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TENTH EDITION
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HUMAN SEXUALITY
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Diversity in Contemporary Society
William L. Yarber
INDIANA UNIVERSITY
Barbara W. Sayad
CALIFORNIA STATE UNIVERSITY, MONTEREY BAY
HUMAN SEXUALITY: DIVERSITY IN CONTEMPORARY SOCIETY, TENTH EDITION
Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright © 2019 by McGraw-Hill
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Library of Congress Cataloging-in-Publication Data

Names: Yarber, William L. (William Lee), 1943- author. | Sayad, Barbara Werner, 1949- author.
Title: Human sexuality: diversity in contemporary society / William L. Yarber, Barbara W. Sayad.
Description: Tenth Edition. | Dubuque, IA : McGraw-Hill Education, [2018] | Revised edition of the
authors’ Human sexuality : diversity in contemporary America, [2016]
Identifiers: LCCN 2018016806 | ISBN 9781260397123 (alk. paper)
Subjects: LCSH: Sex. | Sex customs. | Sexual health.
Classification: LCC HQ21 .S8126 2018 | DDC 306.7
LC record available at https://lccn.loc.gov/2018016806
The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a
website does not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill
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Dedication
This book is dedicated to Elton John, who created the Elton

John AIDS Foundation (EJAF) in the United States in 1992 and
in the United Kingdom in 1993. The EJAF was created to
respond to the need for philanthropic support to address the
global AIDS epidemic, to assure that all people living with HIV
have access to high-quality medical care and treatment, and to
address and reduce the stigma associated with HIV/AIDS. With
the vision and leadership of Elton and the generous support of
many friends and supporters, the two foundations have raised
over $400 million. EJAF raises funds for evidence-based
programs and advocates for policies that protect and
strengthen the health and rights of people affected by HIV/
AIDS. Further, the EJAF is the largest private funder of syringe
exchange programs in the United States, which are valuable in
efforts to end the opioid epidemic.
Elton had a special relationship with Ryan White and has said
that Ryan’s activism, compassion, and courage inspired him to
change his life—to stop abusing drugs and to do something to
honor Ryan and give purpose to his life. After seeking
treatment for his addiction, he created the Elton John AIDS
Foundation, one of the largest funders of HIV/AIDS programs in
the world. President Bill Clinton said “My friend Elton has
touched us all with his music and with the countless lives he
has saved through his AIDS foundation.”
—w. l. y.
To my family, especially Bob, who provide the inspiration,

patience, support, and love I need and appreciate to do this
work.
—b. w. s.
iii
Brief Contents
1 Perspectives on Human Sexuality 1
2 Studying Human Sexuality 25
3 Female Sexual Anatomy, Physiology, and Response 60
4 Male Sexual Anatomy, Physiology, and Response 91
5 Gender and Gender Roles 111
6 Sexuality in Childhood and Adolescence 142
7 Sexuality in Adulthood 167

8 Love and Communication in Intimate Relationships 192
9 Sexual Expression 223
10 Variations in Sexual Behavior 264
11 Contraception and Abortion 288
12 Conception, Pregnancy, and Childbirth 321
13 The Sexual Body in Health and Illness 351
14 Sexual Function Difficulties, Dissatisfaction, Enhancement, and Therapy 380
15 Sexually Transmitted Infections 421
16 HIV and AIDS 456
17 Sexual Assault and Sexual Misconduct 498
18 Sexually Explicit Materials, Sex Workers, and Sex Laws 537

McGraw-Hill Education Psychology APA Documentation Style Guide
iv
Contents
PREFACE xviii | LETTER FROM THE AUTHORS xxix |
ABOUT THE AUTHORS xxxi
1 Perspectives on Human Sexuality 1

STUDYING HUMAN SEXUALITY 2
SEXUALITY, POPULAR CULTURE, AND THE MEDIA 3

Media Portrayals of Sexuality 3
Television and Digital Media 6
Feature-Length Films 8
Lesbian, Gay, Bisexual, Transgender, and Queer People in Film and Television 8
Online Social Networks 9
■ Think About It ONLINE DATING: ASSET OR LIABILITY?
©Peopleimages/iStock/Getty Images
10
SEXUALITY ACROSS CULTURES AND TIMES 13

Sexual Interests 13
Sexual Orientation 15
Gender 16
SOCIETAL NORMS AND SEXUALITY 17

Natural Sexual Behavior 17
■ Think About It AM I NORMAL? 18
Normal Sexual Behavior 19
Sexual Behavior and Variations 20
■ Think About It DECLARATION OF SEXUAL RIGHTS 21
FINAL THOUGHTS 22 | SUMMARY 22 | QUESTIONS FOR DISCUSSION 23 | SEX AND

