vaginal vasocongestion (i.e., vaginal pulse amplitude [VPA], vaginal blood volume [VBV]) using the vaginal plethesmograph. Other genital measurements (such as those for lubrication) have not emerged, are unreliable, or are not sensitive to changes in arousal (see Geer & Head, 1990 , for a review). As a physiological indicator of sexual arousal, it is still unclear what these vaginal signals represent and whether they are analogues of distinct vascular processes ( Levine, 1992 ). However, there is evidence for their convergent validity. For example, VPA and VBV are capable of detecting group differences (e.g., differences in as absolute levels of arousal between women with and those without sexual dysfunctions), and responsiveness to experimental conditions (e.g., novel exposure and habituation to erotic stimuli, contrasts between erotic vs. nonerotic stimuli; Meuwissen & Over, 1990 ; Heiman, Rowland, Hatch, & Gladue, 1991 ; Laan, Everaerd, van Bellen, & Hanewals, 1994 ). Of the two measures, a variety of data suggest that VPA is the more sensitive and reliable genital measure, particularly because of its insensitivity to anxiety-evoking stimuli ( Lann, Everaerd, & Evers, in press ).

The construct of arousability is central to understanding cognitive and affective aspects of sexual excitement in women. According to Bancroft (1989) , arousability is a cognitive sensitivity to external sexual cues. He suggests that high arousability implies enhanced perception, awareness, and processing of not only sexual cues but the bodily responses of sexual excitement. This model seeks to connect cognitive–affective responses with control of genital and peripheral indications of sexual excitement through a neurophysiological substrate for sexual arousal. Fortunately, one of the psychometrically strongest self-report measure for female sexuality is one that also taps sexual arousability, the Sexual Arousability Index (SAI) by Hoon, Hoon, and Wincze (1976) . On this 28-item measure, women rate their sexual arousal for a variety of erotic and explicit sexual behaviors. Both the clinical usefulness and the power of the instrument are likely due to the important steps that were taken in the scale construction and validation process, including selecting items that evidenced convergent validity with criterion variables such as women’s awareness of physiological changes during sexual arousal (e.g., vaginal lubrication, nipple erection, sex flush, breast swelling, muscular tension), ratings of satisfaction with responsiveness, and sexual behavior measures. The measure samples a range of individual and partnered erotic and sexual behaviors; our psychometric studies indicate that the SAI samples the following domains: arousal associated with erotica (e.g., literature or photography) and masturbation, seductive activities (e.g., passionate kissing, being undressed), body caressing by a male partner, oral-genital and genital stimulation, and intercourse ( Andersen, Broffit, Karlsson, & Turnquist, 1989 ). 1

Although there is the expectation that physiologic measures, behavioral reports, and subjective reports converge, examples of dyscrony are common (see Turpin, 1991 , for a discussion of assessment of anxiety disorders), so too in this area, reports are mixed. Significant correlations have been found between genital measures and women’s ratings of their general arousal (e.g., Morokoff, 1985 ; Palace & Gorzalka, 1992 ; Laan, Everaerd, & Evers, in press ), yet low-to-zero correlations have been found between genital measures and women’s ratings of genital arousal (e.g., warmth in the genitals, lubrication; Laan, Everaerd, & Evers, in press ; Palace & Gorzalka, 1992 ). In the Laumann et al. survey, 19% of the female sample reported difficulties with lubrication, but only 12% of women reported anxiety about performance ( Lauman, Gagnon, Michael, & Michaels, 1994 ). Other relevant data indicate that the magnitude of the correlations may be moderated by individual differences among women, such as indications of their sexual responsiveness. For example, Adams, Haynes, and Brayer (1985) found that “infrequently” orgasmic women showed a differential tendency to respond to distracting stimuli; that is, they were less accurate in gauging their physiologic sexual response during a task that was distracting of sexual arousal than were “frequently” orgasmic women. Related examples of this phenomena have been reported by other investigators ( Heiman, 1978 ; Morokoff & Heiman, 1980 ). At this time, there is insufficient data to draw a conclusion about the significance (or lack thereof) of this dysyncrony.

It may be useful to consider other positive affects or emotions that may influence sexual excitement–arousal. This examination provides a way to establish convergent and discriminant validity for the excitement construct. Researchers have found that positive mood, not surprisingly, accompanies sexual arousal in women ( Heiman, 1980 ; Laan, Everaerd, van Bellen, & Hanewald, 1994 ). 2 If an assessment question focuses on sexual excitement in the context of an interpersonal relationship, one of the more relevant emotions may be love. Walster and Berscheid (1974) proposed that people may be apt to experience love whenever they are intensely aroused physiologically (see Hatfield & Rapson, 1993 , for a thorough discussion). People then label this arousal as love. A classic experiment provided evidence for this notion. Dutton and Aron (1974) had men (who were between 19 and 35 years old) walk across one of two bridges. One bridge was suspended over a deep gorge and swayed vigorously from side to side. The other bridge was much more stable and was much closer to the ground. Presumably, participants would be substantially more psychophysiologically aroused by crossing the swaying bridge than by crossing the stable one. As the men walked across the bridge, they were met by a research assistant, who was either male or female and who asked the participant to answer a few questions and to tell a story based on a picture. After the tasks were completed, the research assistant mentioned that if a participant wanted more information, he could call the assistant at home. Two important findings emerged. The first was that the stories of the participants (in response to a Thematic Apperception Test card) were highest in sexual imagery in the group that crossed the swaying bridge and met the female assistant. The second was that members of this condition were also the most likely to call the assistant at home, in some cases, even attempting to arrange another, more personal, meeting. These data have been interpreted as indicating that arousal, accompanied by a plausible labeling of the arousal as love (or at least attraction), seems to be one basis for passionate love (see Sternberg, 1987 , for a related discussion). Although this experiment has not been replicated with women, it illustrates the general phenomena of positive affective labeling with sexual attraction, and possibly sexual arousal.

The 30-item Passionate Love Scale by Hatfield and Sprecher (1986) is reliable and evidences broad construct validity. Passionate love, defined as an intense longing for union with another, consists of three components: cognitive (e.g., intrusive thinking or preoccupation with the partner), emotional (attraction, and especially sexual attraction, for the partner), and behavioral aspects (e.g., efforts to maintain physical closeness to the partner, efforts to help the partner). The measure is correlated but not overlapping with relevant measures of sexual desire and excitement (e.g., interest in engaging in sex with the partner, .34; feelings of sexual excitement, .29 ([ Hatfield & Sprecher, 1986 ]; ratings of sexual satisfaction, .42 [ Traupmann & Hatfield, 1981 ]). Furthermore, women who have a positive view of themselves as sexual persons and their ability to become sexually aroused also report higher levels of passionate love and more romantic involvements ( Andersen & Cyranowski, 1994 ).

Negative affects that may impair excitement

Historically, anxiety has been the hypothesized mechanism in many theories of arousal deficits. Psychodynamic hypotheses emphasize fears of phallic-aggressive impulses, castration, rivalry, or incestuous object choices ( Janssen, 1985 ). More central to contemporary views, Wolpe (1958) was the first to emphasize anxiety-based impairment of physiologic responses. In his view, the sympathetic activity characteristic of anxiety inhibits the local (i.e., genital) parasympathetic activity responsible for the initial phases of sexual excitement (i.e., erection for men and, presumably, lubrication and vasocongestion for women). Initially offered to explain male arousal deficits, the model has been applied less satisfactorily for women. There is little experimental support for the contention that the early phases of sexual arousal in women are primarily parasympathetic ( Geer & Head, 1990 ) or even that anxiety will inhibit the physiologic responses of sexual arousal (although anxiety preexposure will effect verbal reports of subjective arousal; Palace & Gorzalka, 1990 ).

Dysfunctional attentional processes and negative affects have been the core of psychological theories of excitement deficits. 3 Masters and Johnson (1970) proposed two components: “spectatoring” (i.e., attentional distraction as the individual “watches” for his or her sexual responding) and negative expectations that the bodily response (e.g., erection) will be inadequate. Anxiety about performance failure (i.e., the absence of the physiologic responses of excitement) then occurs. Again, male sexual responding is usually the exemplar for this model.

An overlapping, although more detailed, model is Barlow’s (1986 ; see also Beck, 1986 ). When a positive, functional sexual response (e.g., an erection) would be expected, men with sexual difficulties evidence physiologic, cognitive, and emotional characteristics that lead to erectile failure. For example, data indicate that men with erection difficulties underreport their levels of sexual arousal (relative to the magnitude of actual erectile response) if queried ( Sakheim, Barlow, Abramson, & Beck, 1987 ), focus their attention on nonerotic rather than erotic cues ( Abramson, Barlow, Beck, Sakheim, & Kelly, 1985 ), and report negative (depressed) feelings ( Abramson, Barlow, Beck, Sakheim, & Kelly, 1985 ) and a lack of control over their sexual responses ( Beck, Barlow, & Sakheim, 1982 ). This dysfunctional process is reiterated and “improved” (i.e., the dysfunctional individual becomes even more proficient at focusing on the wrong aspects of the sexual context— the consequences of not performing, the continuation of erectile insufficiency), and thus, the individual comes to avoid sexual contexts in the future.

