Paper Human Sexuality
Discuss childbirth in America, particularly with regards to common medical interventions employed in the labor and delivery process. Please express your opinions on what we, as a society, are getting right (if anything) and on what ought to be changed (if anything). Support your arguments with data from peer-reviewed scientific journal articles. Feel free to discuss prenatal or neonatal care if you wish, but be sure to cover labor and delivery. find , chapter 8 and 9
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Discovering Human Sexuality THIRD EDITION
Available free of charge, this online companion to the textbook provides a thorough set of study tools that includes questions, activities, flashcards, and other
resources to help you learn the material quickly and effectively.
Animations (included in the Activities) clearly explain important concepts and processes in easy-to-follow narratives.
A comprehensive set of Study Questions covers the full range of content in every chapter. Each
question is referenced to a textbook section, for review.
Labeling Activities and dynamic step-by-step illustrations simplify complex concepts and reinforce
important anatomy and terminology.
Companion Website
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WEB ACTIVITIES The following activities are available on the site.
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ADDITIonAL fEATurES Chapter outlines & Summaries provide a thorough review of each chapter.
Learning objectives in the form of short-answer questions help you focus on the important topics in each chapter.
Quizzes with multiple choice and essay questions allow you to test your comprehension of each chapter and synthesize and apply the concepts you have learned. (Instructors must register in order for their students to be able to take the quizzes.)
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2.1 The Vulva . . . . . . . . . . . . . . . . . . 22
2.2 Internal Anatomy of the Vulva. . . . . . . . . . . . . . . . . . . . . . . . 29
2.3 The Female Reproductive Tract, Part 1. . . . . . . . . . . . . . . 30
2.4 The Female Reproductive Tract, Part 2. . . . . . . . . . . . . . . 30
2.5 The Pap Test. . . . . . . . . . . . . . 34
2.6 Ovarian and Uterine Cycles . . . . . . . . . . . . 38, 42, 43
2.7 Main Processes of the Menstrual Cycle . . . . . . . . . . 43
2.8 The Reproductive Years . . . . . . . . . . . . . . . . . . . . . . . 44
2.9 Internal Structure of the Lactating Breast. . . . . . . . . . 51
_____________________________________
3.1 The Male External Genitalia . . . . . . . . . . . . . . . . . . . 62
3.2 Internal Structure of the Erect Penis and the Urethra . . . . . . . . . . . . . . . . . . . . . 65
3.3 The Mechanism of Erection . . . . . . . . . . . . . . . . . . . . 69
3.4 The Scrotum and Its Contents. . . . . . . . . . . . . . . . . . . 71
3.5 Internal Structure of the Testicle and Epididymis. . . . . . . . . . . . . . . . . 73
3.6 The Male Reproductive Tract . . . . . . . . . . . . . . . . . . . . . . . . 74
3.7 Anatomy of the Prostate. . . . . . . . . . . . . . . . . . . . 76
_____________________________________
4.1 Development of the Male and Female Reproductive Tracts. . . . . . . . . . . . . . . . . . . . . . . 89
_____________________________________
7.1 Definitions of Sexual Relationships . . . . . . . . . . . 192
7.2 Sternberg’s Seven Types of Love . . . . . . . . . . . . . . . . . . . 209
_____________________________________
8.1 How a Home Pregnancy Test Works . . . . . . . . . . . . . . 229
8.2 In Vitro Fertilization. . . . . 232 _____________________________________
9.1 Vasectomy . . . . . . . . . . . . . . 291
9.2 Tubal Sterilization . . . . . . 292 _____________________________________
15.1 Milestones in the Global HIV/AIDS Pandemic . . . 480
_____________________________________
a.1 Mitosis . . . . . . . . . . . . . . . . . . . 552
a.2 Mitosis Time-Lapse Video . . . . . . . . . . . . . . . . . . . . . 552
a.3 Meiosis. . . . . . . . . . . . . . . . . . . 552
a.4 Differences and Similarities between Meiosis and Mitosis . . . . . . . . . . . . . . . . . . . 552
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Discovering Human Sexuality
third edition
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Sinauer Associates, Inc. Publishers Sunderland, Massachusetts U.S.A.