THE INTERNET 23 | SUGGESTED WEBSITES 23 | SUGGESTED READING 24
2 Studying Human Sexuality 25

SEX, ADVICE COLUMNISTS, AND POP PSYCHOLOGY 26
Information and Advice as Entertainment 27
The Use and Abuse of Research Findings 27
■ Think About It DOES SEX HAVE AN INHERENT MEANING? 28
THINKING OBJECTIVELY ABOUT SEXUALITY 29

Value Judgments Versus Objectivity 29
Opinions, Biases, and Stereotypes 30
Common Fallacies: Egocentric and Ethnocentric Thinking 31 ©Hero/Corbis/Glow Images
v
SEX RESEARCH METHODS 31
Research Concerns 32
Clinical Research 33
Survey Research 33
■ Practically Speaking ANSWERING A SEX RESEARCH QUESTIONNAIRE: MOTIVES FOR FEIGNING
ORGASMS SCALE 34
Observational Research 37
Experimental Research 37
■ Think About It A CONTINUED CHALLENGE FACING SEX RESEARCHERS: SELECTING THE BEST WAY TO
ACCURATELY MEASURE SEXUAL BEHAVIOR AND SEXUAL ORIENTATION 38
THE SEX RESEARCHERS 39

Richard von Krafft-Ebing 39
Sigmund Freud 40
Havelock Ellis 40
Alfred Kinsey 41
William Masters and Virginia Johnson 43
CONTEMPORARY RESEARCH STUDIES 43

The National Health and Social Life Survey 44
The National Survey of Family Growth 44
The Youth Risk Behavior Survey 45
■ Think About It SEX RESEARCH: A BENEFIT TO INDIVIDUALS AND SOCIETY OR A THREAT
TO MORALITY? 46
The National College Health Assessment 47
The National Survey of Sexual Health and Behavior 48
EMERGING RESEARCH PERSPECTIVES 49

Feminist Scholarship 49
Gay, Lesbian, Bisexual, and Transgender Research 50
Directions for Future Research 52
ETHNICITY AND SEXUALITY 52

African Americans 52
Latinos 54
Asian Americans and Pacific Islanders 55
Middle Eastern Americans 55

3 Female Sexual Anatomy, Physiology,

and Response 60
FEMALE SEX ORGANS: WHAT ARE THEY FOR? 61
External Structures (the Vulva) 62
■ Think About It THE GROOMING OF PUBIC HAIR: NUISANCE OR NOVELTY? 64
Internal Structures 65
■ Practically Speaking PERFORMING A GYNECOLOGICAL SELF-EXAMINATION 69
Other Structures 70
©Ingram Publishing/SuperStock
The Breasts 70
vi Contents
FEMALE SEXUAL PHYSIOLOGY 71
Sex Hormones 72
The Ovarian Cycle 73
The Menstrual Cycle 74
■ Practically Speaking VAGINAL AND MENSTRUAL WELL-BEING 79
HUMAN SEXUAL RESPONSE 80

Sexual Response Models 80
Desire and Arousal: Two Sides of the Same Coin? 83
■ Think About It FEMALE GENITAL MUTILATION/CUTTING: HUMAN RIGHTS VIOLATION OR CULTURAL
AND SOCIAL NORM? 86
FEMALE SEXUAL RESPONSE 87

Sexual Excitement 87
Orgasm 87

4 Male Sexual Anatomy, Physiology,

and Response 91
MALE SEX ORGANS: WHAT ARE THEY FOR? 92
External Structures 92
Internal Structures 95
■ Think About It THE QUESTION OF MALE CIRCUMCISION 96
Other Structures 98
MALE SEXUAL PHYSIOLOGY 99

©Cultura RM/Moof/Getty Images
Sex Hormones 99
■ Think About It DOES PENIS SIZE MATTER? 100
■ Practically Speaking SEXUAL AND REPRODUCTIVE HEALTH CARE: WHAT DO MEN NEED? 102
Spermatogenesis 104
Semen Production 105
Homologous Organs 105
MALE SEXUAL RESPONSE 106

Erection 106
Ejaculation and Orgasm 107
■ Think About It MEN AND SEXUAL DESIRE: IT’S MORE COMPLEX THAN WE MIGHT THINK 108
5 Gender and Gender Roles 111