The majority of data for Barlow’s (1986) model of anxiety and cognitive distraction comes from male participants. When the model has been examined, women (usually female undergraduates or, perhaps, women recruited from the community) representing “functional” and “dysfunctional” groups are tested in psychophysiology laboratories. Women are presented with stimuli, usually videotapes, representing anxiety-provoking, neutral, or erotic sequences. Vaginal measures, as well as self-reports of general or genital arousal, are recorded. In tests of the physiologic effects of anxiety, the data have, in general, indicated that genital arousal is not inhibited by anxiety. Using individualized, anxiety-provoking audiotaped scenarios, Beggs, Calhoun, and Wolchik (1987) , for example, found that genital arousal (VBV) increased during the anxiety-provoking condition, although the levels were not as high as those achieved during an erotic verbal stimulus. Palace and Gorzalka (1990) found that preexposure with an anxiety-provoking videotape (e.g., a threatened amputation) in contrast to a neutral videotape facilitated VBV responses during subsequent viewing of erotic scenes for both women with and without sexual dysfunctions. This effect, preexposure to an anxiety-provoking stimulus increasing subsequent VBV during erotica, has also been replicated (Palace, in press). Other data disconfirming of both the Masters and Johnson and the Barlow conceptualizations is that by Laan, Everaerd, van Aanhold, and Rebel (1993) . They found that VPA was higher (rather than lower) under experimental “demand” conditions (i.e., “Try to become as sexually aroused as possible within 2 min and try to maintain it for as long as you can. Your level of sexual arousal will be recorded”) in contrast no demand conditions. Taken together, these data suggest that these previous conceptualizations may be less relevant (if relevant at all) for women, as they substantiate neither the arousal processes (they may be predominately sympathetic rather than parasympathetic) nor hypothesized mechanisms (e.g., performance demand).

For these reasons, we consider anxiety as well as a broad band of other affects that may be relevant to discriminate from excitement processes for assessment. As an aside, we note that the DSM–IV gives no clues as to the direction of assessment and largely omits affective criteria for arousal disorder in women. Disruption of a predominant physiologic response (lubrication and swelling of the genitals) until the “completion of sexual activity” is regarded as pathognomic, and this disturbance needs to result in either “marked distress” or “interpersonal difficulty.”

Sexual anxiety, or related terms, has been used to name scales that differ considerably in content and intent. We also note that, rather than use previously published measures, many investigators commonly develop their own sexual anxiety scales by appending a rating scale (e.g., a scale ranging from 0 [no anxiety at all] to 6 [extremely anxious, nervous, or tense]) to a behavioral hierarchy such as the Bentler (1968) listing. A procedure not unlike the latter was E. Hoon’s (1978) modification of the SAI to the SAI— expanded version (SAI-E). She defined anxiety as a negative feeling of tension or nervousness and used the SAI items but changed the anchors for the rating scale (7-point Likert scale ranging from — 1 [relaxing] to 5 [extremely anxiety provoking]). Somewhat surprising is that in a validity study ( Chambless & Lifshitz, 1984 ), the ratings for the SAI and the anxiety ratings on the SAI-E were uncorrelated but that the anxiety ratings were inversely correlated with reports of orgasm frequency (–.25). Factor analysis of the SAI-E ( Chambless & Lifshitz, 1984 ) reveals a similar structure to that found with the SAI ( Andersen, Broffitt, Karlsson, & Turnquist, 1989 ; see earlier discussion).

In contrast, the Sex Anxiety Inventory ( Janda & O’Grady, 1980 ) defines anxiety as a generalized expectancy for nonspecific external punishment for the violation of, or the anticipation of violating, perceived normative standards of acceptable sexual behavior. This definition and the actual items for the measure are similar to Mosher’s (1965) Sex Guilt Scale, which assesses the expectancy for self-mediated punishment (rather than external). In fact, there is significant overlap between the measures (correlations of .67, or about 45% shared variance between the scales). Factor analysis indicates that the items of the two scales are intermingled across factors.

Some extreme, negative reactions have been termed sexual aversions. In the DSM–IV, sexual aversion is defined as persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital contact with a sexual partner. The behavioral reference of complete (or almost complete) absence of genital contact presumably signifies that all sexual activity is halted, and so the latter stages of the sexual response cycle would thus be circumvented. Aside from specific genital avoidance, there may be wide variation in the clinical pattern of avoidance. Some people proceed up to the point of genital exposure during sex, but others become so avoidant that there is generalization to many stimuli, however sexually vague or intrusive, that become labeled “sexual” and are thus avoided. From an assessment standpoint, aversion may be difficult to distinguish from anxiety with avoidance. At present, there are no experimental or clinical studies that have made the comparison.

Katz and his colleagues ( Katz, Gipson, Kearl, & Kriskovich, 1989 ; Katz, Gipson, & Turner, 1992 ) developed a measure called the Sexual Aversion Scale (SAS), yet the content of the subscales differs from the aforementioned DSM description of sexual aversion. Thirty items are rated on a 4–point Likert scale and assess sexual fears associated with sexually transmitted diseases (primarily HIV), sexual guilt, negative social evaluation, pregnancy, and sexual trauma. Factor analyses suggest that the measure includes two domains that are potentially relevant to negative emotions disruptive of sexual excitement: sexual avoidance (e.g., “I have avoided sexual relations because of my sexual fears,” “I am not afraid of kissing or petting, but intercourse really scares me) and sexual self-consciousness and self-criticism (“I worry a lot about sex,” “I would like to feel less anxious about my sexual behavior,” “I feel sexually inadequate”). The other two factors assess fear of sexually transmitted disease (“The thought of AIDS really scares me”) and childhood sexual trauma (“I was sexually molested when I was a child”). Reliability data include estimates of .85 for internal consistency and .86–.89 for 4-week test-retest reliability. Few validity data are provided, but they are supportive in that the measure correlates .36 with the state and .44 with the trait forms of the Spielberger State–Trait Anxiety Inventory (STAI). Comparison of this measure with the SAI-E indicates that the SAI-E appears to tap anxiety, tension.and nervousness for sexual behaviors. In contrast, the SAS assesses self-reported avoidance of sexual activities and negative emotionality about sex, including worry, self-consciousness, and self-criticism. Although the former factor (sexual avoidance) may be related to sexual aversion as defined by DSM–III–R, it is not clear whether the latter factor (which appears to assess sexual neuroticism) is.

Masters and Johnson (1966) proposed that orgasm is a reflex-like response that occurs once a plateau of excitement has been reached or exceeded, although the specific neurophysiologic mechanisms are not known. The physiologic and behavioral indices of orgasm involve the whole body—facial grimaces, generalized myotonia of the muscles, carpopedal spasms, and contractions of the gluteal and abdominal muscles. For women, orgasm is also marked by rhythmic contractions of the uterus, the vaginal barrel, and the rectal sphincter, beginning at 0.8-s intervals and then diminishing in intensity, duration, and regularity. Attention is focused on internal bodily sensations (concentrated in the clitoris, vagina, and uterus), and one’s awareness of competing environmental stimuli may be lessened. The subjective experience of orgasm includes feelings of intense pleasure with a peaking and rapid, exhilarating release. These sensations are reported to be singular, regardless of the manner in which orgasm is achieved ( Newcomb & Bentler, 1983 ). Women are unique in their capability to be multiorgasmic; that is, women are capable of a series of distinguishable orgasmic responses without a lowering of excitement between them.

There are few assessment measures of orgasm. In fact, in the majority of research (e.g., Kelly, Strassberg, & Kircher, 1990 ; Raboch & Raboch, 1992 ), investigators simply ask women how consistently orgasm is achieved (e.g., 10% of the time or “rarely,” 70% of the time or “on most occasions”). There are unpublished measures (e.g., Warner, 1981 ), and one measure of attributions for orgasm consistency. The latter scale by Loos, Bridges, and Critelli (1987) assesses internal versus external and stable versus unstable attributions for regularity of orgasm during coitus. There are few supporting psychometric data, although the initial report for the measure suggests that it can discriminate between women of high and low orgasm consistency. In our research, we have assessed awareness of the physiological signs and symptoms of orgasm (e.g., Andersen, Anderson, & deProsse, 1989 ). We have found, for example, that women with and without orgasmic dysfunction differ on their awareness of orgasm signs (see Figure 1 ). These data replicate earlier research by Hoon and Hoon (1978) with a nondysfunctional sample. Their data indicated that women reporting the lowest orgasm consistencies were significantly less aware of physiological changes accompanying sexual arousal than women reporting higher consistencies of orgasm.

Percentage of orgasmic and orgasmic dysfunction individuals reporting the occurrence of orgasm signs.

The lack of reliable and valid assessment methods for female orgasm may have contributed to the lack of clarity, heterogeneity, and controversy surrounding the criteria for female orgasmic dysfuntion ( Morokoff, 1989 ; Wakefield, 1987 ). In the current DSM definition of female orgasmic disorder (in DSM–III–R, the label was inhibited female orgasm), it is defined as delayed or absent orgasm following an unimpaired sexual excitement phase. No subtypes are noted, although requiring that the excitement phase be unimpaired imposes a de facto subgroup. Historically, other distinctions have been made. For example, primary orgasmic dysfunction has been the designation for women who have never experienced orgasm under any circumstances (the possible exception might be an occasional orgasm during sleep with erotic dreams). Previous estimates suggested that 5%–10% of sexually active women have not experienced orgasm. In the Laumann et al. (1994) survey, only 29% of women reported that they always had an orgasm with their regular partner during sex and 24% reported an inability to have orgasm ( Lauman, Gagnon, Michael, & Michaels, 1994 ). A second clinical pattern, called secondary orgasmic dysfunction, has been used for women who have orgasms but express concern with their frequency or circumstances of occurrence (e.g., orgasm may occur on a random basis or not with desired activities, such as coitus). For many women, this represents normal variation in sexual response patterns and is usually not appropriate as a diagnostic entity. In fact, the absence of coital orgasm is common for many adult women early in their sexual relationships, as the rate of coital orgasm slightly increases with experience ( Kinsey, Pomeroy, Martin & Gebhard, 1953 ). In the Laumann et al. survey ( Laumann, Gagnon, Michael, & Michaels, 1994 ), 10% of women reported that they climaxed too quickly). Other clinical scenarios (e.g., a woman becoming nonorgasmic after being so) are rare. When this does occur, a history may reveal pharmacologic agents as instrumental; for example, anorgasmia in previously responsive women may be associated with the use of tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, and neuroleptics.