Discovering Human Sexuality
third edition
Simon LeVay west hollywood, california
Janice Baldwin university of california
santa barbara
John Baldwin university of california
santa barbara
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Discovering Human Sexuality, Third Edition Copyright © 2015 by Sinauer Associates, Inc. All rights reserved. This book may not be reproduced in whole or in part without permission from the publisher.
For information or to order, address: Sinauer Associates P.O. Box 407 Sunderland, MA 01375 USA Fax: 413-549-1118 E-mail: publish@sinauer.com Internet: www.sinauer.com
Library of Congress Cataloging-in-Publication Data
LeVay, Simon. Discovering human sexuality / Simon LeVay, West Hollywood, CA, Janice Baldwin, University of California, Santa Barbara, John Baldwin, University of California, Santa Barbara. -- Third edition. pages cm ISBN 978-1-60535-275-6 (alk. paper) 1. Sex (Psychology) 2. Sex (Biology) 3. Sex--Social aspects. I. Baldwin, Janice I. II. Baldwin, John D., 1941- III. Title. BF692.L47 2015 306.7--dc23 2014044757
Printed in the USA 5 4 3 2 1
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mailto:publish@sinauer.com
http://www.sinauer.com
Simon LeVay, PhD is a British-born neuroscientist turned writer and teacher. He has served on the faculties of Harvard Medical School and the Salk Institute for Biologi- cal Studies and has taught at Harvard; the University of California, San Diego; and Stanford University. He is best known for a 1991 study that described a difference in brain structure between heterosexual and homosexual men; this study helped spark a wealth of new research on the biology of sexual orientation. LeVay is the author or coauthor of 11 books, the most recent of which is a historical novel, The Donation of Constantine (Lambourn, 2013).
Janice Baldwin, PhD and John Baldwin, PhD are sociologists at the University of California, Santa Barbara. They have been collaborators in numerous studies and coauthored many articles in the areas of play, creativity, sexuality, and sex educa- tion, as well as the textbook Behavior Principles in Everyday Life (Prentice Hall). John Baldwin’s latest book is Ending the Science Wars (Paradigm, 2008). The Baldwins co- teach an undergraduate human sexuality course that is regularly voted best course at UCSB. They also teach an advanced seminar course on the same topic. Their students run a sex-ed website, SexInfoOnline (www.SexInfoOnline.com).
About the Authors
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http://www.SexInfoOnline.com
chapter 1 Sexuality: Pathways to Understanding 3
chapter 2 Women’s Bodies 21
chapter 3 Men’s Bodies 61
chapter 4 Sex, Gender, and Transgender 87
chapter 5 Attraction, Arousal, and Response 123
chapter 6 Sexual Behavior 155
chapter 7 Sexual Relationships 191
chapter 8 Fertility, Pregnancy, and Childbirth 227
chapter 9 Contraception and Abortion 265
chapter 10 Sexuality across the Life Span: From Birth to Adolescence 305
chapter 11 Sexuality across the Life Span: Adulthood 335
chapter 12 Sexual Orientation 365
chapter 13 Atypical Sexuality 401
chapter 14 Sexual Disorders 431
chapter 15 Sexually Transmitted Infections 461
chapter 16 Sexual Assault, Harassment, and Partner Violence 493
chapter 17 Sex as a Commodity 523
appendix a Sex and Evolution 551
appendix b Sex and the Nervous System 573
Brief Contents
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Contents
Sexuality Is a Broader Concept than Sex 4
Studying Sexuality Has Practical Benefits 4
Sexuality Has Changed over Time 4 Sexuality has been influenced by evolution 5
Society has changed sexuality 5
Box 1.1 Meet My Dads 6
Marriage has been transformed 8
Sex has become a topic of social discourse 9
Social movements have affected sexuality 10
Box 1.2 Freud and Hirschfeld: Contrasting Theories on Sexual Orientation 11
Sexuality Can Be Studied with a Wide Variety of Methods 12
Biomedical research focuses on the underlying mechanisms of sex 12
Psychology includes diverse approaches to sexuality 13
Sociologists focus on the connection between sex and society 15