As noted, the presumption of a normal sexual excitement phase describes a specific subgroup of women with orgasm difficulties, as previous research suggests that women presenting for treatment vary widely not only in their capacity for sexual arousal but in the presence of accompanying negative affects such as anxiety or aversion to sexual activity ( Derogatis, Pagan, Schmidt, Wise, & Glidden, 1986 ; see Andersen, 1983 , for a review). Thus, too, etiological hypotheses for inorgasmia have emphasized the role of anxiety or other distressing affects ( Derogatis, et al., 1986 ; Wolpe, 1958 ), performance anxiety ( Masters & Johnson, 1970 ), and skills deficits ( Barbach, 1975 ). Hypotheses for coitally inorgasmic women often focus on the role of the interpersonal couple relationship (e.g., McGovern, Stewart, & LoPiccolo, 1975 ) or marital satisfaction.

Thus, contrary to the current DSM criteria, theoretical and intervention research suggests that subtypes of orgasmic dysfuntion may exist. If the response cycle conceptualization is considered, previous phases—desire and excitement—would both be expected to have linkages to the occurance of orgasm. For illustration, consider clinical cases of orgasmic dysfunction in which desire may or may not be regularly present, and excitement may or may not be regularly present (see Table 3 ). The consideration of the desire and excitement phases in the context of a presenting complaint of orgasmic dysfunction leads to the delineation of phasic-based subtypes, in this case, subtypes for orgasmic dysfunction. Hence, subtyping for assessment purposes is tied directly to the response cycle conceptualization.

Orgasmic Dysfunction Subtypes

To examine this conceptualization empirically, we inspected the range of sexual arousability and sexual anxiety scores (unfortunately, we did not collect data on desire) of women who presented for a treatment outcome study for primary orgasmic dysfunction ( Andersen, 1981 ). When selecting women for study, we screened in for orgasmic dysfunction and screened out for dyspareunia, vaginismus, or medical problems. In terms of SAI scores for the women as they entered treatment, 70% of the women scored below the 50th percentile based on the Hoon, Hoon, and Wincze (1976) normative data, and, furthermore, 47% of the sample scored below the 25th percentile. Only 30% of the sample presenting for orgasmic dysfunction scored above the 50th percentile on the SAI, with only 7% of the sample above the 75th percentile. These data suggest that the numbers of nonorgasmic women who would report unimpaired sexual arousal (i.e., meeting DSM– IV criteria) would be very low. Furthermore, consideration of the relationship between orgasm and previous response cycle phases may provide useful assessment information for diagnostic and treatment purposes. In summary, it is probable that there are diagnostically distinct subgroups of women who have difficulty with orgasm.

The concluding phase of the sexual response is resolution. After orgasm, the anatomic and physiologic changes of excitement reverse. In women, the orgasmic platform disappears as vasocongestion diminishes, the uterus moves back into the true pelvis, and the vagina shortens and narrows. A filmy sheet of perspiration covers the body and the elevated heart rate and respiration gradually return to normal. If orgasm has occurred, there are concomitant psychological sensations of bodily relaxation and feelings of release and sexual contentment–and satisfaction. If orgasm has not occurred, the same physiologic processes occur at a much slower rate, and the psychologic responses are usually either neutral or negative (e.g., continued sexual tension, disappointment at having not experienced orgasm). As described here, there have been few attempts to assess the state of resolution (but see Andersen, Anderson, & deProsse, 1989 as one example).

In contrast, there are measures that assess global evaluations of one’s sexual life or general satisfaction with sexuality, and as such, reflect a trait like view of resolution (P. M. Bentler, personal communication, October 4, 1994). For example, on the DSFI, there is a 10-item sexual satisfaction scale. Each item appears to assess a different aspect of satisfaction with the sexual life, including satisfaction with the frequency and range of sexual activities, communication with partner, the occurrence of orgasm, and resolution feelings. There are few psychometric data, but the available information is supportive. The internal consistency is .71, and the scale can distinguish from sexually dysfunctional and functional samples.

Conversely, Snell and Papini (1989) have developed a measure of sexual depression or the tendency to feel saddened and generally discouraged about one’s sexual life (e.g., “I feel down about my sex life”). Psychometric data for the scale are available ( Snell, Fisher, & Schuh, 1992 ; Snell & Papini, 1989 ). Internal consistency is .88– .93 and 4-week test–retest reliability is .67 to .76. Validity data indicate that the measure appears to assess relevant aspects of depression, as it is correlated .25 with sexual guilt as assessed with the Janda and O’Grady (1980) measure and it is correlated .32 with the Beck Depression Inventory. In contrast, it is not correlated (—.05) with other negative sexual affects, such as erotophobia ( Fisher, Byrne, White, & Kelley, 1988 ; see Discussion later).

Finally, we note the Sexual Interaction Inventory ( LoPiccolo & Steger, 1974 ), which was designed as an omnibus measure for assessing sexual satisfaction and adjustment in heterosexual couples. In the past 20 years, reliability and validity data have accumulated for this measure; however, we note that the measure would be limited in the assessment of female sexuality per se. Briefly, the measure includes 17 heterosexual behaviors (modeled after the behavioral hierarchies discussed earlier) and a series of questions assessing such areas as satisfaction with the frequency, actual and preferred pleasure from the activity, and estimations of partner’s response.

Individual Differences

With two major exceptions (Freud and Eysenk), few researchers have explored the relationship between personality and sexuality. However, in the past decade there has been a resurgance of research in personality. Here we discuss the relationship between sexual behavior and the response domains and the contemporary general model of personality structure—the Big Five model—and sexually relevant personality factors, such as sexual self-schema.

General Factors

Historically, sexuality occupied a central role in psychology. Freud hypothesized that sexual instincts were the driving force in personality development, and sexual impulses gone awry were the etiological bases for psychopathology. Even later, neoanalysts and object relations theorists focused on the interrelationship between the capacity for sensuality and the development of stable, intimate relationships ( Fairburn, 1952 ; Klein, 1976 ).

In the 1970s Eysenck (1971 Eysenck (1972) , using his three-factor P-E-N model of personality, consisting of psychoticism, extraversion, and neuroticism, showed that personality and sexual variables were correlated. For example, women scoring high on neuroticism had lower reported levels of sexual experience, whereas those high on extraversion (particularly men) had much higher levels of sexual experience. These findings suggested that the negative emotionality characteristic of neuroticism (i.e., anxiety, guilt, and self-consciousness) would be a deterrant to sexual expression, whereas the positive emotionality characteristic of extraversion (i.e., dominance, sociability, exhibitionism, confidence, and excitement seeking) would be facilitative. Also, women scoring high on psychoticism reported greater involvement with coital and oral activities. Other studies of the Eysenck Psychoticism scale indicate that it is a blend of orthogonal Big-Five factors of Agreeableness and Conscientiousness (low A and low C; Goldberg & Rosolack, in press ).

Costa and his colleagues ( Costa, Fagan, Piedmont, Ponticas, & Wise, 1992 ) have used their measure of the Big Five, the NEO (Neuroticism, Extraversion, and Openness) Personality Inventory. They reported data from 163 women seeking outpatient treatment for sexual problems. Scores on the DSFI ( Derogatis & Melisaratos, 1979 ) and the NEO Personality Inventory ( Costa & McCrae, 1985 ) were reported. Women seeking treatment for sexual dysfunction and scoring high on neuroticism (particularly subscales endorsing higher anxiety or depression and self-consciousness) reported lower levels of sexual information (—.19) and poorer body image (.28). Conversely, women scoring higher on openness (individuals who seek out and appreciate varied experiences) reported higher levels of sexual information (.38), higher levels of sexual activity (.26), and a more positive body image (–.20.). No significant correlations were found with the other personality scales (i.e., Extraversion, Agreeableness, or Conscientiousness scales) and the remaining sexuality scales (sexual experience, sexual satisfaction). Other studies with a smaller sample have also failed to find a significant correlation between extraversion and sexuality for women (see Jupp & McCabe, 1989 , for sexual arousability, or Harris, Yullis, & LaCoste, 1980 , for relationship with coital frequency). In comparison, extroversion is a strong, broad band predictor of sexual behaviors and affects for men ( Costa, Fagan, Piedmont, Ponticas,& Wise, 1992 ).

Sexually Relevant Individual Differences

Measures of sexual attitudes, affects, behaviors, and more recently, cognitions, are available. Several individual difference measures assess evaluative (attitudinal) or affective reactions to sexual cues. One example is erotophobia–erotophilia, a tendency to respond to sexual cues along a negative to positive dimension of affect and evaluation ( Byrne, 1983 ; Fisher, Byrne, White, & Kelley, 1988 ). According to this view, erotophobic individuals have negative affective and evaluative responses to sex and should therefore show avoidance, whereas erotophilic individuals, who have a positive affective and evaluative response to sex, should evidence approach responses. Factor analysis of the 21 items indicate that three dimensions are assessed: (a) openness to sexual experiences (primarily pornography); (b) arousal for sexual activities; and, (c) opinions (primarily negative) about homosexuality. Validity research indicates that, as expected, there is a positive correlation between erotophilia scores and measures of sexual behavior (intercourse) and sexual fantasy. Another example is the 43-item Sexual Attitudes Scale ( Hendrick & Hendrick, 1987 ). This scale assesses four attitude topics: sexual permissiveness (similar to the sociosexuality measure), diverse sexual practices (e.g., masturbation) or topics (e.g., sex education), sex as a communication form with another person, and sex as an instrumental activity (e.g., “sex is for pleasure”).

Simpson and Gangestad (1991a , 1991b) have offered a conceptual framework for their focus on sociosexual orientation or the willingness to engage in uncommitted sexual relations. Individuals who possess an unrestricted sociosexual orientation require less closeness and commitment before having sex, whereas a restricted sociosexual orientation requires greater emotional involvement. Validity information indicates, for example, that unrestricted individuals tend to engage in sex at an earlier point in their sexual relationships; are more apt to have concurrent sexual affairs; and have relationships characterized by less commitment, love, and psychological dependency.

Surprisingly, there has been little attention to cognitive representations of sexuality (i.e., self-views of one’s sexuality). From this perspective, cognitions about the self (e.g., Markus & Wurf, 1987 ) would be important. We have proposed that sexual self-schema (self-concept) is a cognitive view about sexual aspects of oneself. One’s sexual self-view is derived from past experience, manifest in current experience, and it guides the processing of domain-relevant social information ( Andersen & Cyranowski, 1994 ). Well-articulated schemas may function as a quick referent of one’s sexual history, and also as a reference point for information—judgments, decisions, inferences, predictions, and behaviors—about the current and future sexual self. In addition to regulating intrapersonal processes, sexual self-schema mediates interpersonal processes, the most obvious being sexual relationships. Individuals with a clearly specified, positive sexual schema, for example, enter sexual relationships more willingly, have a more extensive behavioral repertoire, and evidence more positive emotions when in sexual relationships.

The 26-item Sexual Self-Schema Scale ( Andersen & Cyranowski, 1994 ) includes two positive aspects (an inclination to experience romantic–passionate emotions and a behavioral openness to sexual experiences or relationships) and a negative aspect (embarrassment or conservatism), that appears to be a deterrent to sexual expression. Women with a positive sexual schema, relative to those with a negative schema, view themselves as emotionally romantic or passionate, and as behaviorally open to romantic and sexual relationships and experiences. These women tend to be liberal in their sexual attitudes, and are generally free of such social inhibitions as self-consciousness or embarrassment. Women with positive schemas for example, tend to evaluate various sexual behaviors more positively, report higher levels of arousability across sexual experiences, and are more willing to engage in uncommitted sexual relations. This schematic representation is not merely a summary statement of sexual history, but it marks current and future possibilities, as women with positive schemas anticipate more sexual partners in the future than their counterparts with negative schemas. Despite this seemingly unrestricted view of sexuality, it is perhaps important to note that affects and behaviors indicative of romantic, loving, and intimate attachments are also central to women with positive sexual schemas, as they report extensive histories of romantic ties. This latter aspect distinguishes the sexual schema construct from Simpson and Gangestad’s (1991a , 1991b ) concept of sociosexuality. In their view, individuals who are characterized as “unrestricted” in their sexual orientation report higher rates of sexual behavior as do the women with positive schemas; however unrestricted individuals also have less commitment and weaker affectional bonds. Thus, the positive schematic representation of a sexual woman includes both arousal–drive and romantic–attachment elements.

Conversely, women holding clear negative self-views of their sexuality tend to describe themselves as emotionally cold or unromantic and as behaviorally inhibited in their sexual and romantic relationships. These women tend to espouse conservative (and, at times, negative) attitudes and values about sexual matters and may describe themselves as self-conscious, embarrassed, or not confident in a variety of social and sexual contexts. Finally, there may be some potential vulnerability for women with negative self-views because their self-view can be significantly moderated or defined by others (e.g., the presence of a current sexual relationship), whereas this does not appear to be the case for the women with positive schemas.

In addition to representing positive and negative sexual schemas, the Sexual Self-Schema Scale can be scored to represent aschematic and coschematic profiles. Women who are aschematic appear to lack a coherent framework for guiding sexually relevant perceptions, cognitions, and behaviors. On the schema measure, they provide weak endorsements of both positive and negative schema adjectives. Hypotheses that such women have lower rates of sexual behavior and less positive sexual affects (e.g., sexual arousability and love for the sexual partner) have been confirmed. Alternatively, coschematic individuals have a schematic representation of their sexuality that is, in some sense, “conflicted.” Their pattern of responding on the schema measure is to provide strong endorsements of both positive and negative aspects. Our hypothesis that coschematic women might evidence discrepancies in their sexual affects has been confirmed; these women report higher levels of sexual anxiety, yet high levels of romantic attachment (love) for a partner. A final methodologic note about the scale is that the measure consists of 26 trait adjectives, and respondents completing the measure have no notion that an aspect of sexuality is being assessed. This aspect of the measure contrasts markedly with every assessment scale reviewed here, and it thus offers significant methodologic and clinical advantages. In summary, sexual schema is a previously untapped yet seemingly important aspect of women’s sexuality and self-concept.

Integration: An Empirical Examination of Sexual Behaviors, Sexual Responses, and Individual Differences

To illustrate the relationship between the domains identified here, we present data from female undergraduates (N = 172) who completed several measures of sexual behavior, response cycle, and personality as part of another study ( Andersen & Cyranowski, 1994 ). We used Goldberg’s (1992) measure of the Big Five and several of the assessment measures discussed earlier. Measures of current sexual behavior (e.g., frequency of intercourse) were actually completed on two occasions, separated by 2 months. For the present analyses, we averaged the current sexual behavior variables to obtain a more stable estimate.

The data are provided in Table 4 . Considering the five personality dimensions, the most consistent pattern of relationships was found for the Extraversion scale. This pattern is inconsistent with the pattern that Costa et al. (1992) obtained using the NEO-PI with older women seeking treatment. One interpretation of these differences is that they indicate important generational and developmental differences in the study samples. In primarily young, unmarried women, extraversion may be related to the likelihood of engaging in sex, the variability in one’s behavior, and the affects associated with sex. Among older, predominately married women whose patterns of sexual behavior and responding may be more established, the dimension of neuroticism appears to be a more important personality variable.

Correlations Between Sexual Behavior and Responses and Measures of Individual Difference for College-Age Women (N = 172)

Note. All correlations >. 15 are significant, p= .05. DSFI = Derogatis Sexual Functioning Inventory; SAI = Sexual Arousability Index; Love = Hatfield Passionate Love Scale.

Comparison of the Big Five data with the sexual-specific measures reveals the usefulness of using such measures to predict sexual variables. As might be anticipated, the sociosexuality measure correlated strongly with measures of sexual behavior, and these data suggest potential overlap with measures assessing sexual history, particularly the number of previous partners. For the erotophobia measure, these data suggest that the construct functions as a generalized deterrent for sexual behavior as well as positive sexual responses. Finally, the sexual schema measure, as would be predicted, is correlated to virtually all aspects of sexuality.

We propose that the assessment of female sexuality be considered within the conceptual domains of sexual behaviors, sexual responses, and individual differences rather than by categories (e.g., functional vs. dysfunctional) or measures. Self-reports of sexual behavior have proven a necessary mainstay in both historical and contemporary assessments of female sexuality. However, many methodological problems of such assessments remain (see Catania et al., 1990 ), and today the area continues with a heterosexual emphasis. Still, sufficient research has emerged to suggest that the behavioral domain for women includes the behaviors of masturbation and other individual erotic activities, and arousing activities with a heterosexual partner ranging from kissing, erotic caressing, oral-genital contact, and anal stimulation, to intercourse.

A response cycle conceptualization, a four-stage model consisting of sexual desire, excitement, orgasm, and resolution, offers conceptual and diagnostic advantages. Within this framework, we considered physiological, cognitive, and affective assessment approaches. One area in need of scientific advancement is the concept of sexual desire (but see Beck, 1995 ). There are no measures of desire, per se, with the current alternatives including measures of sexual cognitions or proxy variables.

In contrast, theories have been proposed and several measures have been developed for the assessment of sexual excitement and related affects. With few exceptions, however, these efforts have consisted of the application of theories and methods for understanding men’s sexuality to the discovery of women’s arousal processes. Although useful data has resulted, the majority of it indicates that the empirical fit is poor. For example, data appear to support the influence of hormonal mechanisms on male sexual desire and behaviors, but data assessing hormone–behavior relationships for women are considerably less clear. Whereas there has been some confirmation of sexual arousal models of male response, empirical tests have disconfirmed these same conceptualizations when applied to women, such as parasympathetic predominance for initial arousal, anxiety inhibiting physiological arousal, and disruptive effects of performance demand.

In short, theoretical advances are needed in the understanding of sexual excitement processes for women. Toward this end, our discussion includes both positive and negative affects, as there is evidence for dysyncrony, but it also provides a manner for clarifying the boundaries for the construct. Within the domain of positive affects, emotions such as romantic attachment or love might be considered, as a variety of converging data indicate that for women these feelings are closely tied to sexual affects. For example, there are gender differences in content of sexual fantasies with women focusing on the personal–emotional feelings in contrast to men, who focus on the sexual content per se ( Ellis & Symons, 1990 ); research on women’s self-esteem suggests that it comes, in part, from a sensitivity and interdependence with others ( Joseph, Markus, & Tafarodi, 1992 ) rather than the more independent orientation common for men; and, finally, women’s own judgments about a “sexual woman” describe her as one who is passionate as well as romantic and loving ( Andersen & Cyranowski, 1994 ).

With regard to negative affects that may inhibit or lower sexual arousal, we proposed several which fall within the domain of negative emotionality. This includes anxiety (i.e., tension and nervousness as assessed, e.g., with the SAI-E), sexual guilt or self-blame (e.g., the Janda & O’Grady measure), sexual self-criticism and self-consciousness (subscale of the SAS), and global sexual depression (i.e., sadness and hopelessness about one’s sexual life, as found in the Snell and Papini measure). It is also likely that aspects that tap behavioral avoidance are relevant to sexual excitement, including avoidance of sexual activities or stimuli per se (e.g., such as the sexual avoidance factor on the Katz Aversion Scale).

It is somewhat puzzling that, despite the considerable research tradition on the treatment of orgasmic dysfunction, there has been very little energy directed toward assessment. The modal strategy in research is to obtain frequency estimates for orgasm and then provide supplementary information on sexual affects (e.g., sexual arousal). In conceptualizing and assessing orgasm, we urge a view that considers the previous sexual responses of desire and excitement, as a variety of data suggest that subtypes of women with orgasm difficulties exist. Finally, there are no measures of sexual resolution per se. Instead, measures of sexual “satisfaction” exist. These latter measures do not appear to tap resolution, and it is unlikely that such measures would add incremental value to an assessment that included other, more central topics, such as sexual behavior or sexual excitement.