The economic approach weighs costs and benefits 16
Chapter 1 Sexuality: Pathways to Understanding 3
A Woman’s Vulva Includes Her Mons, Labia, Vaginal Opening, and Clitoris 22
There is more to the clitoris than meets the eye 24
Box 2.1 Female Genital Cutting 26
The appearance of the vaginal opening is variable 27
The Vagina Is the Outermost Portion of the Female Reproductive Tract 29
The vagina undergoes changes during arousal 31
The G-spot is a controversial erogenous zone 31
The Anus Can Also Be a Sex Organ 32
The Uterus Serves a Double Duty 32 Box 2.2 Genital Self-Examination 33
Cancer can affect the cervix or the endometrium 34
Other uterine conditions include fibroids, endometriosis, abnormal bleeding, and prolapse 35
Should hysterectomy be so common? 36
The Oviducts Are the Site of Fertilization 36
The Ovaries Produce Ova and Sex Hormones 37
Box 2.3 The Feedback Loop that Controls Female Hormone Production 38
Menstruation Is a Biological Process with Cultural and Practical Aspects 40
Box 2.4 Menstrual Synchrony: Reality or Myth? 41
The menstrual cycle has three phases 42
The cycle is driven by hormonal changes 43
Does the menstrual cycle influence sexuality? 44
Attitudes toward menstruation vary 44
Box 2.5 Attitudes toward Menstruation 45
Women use pads, tampons, or cups during menstruation 46
Menstrual Problems Are Common but Treatable 48
Menstrual pain may or may not reflect underlying pelvic disease 48
The premenstrual syndrome has physical and psychological aspects 48
Menstruation stops during pregnancy—and for many other reasons 49
Sex steroids affect systems in women besides the reproductive tract 50
The Breasts Have Both Erotic and Reproductive Significance 50
Chapter 2 Women’s Bodies 21
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x CONTENTS
Breast cancer mortality can be reduced 51
Many factors affect the risk of breast cancer 52
Early detection is important 54
Box 2.6 Breast Self-Examination 55
Treatment depends on the diagnostic findings and the woman’s choice 56
Most women with breast cancer return to an active sex life 56
The Male External Genitalia Are the Penis and Scrotum 62
The penis combines erotic, reproductive, and urinary functions 63
Box 3.1 Male Circumcision 64
Box 3.2 How Big Should a Penis Be? 67
Box 3.3 Diphallia 68
Penile Erection Involves Nerves, Blood, and Chemistry 68
Erection is filling of the penis with blood 69
Muscles are also involved in erection 70
Erections occur during sleep 70
The scrotum regulates the temperature of the testicles 70
The Testicles Produce Sperm and Sex Hormones 71
Other glands contribute secretions to the semen 73
What is semen? 74
Box 3.4 Disorders of the Testicles 75
Box 3.5 Disorders of the Prostate Gland 76
Ejaculation Requires Coordination of Muscles and Glands 77
The testicles secrete sex hormones 78
Box 3.6 Designer Steroids 80
The brain and pituitary gland regulate hormone levels 80
Nudity Is Culturally Regulated 81
Chapter 3 Men’s Bodies 61
Genes and Hormones Guide Sex Development 88
Female and male reproductive tracts develop from different precursors 88
Female and male external genitalia develop from the same precursors 89
The gonads descend during development 91
Puberty is sexual maturation 92
The brain also differentiates sexually 92
Sex Development May Go Awry 93 Chromosomal anomalies affect growth and fertility 93
The gonads or genitals may be sexually ambiguous 95
Box 4.1 My Life with Androgen Insensitivity Syndrome 96
Gender Is a Central Aspect of Personhood 97 Gender identity might not match anatomical sex 97
Women and men differ in a variety of cognitive and personality traits 98
There are Many Sex Differences in Sexuality 99
Many gender differences arise early in life 101
Biological Factors Influence Gender 102
Evolutionary forces act differently on females and males 102
Box 4.2 Gendered Play in Primates 103
Experiments demonstrate a role for sex hormones 103
Life Experiences Influence Gender 105 Gender is molded by socialization 105
Cognitive developmental models emphasize thought processes 108
Gender Development Is Interactive 108 Box 4.3 The Boy Who Was Raised as a Girl 109