This is a point in time when psychology has come full circle, and there is renewed interest in the role of individual differences in predicting and understanding psychological phenomena. Additional research with the contemporary model of personality structure, the Big Five Model, but even more specifically the “big two”—extraversion and neuroticism—may be of some value in understanding women’s sexuality. The available data suggest, however, that conclusions about the role of personality in female sexuality may operate differently depending on the developmental stage in a woman’s sexual life. Specifically, characteristics of positive emotionality or extraversion may be more influential as women begin sexual interactions with others, whereas negative emotionality or neuroticism may play a greater role when sexual patterns are established or when the woman is “older.” More powerful predictors of sexuality, however, are the sex-specific measures. The Sociosexuality measure seems suited to the prediction of sexual behavior variables, whereas the Erotophobia-Erotophilia measure may function as a suppressor variable in the prediction of sexual behaviors and responses. The Sexual Schema measure is unique in its cognitive focus, its band width in the prediction of sexual phenomena, and its capability of differentiating topologies of women (positive schema, coschematic, aschematic, and negative schema) who differ in their sexual behaviors and responses. Finally, the Sexual Schema scale is the only sexuality measure that includes no explicit sexual content in the items; respondents are unaware that a sexual construct is being assessed.

In conclusion, we urge consideration of constructs when making choices for the assessment of female sexuality. We underscore the domains of sexual behaviors, responses, and individual differences, with each clarified by subdomains or constructs. In so doing, we hope to facilitate the suggestion and testing of theoretical, nomological networks for the understanding of women’s sexuality.

Acknowledgments

This research was supported by research funds from the American Cancer Society (PBR-89) and the U.S. Army Medical Research Acquisition Activity (DAMD17-94-J-4165).

1 Comparison of the SAI factor-analytic data ( Andersen, Broffitt, Karlsson, & Turnquist, 1989 ) with those of the Bentler (1968) behavioral hierarchy or the Derogatis Sexual Experience scale ( Andersen & Broffitt, 1988 ) reveal very similar factor structures. This suggests that a broad sampling of both individual and couple sexual behaviors for women would likely yield a domain representation of the following: (a) masturbation and other individual erotic activities; (b) pleasant, potentially arousing activities with a partner, the majority of which occur while clothed, such as kissing with tongue contact, erotic embraces, lying together, or breast fondling; (c) intimate touching, caressing, and kissing of the body (but excluding oral-genital contact) by or with a partner; (d) manual and oral-genital stimulation of a partner or by a partner; (e) various intercourse positions; (f) anal stimulation and anal intercourse.

2 However, in an experimental test of this question using a novel strategy to induce a positive versus a neutral mood (a comparison of two musical stimuli, which presumably differed in their mood induction properties), there was no difference in the stimuli in their effect on VPA or subjective ratings of arousal ( Laan, Everaerd, van Berlo, & Rifs, in press ). This manipulation may have failed because of the use of a non-standardized mood induction rather than other validated procedures (e.g., Velton Mood Induction) or the lack of a mood comparison that was strong enough, such as positive versus negative mood.

3 Again, these theories elaborate the arousal deficit processes for male responses, and then the models are expanded to included women. Even so, the majority of the supporting data come from studies with men, and so we cite the studies with women as is possible.