Transgender People Cross Society’s Deepest Divide 110
Box 4.4 Trans Men and Women in Cross- Cultural Perspective 111
Transexual individuals are of more than one kind 112
Changing sex is a multistage process 113
Some transgender people do not want surgery 115
Box 4.5 How Should We Treat Gender- Dysphoric Children? 116
Trans people struggle for awareness and acceptance 118
Chapter 4 Sex, Gender, and Transgender 87
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CONTENTS xI
Sexual Attraction: It Takes Two 124 Beauty is not entirely in the eye of the beholder 124
Culture influences the attractiveness of bodies 126
Attractiveness involves senses besides vision 129
Behavior and personality influence sexual attractiveness 130
Box 5.1 Sex Pheromones 131
Familiarity may increase or decrease attraction 133
Perceived attractiveness varies around the menstrual cycle 135
Judgments of attractiveness change as people get to know each other 136
Asexual women and men do not experience sexual attraction 136
Sexual Arousal Has Multiple Roots 137 Fantasy is a common mode of sexual arousal 138
Arousal occurs in response to a partner 139
Hormones influence sexual arousability 140
Conditioning may influence arousal 141
Box 5.2 Aphrodisiacs and Drugs 142
Sexual Arousal Follows a Response Cycle 143
In the excitement phase, genital responses begin 143
In the plateau phase, arousal is maintained 144
Orgasm is the climax of sexual arousal 145
Box 5.3 Female Ejaculation 146
Brain imaging suggests where orgasm may be experienced 147
Box 5.4 Foot Orgasms 148
In the resolution phase, arousal subsides 149
The phases may be linked in different ways 149
Some people experience multiple orgasms 150
Men experience a refractory period 151
The Masters and Johnson cycle may be incomplete 151
Chapter 5 Attraction, Arousal, and Response 123
People Derive Pleasure from Diverse Sexual Behaviors 156
Masturbation Is a Very Common Form of Sexual Expression 156
Box 6.1 Sex and Happiness 157
Negative attitudes toward masturbation are still prevalent 158
Several demographic factors influence masturbation 158
Women use more diverse techniques of masturbation than men 160
Gay people masturbate more than heterosexuals 161
Different cultures have different attitudes toward masturbation 161
The Kiss Represents True Love— Sometimes 162
Sexual Touching Takes Many Forms 163
Oral Sex Is Increasingly Popular 164 Fellatio is oral stimulation of the penis 164
Cunnilingus is oral stimulation of the vulva 165
Most Heterosexual Sex Includes Coitus 166 Coitus can be performed in many different
positions 166
The man-above position is a traditional favorite 167
The women’s movement encouraged alternative positions 168
Box 6.2 Progress in Coitus Research 169
Box 6.3 Sex and the Seasons 171
Anal Sex May Be a Part of Either Heterosexual or Male Homosexual Behavior 172
Men and Women May Have Different Preferences for Sexual Encounters 173
Sex Toys Are Used to Enhance Sexual Pleasure 174
Sex May Be in Groups 177 Box 6.4 What Is “Great Sex”? 178
Sexual Behavior and Attitudes Vary among Cultures 179
The Kama Sutra is the classic work on how to make love 179
The Aka emphasize the importance of frequent sex 181
Many Disabled People Have Active Sex Lives 181
Box 6.5 On Seeing a Sex Surrogate 182
Many intellectually disabled people are competent to make sexual choices 183
Spinal cord injuries present a major challenge to sexual expression 184
Arthritis is the number one disability affecting sex 186
Chapter 6 Sexual Behavior 155
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xII CONTENTS
Sexual Relationships Are Motivated by Many Factors 192
Moral Judgments about Sex Depend on Its Context 192
Demographic factors affect sexual attitudes 192
Box 7.1 Who May Marry? 194
Americans’ Attitudes Have Changed over Time 195
Casual Sex Has More Appeal to Men than to Women 196
Hooking up—the new norm? 196
Box 7.2 Straight Women, Gay Sex 197
Hookups can be pleasurable or abusive 198
Hookups can have positive or negative consequences 200
Casual sex is more accepted in the gay male community 200
Negotiating sex involves flirting 201
Box 7.3 Flirting Styles 202
Non-Cohabiting Relationships Are Often Short-Lived 203
Same-sex relationships have their own scripts 205
Non-cohabiting relationships may evolve rapidly 205
Love Cements Many Sexual Relationships 206
There are different kinds of love 206
Being in love may be the justification for marriage or sex 206
Liking and reciprocal attraction precede falling in love 206
Researchers are probing the biological basis of love 207
One theory proposes that love has three components 208
Unrequited Love Is Painful for Both Parties 210
Box 7.4 Love Stories 211
The rejector may experience guilt 212
Life Experiences Mold Our Sexual Relationships 213
Relationship styles are influenced by childhood attachments 213
Couples in relationships resemble each other 213
Communication Is a Key Factor in the Success of Relationships 214
Communication may be inhibited by upbringing or by the gender barrier 214
Relationship and marriage education teaches communication skills 215
How couples deal with conflict affects the stability of their relationship 216
Love, Jealousy, and Infidelity Are Intertwined 218
Jealousy can have a positive function 218
Extra-Pair Relationships Have Many Styles and Motivations 219
Personal and evolutionary factors influence infidelity 220
Box 7.5 We Just Clicked 221
Extra-pair relationships are uncommon 222
Chapter 7 Sexual Relationships 191
Pregnancy and Childbirth Raise Major Health Concerns 228
Pregnancy Is Confirmed by Hormonal Tests 228
Box 8.1 Birth Facts 229
Infertility Can Result from a Problem in the Woman or in the Man 230
A variety of factors can reduce sperm counts 230
Box 8.2 Declining Sperm Counts? 231
In vitro fertilization can circumvent many sperm problems 232
Box 8.3 Choosing Children’s Sex 234
Sperm can be donated 235
Abnormalities of the female reproductive tract may reduce fertility 236
Failure to ovulate can be dealt with by drugs or by egg donation 236
Surrogate mothers bear children for others 236
Adoption is limited by the supply of healthy infants 237
Fertility declines with age 237
Many Embryos Do Not Survive 239 Rh factor incompatibility can threaten second
pregnancies 239
Ectopic pregnancy can endanger the mother’s life 239
Chapter 8 Fertility, Pregnancy, and Childbirth 227
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CONTENTS xIII
Pregnancy Is Conventionally Divided into Three Trimesters 240
The First Trimester Is a Period of Major Changes 240
Prenatal care provides health screening, education, and support 242
Adequate nutrition is vital to a successful pregnancy 242
Tobacco, alcohol, drugs, and radiation can harm the fetus 243
The Second Trimester Is the Easiest 245 Tests can detect fetal abnormalities 245
Sex during pregnancy is healthy 247
Moderate exercise during pregnancy is beneficial 248
The Third Trimester Is a Time of Preparation 248
A hospital is the best location for childbirth if complications are foreseen 249
Childbirth classes prepare parents for birth 249
The fetus also makes preparations for birth 250
Labor Has Three Stages 251
The first stage of labor is marked by uterine contractions and cervical dilation 251
Box 8.4 Pain-free Childbirth 253
The second stage is the delivery of the baby 254
The newborn child adapts quickly 255
The third stage is the expulsion of the placenta 255
Box 8.5 Cesarean Section 256
Premature or delayed birth is hazardous 256
The Period after Birth Places Many Demands on Parents 257
Postpartum depression may be accompanied by disordered thinking 258
Childbirth and parenthood affect sexuality 258
Breast-Feeding Is the Preferred Method of Nourishing the Infant 259
Lactation is orchestrated by hormones 259
The content of breast milk changes over time 259
Infant formula is an alternative to breast milk 260
Breast-feeding has many advantages and some drawbacks 260
Birth Control Has a Long History 266 Feminists led the campaign to legalize
contraception 266
Box 9.1 Margaret Sanger and the Birth Control Movement 267
Contraception has not yet solved the problem of unintended pregnancy 268