• Abramson DJ, Barlow DH, Beck JG, Sakheim DK, Kelly JP. The effects of attentional focus and partner responsiveness on sexual responding: Replication and extension. Archives of Sexual Behavior. 1985; 14 :361–371. [ PubMed ] [ Google Scholar ]
• Abramson PR. Sexual science: Emerging discipline or oxymoron. The Journal of Sex Research. 1990; 27 :147–165. [ Google Scholar ]
• Adams AE, Haynes SN, Brayer MA. Cognitive distraction in female sexual arousal. Psychophysiology. 1985; 22 :689–696. [ PubMed ] [ Google Scholar ]
• Alexander GM, Sherwin BB. Sex steroids, sexual behavior, and selection attention for erotic stimuli in women using oral contraceptives. Psychoneuroendocrinology. 1993; 18 :91–102. [ PubMed ] [ Google Scholar ]
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3. Washington, DC: Author; 1987. [ Google Scholar ]
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4. Washington, DC: Author; 1994. [ Google Scholar ]
• Andersen BL. A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. Journal of Consulting and Clinical Psychology. 1981; 49 :568–570. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Andersen BL. Primary orgasmic dysfunction: Diagnostic considerations and review of treatment. Psychological Bulletin. 1983; 93 :105–136. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Andersen BL, Anderson B, deProsse C. Controlled prospective longitudinal study of women with cancer: I. Sexual functioning outcomes. Journal of consulting and Clinical Psychology. 1989; 57 :683–691. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Andersen BL, Broffitt B. Is there a reliable and valid self report measure of sexual behavior? Archives of Sexual Behavior. 1988; 17 :509–525. [ PubMed ] [ Google Scholar ]
• Andersen BL, Broffitt B, Karlsson JA, Turnquist DC. A psychometric analysis of the Sexual Arousability Index. Journal of Consulting and Clinical Psychology. 1989; 57 :123–130. [ PubMed ] [ Google Scholar ]
• Andersen BL, Cyranowski JC. Women’s sexual self schema. Journal of Personality and Social Psychology. 1994; 67 :1079–1100. [ PubMed ] [ Google Scholar ]
• Andersen BL, Jochimsen PR. Sexual functioning among breast cancer, gynecologic cancer, and healthy women. Journal of Consulting and Clinical Psychology. 1985; 53 :25–32. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Bancroft J. A physiological approach. In: Geer JH, O’Donahue WT, editors. Theories of human sexuality. New York: Plenum Press; 1988. pp. 411–421. [ Google Scholar ]
• Bancroft J. Sexual desire and the brain. Sexual and Marital Threapy. 1989; 3 :11–27. [ Google Scholar ]
• Bancroft JH, Wu FCW. Changes in erectile responsiveness during androgen replacement therapy. Archives of Sexual Behavior. 1983; 12 :59–66. [ PubMed ] [ Google Scholar ]
• Barbach LG. For yourself: The fulfillment of female sexuality. New York: Doubleday; 1975. [ Google Scholar ]
• Barlow DH. Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology. 1986; 54 :140–148. [ PubMed ] [ Google Scholar ]
• Beck JG. Self-generated distraction in erectile dysfunction: The role of attentional processes. Advances in Behavior Research and Therapy. 1986; 8 :205–221. [ Google Scholar ]
• Beck JG. Hypoactive sexual desire disorder: An overview. Journal of Consulting and Clinical Psychology. 1995; 63 :919–927. [ PubMed ] [ Google Scholar ]
• Beck JG, Barlow DH, Sakheim DK. Sexual arousal and suppression patterns in function and dysfunctional men; Paper presented at the 90th Annual Convention of the American Psychological Association; Washington, DC. 1982. Aug, [ Google Scholar ]
• Beck JG, Bozman AW, Qualtrough T. The experience of sexual desire: Psychological correlates in a college sample. The Journal of Sex Research. 1991; 28 :443–456. [ Google Scholar ]
• Bentler PM. Heterosexual behavior assessment—II: Females. Behavior Research & Therapy. 1968; 6 :27–30. [ PubMed ] [ Google Scholar ]
• Beggs VE, Calhoun KS, Wolchik SA. Sexual anxiety and female sexual arousal: A comparison of arousal during sexual anxiety stimuli and sexual pleasure stimuli. Archives of Sexual Behavior. 1987; 16 :311–319. [ PubMed ] [ Google Scholar ]
• Brady JP, Levitt EE. The scalability of sexual experiences. Psychological Record. 1965; 15 :275–279. [ Google Scholar ]
• Burger HG, Hailes J, Menelaus M, Nelson J, Hudson B, Balazs N. The management of persistent menopausal symptoms with oestradiol-testosterone implants: Clinical, lipid, and hormonal results. Maturitas. 1984; 6 :351–358. [ PubMed ] [ Google Scholar ]
• Byrne D. The antecedents, correlates, and consequents of erotophobia-erotophilia. In: Davis C, editor. Challenges in sexual science: Current theoretical issues and research advances. Philadelphia: Society for the Scientific Study of Sex; 1983. pp. 53–75. [ Google Scholar ]
• Cacioppo JT, Petty RE. Social psychological procedures for cognitive response assessment: The thought listing technique. In: Merluzzi T, Glass C, Genest M, editors. Cognitive assessment. New York: Guilford Press; 1981. pp. 309–342. [ Google Scholar ]
• Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychological Bulletin. 1990; 108 :339–362. [ PubMed ] [ Google Scholar ]
• Chambless DL, Lifshitz JL. Self-reported sexual anxiety and arousal: The expanded Sexual Arousability Inventory. The Journal of Sex Research. 1984; 20 :241–254. [ Google Scholar ]
• Costa PT, Pagan PJ, Piedmont RL, Ponticas Y, Wise TN. The Five-Factor Model of personality and sexual functioning in outpatient men and women. Psychiatric Medicine. 1992; 10 :199–215. [ PubMed ] [ Google Scholar ]
• Costa PT, McCrae RR. The NEO Personality Inventory manual. Odessa, FL: Psychological Assessment Resources; 1985. [ Google Scholar ]
• Derogatis LR, Pagan PJ, Schmidt CW, Wise TN, Glidden KS. Psychological subtypes of anorgasmia: A marker variable approach. Journal of Sex & Marital Therapy. 1986; 5 :197–210. [ PubMed ] [ Google Scholar ]
• Derogatis LR, Melisaratos N. The DSFI: A multidimensional measure of sexual functioning. Journal of Sex and Marital Therapy. 1979; 5 :244–281. [ PubMed ] [ Google Scholar ]
• Dutton DG, Aron AP. Some evidence for heightened sexual attraction under conditions of high anxiety. Journal of Personality and Social Psychology. 1974; 30 :510–517. [ PubMed ] [ Google Scholar ]
• Ellis H. Studies in the psychology of sex: Volume 5. Erotic symbolism. The mechanism of detumescence. The psychic state in pregnancy. Philadelphia: F. A. Davis Co; 1906. [ Google Scholar ]
• Ellis BJ, Symons D. Sex differences in sexual fantasy: An evolutionary psychological approach. The Journal of Sex Research. 1990; 27 :527–555. [ Google Scholar ]
• Eysenck HJ. Personality and sexual adjustment. British Journal of Psychiatry. 1971; 118 :593–608. [ PubMed ] [ Google Scholar ]
• Eyesenck HJ. Personality and sexual behavior. Journal of Psychosomatic Research. 1972; 16 :141–152. [ PubMed ] [ Google Scholar ]
• Fairburn WRD. An object relations theory of personality. New York: Basic Books; 1952. [ Google Scholar ]
• Fisher WA, Byrne D, White LA, Kelley K. Erotophobia-erotophilia as a dimension of personality. The Journal of Sex Research. 1988; 25 :123–151. [ Google Scholar ]
• Geer JH, Head S. The sexual response system. In: Cacioppo JT, Tassinary L, editors. Principles of psychophysiology: Physical, social, and inferential elements. Cambridge, United Kingdom: Cambridge Press; 1990. pp. 599–630. [ Google Scholar ]
• Goldberg LR. The development of markers for the Big-Five factor structure. Psychological Assessment. 1992; 4 :26–42. [ Google Scholar ]
• Goldberg LR. The structure of personality traits. American Psychologist. 1993; 48 :26–34. [ PubMed ] [ Google Scholar ]
• Goldberg LR, Rosolack TK. Pitting the Big Five factor structure against its competitors: An empirical comparison with Eysenck’s P-E-N model. In: Halverson CF, Kohnstamm GA, Martin RP, editors. The development structure of temperament and personality from infancy to adulthood. Hillsdale, NJ: Erlbaum; in press. [ Google Scholar ]
• Harris R, Yullis S, LaCoste D. Relationships among sexual arousability, imagery ability, and introversion–extraversion. The Journal of Sex Research. 1980; 16 :72–86. [ Google Scholar ]
• Hatfield E, Rapson RL. Passionate love/sexual desire: Can the same paradigm explain both? Archives of Sexual Behavior. 1987; 16 :259–277. [ PubMed ] [ Google Scholar ]
• Hatfield E, Rapson RL. Love, sex, and intimacy: Their psychology, biology, and history. New York: Harper Collins; 1993. [ Google Scholar ]
• Hatfield E, Sprecher S. Measuring passionate love in intimate relationships. Journal of Adolescence. 1986; 9 :383–410. [ PubMed ] [ Google Scholar ]
• Heiman JR. Issues in the use of psychophysiology to assess female sexual dysfunction. In: LoPiccolo J, LoPiccolo L, editors. Handbook of sex therapy. New York: Plenum Press; 1978. pp. 123–135. [ PubMed ] [ Google Scholar ]
• Heiman JR. Female sexual response patterns. Interactions of physiological, affective, and contextual cues. Archives of General Psychiatry. 1980; 37 :1311–1316. [ PubMed ] [ Google Scholar ]
• Heiman JR, Rowland DL, Hatch JP, Gladue BA. Psychophysiological and endocrine responses to sexual arousal in women . Archives of Sexual Behavior. 1991; 20 :171–186. [ PubMed ] [ Google Scholar ]
• Hendrick S, Hendrick C. Multidimensionality of sexual attitudes. The Journal of Sex Research. 1987; 23 :502–526. [ Google Scholar ]
• Hoon EF. The expanded sexual arousability inventory. 1978 Unpublished manuscript. [ Google Scholar ]
• Hoon EF, Hoon PW. Styles of sexual expression in women: Clinical implications of multivariate analyses. Archives of Sexual Behavior. 1978; 7 :105–116. [ PubMed ] [ Google Scholar ]
• Hoon EF, Hoon PW, Wincze JP. An inventory for the measurement of female sexual arousability: The SAI. Archives of Sexual Behavior. 1976; 5 :291–300. [ PubMed ] [ Google Scholar ]
• Janda LH, O’Grady KE. Development of a Sex Anxiety Inventory. Journal of Consulting and Clinical Psychology. 1980; 48 :169–175. [ PubMed ] [ Google Scholar ]
• Janssen PL. Psychodynamic study of male potency disorders: An overview. Psychotherapy and Psychosomatics. 1985; 44 :6–17. [ PubMed ] [ Google Scholar ]
• Jones JC, Barlow DH. Self-reported frequency of sexual urges, fantasies, and masturbatory fantasies in heterosexual males and females. Archives of Sexual Behavior. 1990; 19 :269–279. [ PubMed ] [ Google Scholar ]
• Joseph RA, Markus HR, Tafarodi RW. Gender and self-esteem. Journal of Personality and Social Psychology. 1992; 63 :391–402. [ PubMed ] [ Google Scholar ]
• Jupp JJ, McCabe M. Sexual desire, general arousability, and sexual dysfunction. Archives of Sexual Behavior. 1989; 18 :509–516. [ PubMed ] [ Google Scholar ]
• Kaplan HS. The new sex therapy. New York: Brunner/Mazel; 1977. [ Google Scholar ]
• Kaplan HS. Disorders of sexual desire. New York: Brunner/Mazel; 1979. [ Google Scholar ]
• Kaplan HS. Anxiety and sexual dysfunction. Journal of Clinical Psychiatry. 1988; 49 :21–25. [ PubMed ] [ Google Scholar ]
• Katz RC, Gipson MT, Kearl A, Kriskovich M. Assessing sexual aversion in college students: The Sexual Aversion Scale. Journal of Sex & Marital Therapy. 1989; 15 :135–140. [ PubMed ] [ Google Scholar ]
• Katz RC, Gipson MT, Turner S. Brief report: Recent findings on the Sexual Aversion Scale. Journal of Sex & Marital Therapy. 1992; 18 :141–145. [ PubMed ] [ Google Scholar ]
• Kelly MP, Strassberg DS, Kircher JR. Attitudinal and experiential correlates of anorgasmia. Archives of Sexual Behavior. 1990; 19 :165–177. [ PubMed ] [ Google Scholar ]
• Kinsey AC, Pomeroy WB, Martin CE. Sexual behavior in the human male. Philadelphia: W. B. Saunders; 1948. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kinsey AC, Pomeroy WG, Martin EC, Gebhard PH. Sexual behavior in the human female. Philadelphia: W. B. Saunders; 1953. [ Google Scholar ]
• Klein GS. Freud’s two theories of sexuality. Psychological Issues. 1976; 4 :14–70. [ Google Scholar ]
• Laan E, Everaerd W, Evers A. Assessment of female sexual arousal: Response specificity and construct validity. Psychophysiology in press. [ PubMed ] [ Google Scholar ]
• Laan E, Everaerd W, van Aanhold M, Rebel M. Performance demand and sexual arousal in women. Behavior Research and Therapy. 1993; 31 :25–35. [ PubMed ] [ Google Scholar ]
• Laan E, Everaerd W, van Bellen G, Hanewald G. Women’s sexual and emotional responses to male- and female-produced erotica . Archives of Sexual Behavior. 1994; 23 :153–170. [ PubMed ] [ Google Scholar ]
• Laan E, Everaerd W, van Berlo R, Rijs L. Mood and sexual arousal in women. Behavior Research and Therapy in press. [ PubMed ] [ Google Scholar ]
• Laumann EO, Gagnon JH, Michael RT, Michaels S. The social organization of sexuality: Sexual practices in the United States. Chicago: The University of Chicago Press; 1994. [ Google Scholar ]
• Leiblum SR, Rosen RC, editors. Sexual desire disorders. New York: Guilford Press; 1988. [ Google Scholar ]
• Levine RL. The mechanisms of human female sexual arousal. In: Bancroft J, Davis CM, Ruppel HJ, editors. Annual review of sex research. Vol. 3. Lake Mills, IA: Stoyles Graphic Services; 1992. pp. 1–48. [ Google Scholar ]
• Lief HI. Inhibited sexual desire. Medical Aspects of Human Sexuality. 1977; 7 :94–95. [ Google Scholar ]
• Loos VE, Bridges CF, Critelli JW. Weiner’s attribution theory and female orgasm consistency. Journal of Sex Research. 1987; 23 :348–361. [ Google Scholar ]
• LoPiccolo J, Steger JC. The sexual interaction inventory: A new instrument for assessment of sexual dysfunction. Archives of Sexual Behavior. 1974; 3 :585–595. [ PubMed ] [ Google Scholar ]
• Lunde I, Larsen GK, Fog E, Garde K. Sexual desire, orgasm, and sexual fantasies: A study of 625 Danish women born in 1910, 1936, and 1958. Journal of Sex Education & Therapy. 1991; 17 :111–115. [ Google Scholar ]
• Markus H, Wurf E. The dynamic self-concept: A social psychological perspective. Annual Review of Psychology. 1987; 38 :299–33. [ Google Scholar ]
• Masters WH, Johnson VE. Human sexual response. Boston: Little, Brown; 1966. [ Google Scholar ]
• Masters WH, Johnson VE. Human sexual inadequacy. Boston: Little, Brown; 1970. [ Google Scholar ]
• McCarthy BW. Strategies and techniques for the treatment of inhibited sexual desire. Journal of Sex & Marital Therapy. 1984; 10 :97–104. [ PubMed ] [ Google Scholar ]
• McGovern KB, Stewart RC, LoPiccolo J. Secondary orgasmic dysfunction. I. Analysis and strategies for treatment. Archives of Sexual Behavior. 1975; 4 :265–275. [ PubMed ] [ Google Scholar ]
• Meuwissen I, Over R. Habituation and dishabituation of female sexual arousal. Behavior Research and Therapy. 1990; 28 :217–226. [ PubMed ] [ Google Scholar ]
• Morokoff PJ. Effects of sex guilt, repression, sexual arousability, and sexual experience on female sexual arousal during erotica and fantasy. Journal of Personality and Social Psychology. 1985; 49 :177–187. [ Google Scholar ]
• Morokoff P. Volunteer bias in the psychophysiological study of female sexuality. The Journal of Sex Research. 1986; 22 :35–51. [ Google Scholar ]
• Morokoff PJ. Sex bias and POD. American Psychologist. 1989; 44 :73–75. [ PubMed ] [ Google Scholar ]
• Morokoff PJ, Heiman JR. Effects of erotic stimuli on sexually functional and dysfunctional women: Multiple measures before and after sex therapy. Behavior Research and Therapy. 1980; 18 :127–137. [ PubMed ] [ Google Scholar ]
• Mosher DL. The development and multitrait-multimethod analysis of three measures of three aspects of guilt. Journal of Consulting Psychology. 1965; 30 :25–29. [ Google Scholar ]
• Newcomb MD, Bentler PM. Dimensions of subjective female orgasmic responsiveness. Journal of Personality and Social Psychology. 1983; 44 :862–873. [ PubMed ] [ Google Scholar ]
• Nutter DE, Condron MK. Sexual fantasy and activity patterns of females with inhibited sexual desire versus normal controls. Journal of Sex & Marital Therapy. 1983; 9 :276–282. [ PubMed ] [ Google Scholar ]
• O’Carroll R, Shapiro C, Bancroft J. Androgens, behavior, and nocturnal erections in hypogonadal men: The effect of varying the replacement dose. Clinical Endocrinology. 1985; 23 :527–538. [ PubMed ] [ Google Scholar ]
• Palace EM. Modification of dysfunctional patterns of sexual response through autonomic arousal and false physiological feedback. Journal of Consulting and Clinical Psychology. 1995; 63 :604–615. [ PubMed ] [ Google Scholar ]
• Palace EM, Gorzalka BB. The enhancing effects of anxiety on arousal in sexually dysfunctional and functional women. Journal of Abnormal Psychology. 1990; 99 :403–411. [ PubMed ] [ Google Scholar ]
• Palace EM, Gorzalka BB. Differential patterns of arousal in sexually functional and dysfunctional women: Physiological and subjective components of sexual response. Archives of Sexual Behavior. 1992; 21 :135–159. [ PubMed ] [ Google Scholar ]
• Podell L, Perkins JC. A Guttman scale for sexual experience: a methodological note. Journal of Abnormal Psychology. 1957; 54 :420–422. [ PubMed ] [ Google Scholar ]
• Raboch J, Raboch J. Infrequent orgasms in women. Journal of Sex & Marital Therapy. 1992; 18 :114–120. [ PubMed ] [ Google Scholar ]
• Rosen RC, Beck JG. Patterns of sexual arousal: Psychophysiological processes & clinical applications. New York: Guilford Press; 1988. [ Google Scholar ]
• Sakheim DK, Barlow DH, Abramson DJ, Beck JG. Distinguishing between organogenic and psychogenic erectile dysfunction. Behavior Research and Therapy. 1987; 25 :379–390. [ PubMed ] [ Google Scholar ]
• Schreiner-Engel P, Schiavi RC, Smith H, White D. Plasma testosterone and female sexual behavior. In: Hock Z, Lief HI, editors. Proceedings of the 5th World Congress of Sexology. Amsterdam: Excertpa Medica; 1982. [ Google Scholar ]
• Schreiner-Engel P, Schiavi RC, White D, Ghizzani A. Low sexual desire in women: The role of reproductive hormones. Hormones and Behavior. 1989; 23 :221–234. [ PubMed ] [ Google Scholar ]
• Simpson JA, Gangestad SW. Personality and sexuality: Empirical relations and an integrative theoretical model. In: McKinney K, Sprecher S, editors. Sexuality and close relationships. Hillsdale, NJ: Erlbaum; 1991a. pp. 71–91. [ Google Scholar ]
• Simpson JA, Gangestad SW. Individual differences in sociosexuality: Evidence for convergent and discriminant validity. Journal of Personality and Social Psychology. 1991b; 60 :870–833. [ PubMed ] [ Google Scholar ]
• Singer B, Toates FM. Sexual motivation. The Journal of Sex Research. 1987; 23 :481–501. [ Google Scholar ]
• Sintchak G, & Geer JH. A vaginal plethysmograph system. Psychophysiology. 1975; 12 :113–115. [ PubMed ] [ Google Scholar ]
• Snell WS, Papini DR. The sexuality scale: An instrument to measure sexual-esteem, sexual-depression, and sexual-preoccupation. The Journal of Sex Research. 1989; 26 :256–263. [ Google Scholar ]
• Snell WS, Fisher TD, Schuh T. Reliability and validity of the Sexuality Scale: A measure of sexual-esteem, sexual-depression, and sexual-preoccupation. The Journal of Sex Research. 1992; 29 :261–273. [ Google Scholar ]
• Sternberg RJ. Liking versus loving: A comparative evaluation of theories. Psychological Bulletin. 1987; 102 :331–345. [ Google Scholar ]
• Studd JW, Collins WP, Chakravarti S, Newton JR, Oram D, Parsons A. Oestradiol and testosterone implants in the treatment of psychosexual problems in the postmenopausal women. British Journal of Obstetrics and Gyneacology. 1977; 84 :314–315. [ Google Scholar ]
• Terman LM, Buttenwieser P, Ferguson LW, Johnson WB, Wilson DP. Psychological factors in marital happiness. New York: McGraw-Hill; 1938. [ Google Scholar ]
• Traupmann J, Eckels E, Hatfield E. Intimacy in older women’s lives. The Gerontologist. 1982; 22 :493–498. [ PubMed ] [ Google Scholar ]
• Traupmann J, Hatfield E. Love and its effect on mental and physical health. In: Fogel R, Hatfield E, Kiesler S, Shanas E, editors. Aging: Stability and change in the family. New York: Academic Press; 1981. pp. 253–274. [ Google Scholar ]
• Turpin G. The psychophysiological assessment of anxiety disorders: Three-systems measurement and beyond. Psychological Assessment. 1991; 3 :366–375. [ Google Scholar ]
• Wakefield JC. Sex bias in the diagnosis of primary orgasmic dysfunction. American Psychologist. 1987; 42 :464–471. [ PubMed ] [ Google Scholar ]
• Walling MK, Andersen BL, Johnson SR. Hormonal replacement therapy for postmenopausal women: Sexual outcomes and related gynecologic effects. Archives of Sexual Behavior. 1990; 119 :119–137. [ PubMed ] [ Google Scholar ]
• Walster E, Berscheid E. A little bit about love: A minor essay on a major topic. In: Huston TL, editor. Foundations of interpersonal attraction. New York: Academic Press; 1974. pp. 355–381. [ Google Scholar ]
• Warner J. A factor-analytic study of the physical and affective dimensions of peak of female sexual response in partner-related sexual activity. Teachers College, Columbia University; 1981. Unpublished doctoral dissertation. [ Google Scholar ]
• Wilson GD. Measurement of sex fantasy. Sexual and Marital Therapy. 1988; 3 :45–55. [ Google Scholar ]
• Wolpe J. Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press; 1958. [ Google Scholar ]
• Zimmer D, Borchardt E, Fischle C. Sexual fantasies of sexually distressed and nondistressed men and women: An empirical comparison. Journal of Sex & Marital Therapy. 1983; 9 :38–50. [ PubMed ] [ Google Scholar ]
• Zuckerman M. Physiological measures of sexual arousal in the human. Psychological Bulletin. 1971; 75 :297–329. [ PubMed ] [ Google Scholar ]
• Zuckerman M. Scales for sexual experience for males and females. Journal of Consulting and Clinical Psychology. 1973; 41 :27–29. [ Google Scholar ]