Different users have different contraceptive needs 268
Physical Methods Block Sperm Transport 270
Male condoms are reliable when properly used 270
Female condoms are relatively intrusive 272
Box 9.2 Male Contraceptives of the Future? 273
Diaphragms and cervical caps are inconvenient but have few side effects 274
Spermicides are not very reliable when used alone 275
Intrauterine devices require little attention 276
Hormone-Based Methods Are Easy to Use 277
Combination pills offer health benefits 278
Continuous use of combination pills eliminates menstrual periods 280
Progestin-only pills have fewer side effects 281
Hormones Can Be Administered by Non-Oral Routes 282
Depo-Provera lasts three months 282
Transdermal patches last a week 283
Vaginal rings last three weeks 284
Implants are extremely reliable 285
Behavioral Methods Can Be Demanding 285 In fertility awareness methods, couples avoid coitus
during the fertile window 285
The withdrawal method is simple but challenging 287
Noncoital sex can be used as a means of avoiding pregnancy 288
There Are Contraceptive Options after Unprotected Coitus 289
Sterilization Is Highly Reliable 290 Vasectomy is a brief outpatient procedure 290
Tubal sterilization is more invasive and expensive 292
Disabled Persons Have Special Contraceptive Needs 293
Several Safe Abortion Procedures Are Available 293
Chapter 9 Contraception and Abortion 265
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xIV CONTENTS
Box 9.3 Abortion in the United States: Key Statistics 294
Vacuum aspiration is the standard first-trimester surgical method 295
Dilation and evacuation is used early in the second trimester 295
Induced labor and hysterotomy are performed late in the second trimester 296
Medical abortions are two-step procedures 296
Abortions do not cause long-lasting ill effects 297
Box 9.4 Does Abortion Traumatize Women? 298
Americans Are Divided on Abortion, but Most Favor Restricted Availability 298
The availability of abortion is decreasing 299
Box 9.5 Feticide 301
Some Forms of Childhood Sexual Expression Are Common 306
Primates display sexual behavior early in life 306
In contemporary Western culture, children are insulated from sex 306
Some children engage in solitary sexual activity 307
Box 10.1 Talking with Children about Sex 308
Sex with others can occur during childhood 309
Cultures vary in their attitudes toward childhood sexuality 310
Some Children Have Sexual Contacts with Adults 311
Most adult-child contacts involve older children and are single encounters 311
Some kinds of adult-child sex are more harmful than others 311
Strategies to prevent adult-child sex are quite effective 312
Box 10.2 Sex and Suggestibility 313
Preadolescence May Be Marked by an Increase in Sexual Interest 314
Preadolescent children segregate by sex 314
Strict gender norms may traumatize children who become gay adults 314
Puberty Is a Period of Rapid Maturation 315 Puberty is marked by visible and invisible changes 315
Box 10.3 My First Period 317
Puberty occurs earlier in girls than boys 318
What drives puberty? 319
The body signals its readiness for puberty to the brain 320
Puberty may come too early or too late 321
Adolescence Is a Time of Sexual Exploration 322
Many cultures have puberty rites 322
There are social influences on teen sexual behavior 323
Social media have risks and benefits 324
Males masturbate more than females 325
The sexual behavior of American teens has increased and diversified 326
Box 10.4 Losing It 327
Noncoital sex is popular among teens 328
Teen Sexuality Is Central to Identity Development 329
Teen relationships are often short-lived 330
Teen pregnancy is declining but is still too common 330
Chapter 10 Sexuality across the Life Span: From Birth to Adolescence 305
In Young Adulthood, Conflicting Demands Influence Sexual Expression 336
Most young men and women have only a few sex partners 336
Cohabitation Is an Increasingly Prevalent Lifestyle 337
Box 11.1 Cohabitation: Laws in Conflict 337
Cohabitation has diverse meanings 338
Cohabitation does not harm a subsequent marriage 339