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• SDSU joins NASEM, contributing to sexual violence prevention efforts and research

Members of National Academies of Sciences, Engineering, and Medicine are collectively committed to targeted action on addressing and preventing sexual harassment in higher education.

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As part of the San Diego State University’s ongoing efforts to prevent sexual harassment, the university is now a National Academies of Sciences, Engineering, and Medicine (NASEM) Action Collaborative member, joining institutions in addressing gender-based violence nationwide. 

NASEM’s Action Collaborative membership comes following a competitive application process, and current members include Boston University, Johns Hopkins University, the Massachusetts Institute of Technology, the National Oceanic and Atmospheric Administration, and others.  

The group collectively engage and learn from research experts and practitioners, identify barriers and challenges and identify and commit to research related to sexual violence and prevention. 

“As an institution fully committed to tackling this problem holistically, we are incredibly pleased to join with others who have embraced or are creating transformational, proactive practices that will help us to better serve survivors, and create a culture of care and accountability,” said SDSU President Adela de la Torre . 

“We recognize that the most marginalized members of our community are the most at risk for harm. Our commitments to prevent sexual harassment, address other forms of gender-based violence, and support survivors are aligned with the NASEM Action Collaborative goals,” de la Torre said. 

Created in April 2019, NASEM’s Action Collaborative grew out of a desire among higher education institutions to collaborate and learn from each other in response to the National Academies’ 2018 Sexual Harassment of Women report . By 2020, the collaborative had more than 55 members and, in more recent years, has introduced members outside of the higher education sector. Action Collaborative members have contributed to policy changes and research in the interest of preventing and addressing all forms of sexual violence.

At SDSU, de la Torre established the Blue Ribbon Task Force on Gender-Based Violence in 2023 to assess the urgent problem of sexual assault on our campus and nationally in higher education. The group, which continues to meet, has led a series of listening sessions and webinars and is charged with reviewing SDSU, statewide, and national sexual harassment policies and procedures and recommending strategies to improve these. Task force members are also currently identifying recommendations for opportunities to improve training and prevention. 

“We have a solid body of research and empirical evidence that sexual harassment undermines the professional and educational attainment and mental and physical health of people of all genders,” said Monica J. Casper , Special Assistant to the President on Gender-Based Violence, who leads these efforts. 

“A holistic, systemic action-oriented approach is the only way to address gender-based violence,” Casper said.

SDSU maintains extensive education activities around student safety, including those for sexual violence and sexual misconduct prevention, beginning with orientation, and including mandatory training for faculty and staff. 

Departments and groups also organize events and activities to provide opportunities for safe and welcoming community connections, including Aztec Nights events and other workshops, lectures and other activities. 