Chapter 11 Sexuality across the Life Span: Adulthood 335
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CONTENTS xV
Marriage Takes Diverse Forms 339 The formalization of sexual unions has social
and personal functions 340
Many societies have permitted polygamy 340
Box 11.2 Mormon Polygamy 341
Polyamory includes a variety of nonmonogamous relationships 342
The Institution of Marriage Is Evolving 343 Box 11.3 Extreme Marriages 344
Companionate marriage makes the availability of divorce a necessity 344
Marriage is becoming a minority status 345
Relationship options have diversified 345
Most Long-Term Couples Are Satisfied with Their Sex Lives 346
The frequency of sex declines in the course of long-term relationships 347
Marital satisfaction declines during middle age 348
Many Factors Bring Relationships to an End 348
Box 11.4 You Know the Future of Your Marriage 349
Dissimilarity between husbands and wives shortens marriages 350
Marital Disruption Can Have Negative and Positive Consequences 351
Divorced men and women can suffer psychological, physical, and economic damage 351
Divorce may be the start of a new life 351
Many divorced people remarry 352
Does marriage have a future? 352
Menopause Marks Women’s Transition to Infertility 353
Menopause may be caused by depletion of ova 354
Women may experience a decline in sexual desire at menopause 354
Decreased hormone levels affect a woman’s physiology 355
Hormone therapy can reduce menopausal symptoms 355
Ethnicity influences the experience of menopause 356
Men’s Fertility Declines Gradually with Age 357
The Sex Lives of Old People Have Traditionally Been Ignored 357
Aging is accompanied by physiological changes in the sexual response 359
Medical conditions, drugs, and social factors can impair the sexuality of older people 359
Box 11.5 Seniors on Sex 360
The experience of aging affects people in diverse ways 360
There Is a Spectrum of Sexual Orientations 366
Sexual Orientation Is Not an Isolated Trait 367
Diverse Theories Attempt to Explain Sexual Orientation 368
Box 12.1 Boys Will Be Girls 369
Freud proposed psychodynamic models 370
Sexual orientation has been attributed to socialization 370
Biological theories focus on prenatal hormones and genes 371
Box 12.2 Why Gay Genes? 374
The Gay Community Has Struggled for Equal Rights 375
The gay rights movement began in Germany 375
Box 12.3 Gay Martyrs 376
Gay rights are a global issue 377
Growing Up Gay Presents Challenges 379 Box 12.4 Global Perspectives on Sexual Orientation 380
Box 12.5 Gay and Homeless 381
Coming out is a lifelong process 382
Lesbians and gay men are well represented in certain occupations 383
Gay People Who Belong to Minorities Have Special Concerns 384
Gay Sex Has Its Own Style 385 There is diversity within the gay community 386
Some gay people are parents 387
Changing One’s Sexual Orientation Is Difficult or Impossible 388
Homophobia Has Multiple Roots 389
Chapter 12 Sexual Orientation 365
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xVI CONTENTS
Cultural indoctrination transmits homophobia across generations 390
Gays are seen as rule breakers 391
Overcoming homophobia is a grassroots enterprise 392
Bisexual People Are Caught between Two Worlds 393
The prevalence of bisexuality depends on definitions 393
Bisexual people face prejudice 395
Lesbian, gay, straight, bi, other—more alike than different 396
Sexual Variety Is the Spice of Life 402 Most fetishes are related to the body 402
Box 13.1 Rubber Fetishism and the Internet 405
People cross-dress for a variety of reasons 406
Some men are aroused by trans women 407
Sadomasochism involves the infliction or receipt of pain or degradation 407
Box 13.2 In the Dungeon 409
Adult babies reenact infancy 410
Paraphilic Disorders Cause Distress or Harm Others 410
Exhibitionists expose themselves to nonconsenting persons 412
Obscene telephone calling is related to exhibitionism 413
Voyeurs are aroused by watching others 413
Frotteurism involves surreptitious physical contact 414
Some Adults Are Sexually Attracted to Children 414
Box 13.3 Frotteurism on Public Transit 415