Also, in earlier years, the Presidential Task Force on Student Activities and Safety report and the Presidential Task Force on Alcohol and Substance Misuse report were each established to implement or enhance educational programs, policies and intervention efforts around student safety and well being, to include sexual misconduct, sexual assault and sexual violence. The work of both groups resulted in: a Hazing Prevention Task Force to combat hazing and to also address alcohol use and misuse and other behaviors; the Good Samaritan Policy for Recognized Student Organizations; and the Amnesty Policy has been implemented for individual students.

“Our approach is a combined focus on compliance, education, accountability, a culture of care and in leading in support for survivors,” said Casper. “Our ongoing work aligns with the NASEM Action Collaborative, and we look forward to sharing and learning additional best practices from our colleagues nationwide.”  

An important note

SDSU encourages anyone who is a victim of sexual assault, and anyone who knows someone who has been harmed, to call 911 and report it as soon as possible to police. There are other resources for students, faculty and staff, including the university’s reporting tools, support resources and a victim advocate. Also, the Center for Community Solutions, which operates a 24-hour crisis line in San Diego County at 888-385-4657 for crisis intervention and information and referrals related to sexual assault.

SDSU encourages anyone who is a victim of sexual assault, and anyone who knows someone who has been harmed, to call 911 and report it as soon as possible to police. There are other resources for students, faculty and staff, including the university’s reporting tools , support resources and a victim advocate . Also, the Center for Community Solutions, which operates a 24-hour crisis line in San Diego County at 888-385-4657 for crisis intervention and information and referrals related to sexual assault.

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Why are there more cases of teachers sexually assaulting students? | Opinion

There is no pinpointed reason why we are seeing an increase in teacher-student relationships. some experts say it comes down to access and lack of boundaries..

Things have changed a lot since I was in high school. I remember not even knowing any of my teachers' first names. It was usually Mr. (last name) or Mrs. (last name). We didn’t talk outside school hours.

Which makes the trend we're witnessing today all the more baffling. A recent FOX News study found that 349 public educators were arrested for child related sex crimes in 2022 alone.

There is no pinpointed reason for why we are seeing an increase in teacher-student relationships. Some experts say it comes down to access and lack of boundaries. Social media has made communication more accessible; simple chats over assignments can quickly become inappropriate.

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Equally troubling is that sexual abuse is often not reported, and there is a lack of comprehensive data on instances of teacher sexual abuse toward students. For instance, a 20-year-old analysis by the U.S. Department of Education revealed that during their K-12 education, approximately one in 10 children experience some form of sexual misconduct from an educator. Data concerning this disturbing trend needs to be updated.

“I’m not an expert on the sex offender mind, but what I can say is that those who commit these crimes can come from all walks of life and genders,” said Ian Henderson, policy and systems director with the Madison-based Wisconsin Coalition Against Sexual Assault .

Gov. Tony Evers signed bipartisan law on sexual misconduct

In March, Gov. Tony Evers signed a bipartisan law that further criminalizes sexual misconduct by school staff members or volunteers against students. Sexual misconduct is defined as any verbal or physical conduct of a sexual nature. Any educator who is convicted of this crime could face up to 3-1/2 years in prison, as well as have their teaching license revoked by the state's Department of Instruction.

"As a former educator, I'm thinking, how can we ever get to this point that we need a bill (for this)," Evers told the Journal Sentinel after signing the legislation. 

Over the past several years there have been numerous cases where Wisconsin educators have been accused of sexual misconduct with a child. These cases involve male and female teachers of varying ages accused of inappropriate behavior. Here are just a few:

• Kevin Buelow , 50, a former Catholic school teacher, was sentenced to 20 years in March for sexually assaulting students in Waukesha and Milwaukee counties. In January, a Milwaukee County jury found Buelow guilty of two counts of first-degree child sex assault, where the child was under the age of 13, in incidents at St. Matthias Parish School in Milwaukee from 2010 to 2012. He was convicted in January 2023 of inappropriately touching three students while he was a fourth-grade teacher at Holy Apostles in New Berlin between 2013-2018.
• Jessica Kelbel , 29, a former special education teacher at The Richardson School in Madison, was charged in February for sexual assault of a student. Her relationship with the student allegedly went on for more than a year. She initially denied the allegations but admitted to having oral sex with the student in October 2023. She resigned in February . The victim’s mother contacted authorities, saying her son had a crush on the teacher and knew personal information about Kelbel and her children.
• Anne Nelson-Koch , 75, was convicted on 25 separate counts, all relating to months of sexual abuse of a teenage boy. In November, a Monroe County judge sentenced her to 10 years in prison, followed by 15 years of probation.
• Christian Enwright , 29, a teacher at Kenosha School of Technology Enhanced Curriculum West, was charged in May with 22 counts of misdemeanor disorderly conduct for allegedly grooming a student. According to a criminal complaint, Enwright had an "inappropriate relationship" with a 14-year-old female student. The girl told school officials the two were "friends" on Snapchat and TikTok since June 2023. When authorities searched her phone they found Enwright sent her inappropriate photos of himself. He was fired May 7.
• Rebecca Kilps , 35, a former Two Rivers Spanish Teacher, was found guilty in a student sex assault case. Kilps was sentenced in January 2023 after she entered a “no contest” plea to charges of sexual assault of a student by school staff and sexual intercourse with a child 16 or older. In a plea agreement, two counts were changed to a misdemeanor, and the other felony charge was kept with a deferred judgment agreement. Kim's husband called the police on his wife after looking through her messages. He said the messages showed Kilps and the victim talking about having a future together and being in love, the complaint said.

It is worth noting that some of these teachers are married and have children. Inappropriate relationships between teachers and students have been a longstanding issue. However, the problem has received more attention in recent years , as pointed out by Henderson. He attributed this to increased media coverage, the #metoo movement, and increased interactions between teachers and students through text and social media.

Two egregious case of rape and misconduct stand out

While all of the cases I highlighted are disturbing, two stand out and illustrate the need for additional research and efforts to combat sexual abuse of students.

The first involves Rachel Goodle, a former Oak Creek High School teacher. Goodle was charged in July with second-degree sexual assault of a child and sexual assault of a student by school staff for an alleged incident on Dec. 2, 2022.

According to a criminal complaint, Goodle, an English teacher, was seen last December sitting together with a student at a school basketball game. The male student told authorities that he and Goodle had sex in the back of her classroom and that there had been “rumors for months about an inappropriate relationship between himself and Goodle.” If convicted, she faces up to 46 years in prison.

Goodle, 22, sued the district in July to block the release of her records.

When I was in high school, I didn’t have any 22-year-old teachers. Most of my teachers were in their 40s and 50s, and a few were close to retirement age. Due to this age difference, a clear sense of respect was established between the students and the teachers. I have spoken at schools where I didn’t know the teacher was the teacher based on their age and how they presented themselves.

The other case involved Tyesha Bolden, 35, a former teacher at a private school in Wauwatosa, who admitted to having a sexual relationship with a 13-year-old male student and purchasing him a handgun for his 14 th birthday.

Bolden, who taught eighth grade at Pilgrim Lutheran School in Wauwatosa, became the boy’s teacher in October 2022. Shortly after, she began texting him, and in early 2023, she started sending him provocative photos of herself. According to a criminal complaint, she even told him she loved him unconditionally.

Bolden allowed the boy to spend the night at her home several times, and the victim told investigators that he and Bolden had sex in a wooded area before summer break.

To add to all of that, the victim even convinced Bolden to give him money and got her to buy him a Glock 19 for his 14 th birthday. It’s mind-boggling that a 35-year-old woman would even be attracted to a 13-year-old boy.

Not only did she rape this young man — yes, it's rape because he could not legally consent at 13 — but she bought him a gun, which he could have used to commit a robbery, shooting or homicide.

In March, she was sentenced to six years of confinement and seven years of extended supervision. She’s lucky because had he used that gun to hurt someone, that could have easily been on her.

These relationships can have devastating consequences

The first teacher-student sex case that I remember is when Washington state teacher Mary K. Letourneau admitted to having sex with then-12-year-old student Vili Fualaau in 1997. To call it a sensational story in the pre-social media era would be an understatement.

The Letourneau story was a case study of what would become a bigger problem. The middle-school teacher seemed like she had it all. She had stunning good looks. She was married and a mother of four. In June 1996, she was caught having sex in a minivan with her 12-year-old student.

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By the time of her arrest, she was already pregnant by her 12-year-old victim. To compound matters, after she was released on probation, she was ordered to stay away from the victim, but weeks after her release, she was with him again. She gave birth to her second child behind bars.

The two got married in May 2005. They divorced in 2019. Letourneau, 58, died of colon cancer on July 6, 2020 .

It's been 27 years since Letourneau became a household name but today, there are so many cases it's hard to keep up and experts are trying to determine why these cases continue. Some cite the unlimited access teachers and students have to one another.

When I was in school, as the bell rang at 2:45 p.m., marking an end to the school day, I didn’t see my teachers or have any contact with them until the next day. Today, teachers can communicate with their students via text, Facetime and social media.

This can open Pandora's box. Something can start innocent and turn into something criminal. Many criminal complaints show how these inappropriate relationships start innocently enough.

Bolden, the teacher who purchased a gun for a student, first began texting with her victim. Their conversations escalated to the point where she sent him suggestive photos of herself. He promised not to tell anyone when she told him to delete the images.

The situation went too far and resulted in Bolden losing her career and freedom over her inappropriate relationship with a 13-year-old student.

While teachers who engage in such behaviors are punished, the long-term physical and mental damage inflicted upon the students they teach cannot be overlooked.

Henderson, from the Wisconsin Coalition Against Sexual Assault, said that when a teacher crosses the line with a student, the effects on the child can be far-reaching. When a child is sexually assaulted by someone they trusted, it can leave them feeling confused and vulnerable.

“The long-term effects can have devastating consequences,” he said.

If a child tells you they have been sexually assaulted, Henderson says, "Believe them."

Then contact the police.

Reach James E. Causey at  [email protected] ; follow him on X @jecausey .

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