STUDYING GENDER AND GENDER ROLES 113
Sex, Gender, and Gender Roles: What’s the Difference? 113
Sex and Gender Identity 114
Masculinity and Femininity: Opposites, Similar, or Blended? 115
■ Think About It SEXUAL FLUIDITY: WOMEN’S AND MEN’S VARIABLE SEXUAL ATTRACTIONS 117
Gender and Sexual Orientation 118
©Jeff Gross/Getty Images
Contents vii
GENDER-ROLE LEARNING 118
Theories of Socialization 118
Gender-Role Learning in Childhood and Adolescence 119
Gender Schemas: Exaggerating Differences 123
CONTEMPORARY GENDER ROLES AND SCRIPTS 123

Traditional Gender Roles and Scripts 123
Changing Gender Roles and Scripts 125
GENDER VARIATIONS 126

The Transgender Phenomenon 127
■ Practically Speaking A QUICK GLOSSARY ON SEX, GENDER, AND GENDER VARIATIONS 128
■ Think About It GENDER-CONFIRMING SURGERY: PSYCHOLOGICAL AND PHYSIOLOGICAL NEEDS 130

Gender Dysphoria 131
Disorders of Sex Development (DSD) 133
Unclassified Congenital Condition 136
Coming to Terms With Differences 136
■ Think About It TRANSGENDER PEOPLE AND BATHROOM ACCESS: WHAT’S THE DEAL? 137
6 Sexuality in Childhood
and Adolescence 142
SEXUALITY IN INFANCY AND CHILDHOOD (AGES 0 TO 11) 143
Infancy and Sexual Response (Ages 0 to 2) 144
Childhood Sexuality (Ages 3 to 11) 144
The Family Context 146
SEXUALITY IN ADOLESCENCE (AGES 12 TO 19) 147

©WeAre/Shutterstock Psychosexual Development 147
Adolescent Sexual Behavior 155
■ Think About It VIRGINITY—WHATEVER THAT MEANS 157
Teenage Pregnancy 159

■ Think About It ”GOOD ENOUGH SEX”: THE WAY TO LIFETIME COUPLE SATISFACTION 160
Sexuality Education 162
■ Think About It HEALTHY TEEN SEXUALITY 164
7 Sexuality in Adulthood 167

SEXUALITY IN EARLY ADULTHOOD 168
Developmental Concerns 168
Establishing Sexual Orientation and Identity 169
■ Think About It LIFE BEHAVIORS OF A SEXUALLY HEALTHY ADULT 170
Being Single 174

■ Think About It SINGLES IN AMERICA: DATING TRENDS, RITUALS, AND SOCIAL MEDIA 178
©Image Source/Getty Images
viii Contents
Cohabitation 179
Same-Sex Marriage 179
SEXUALITY IN MIDDLE ADULTHOOD 180

Sexuality in Marriage and Established Relationships 180
■ Think About It ARE SAME-SEX COUPLES AND FAMILIES ANY DIFFERENT FROM
HETEROSEXUAL ONES? 182

Divorce and After 182
SEXUALITY IN LATE ADULTHOOD 184

Stereotypes of Aging 185
Sexuality and Aging 185
8 Love and Communication in Intimate

Relationships 192
FRIENDSHIP AND LOVE 194
LOVE AND SEXUALITY 195

Men, Women, Sex, and Love 195
Love Without Sex: Celibacy and Asexuality 197
HOW DO I LOVE THEE? APPROACHES AND ATTITUDES RELATED TO LOVE 197

Styles of Love 197 ©Andersen Ross/Getty Images
The Triangular Theory of Love 198
Love as Attachment 201
Unrequited Love 202
JEALOUSY 202
The Psychological Dimension of Jealousy 203
■ Think About It THE SCIENCE OF LOVE 204
Managing Jealousy 205

Extrarelational Sex 205
Rebound Sex 207
MAKING LOVE LAST: FROM PASSION TO INTIMACY 207
THE NATURE OF COMMUNICATION 208

The Cultural Context 208
The Social Context 209
The Psychological Context 209
Nonverbal Communication 209
SEXUAL COMMUNICATION 211

Sexual Communication in Beginning Relationships 211
Sexual Communication in Established Relationships 213
■ Think About It LET’S (NOT) TALK ABOUT SEX: AVOIDING THE DISCUSSION ABOUT PAST LOVERS 214
DEVELOPING COMMUNICATION SKILLS 214

Talking About Sex 214
■ Practically Speaking COMMUNICATION PATTERNS AND PARTNER SATISFACTION 216
Contents ix
CONFLICT AND INTIMACY 217
Sexual Conflicts 218
■ Practically Speaking LESSONS FROM THE LOVE LAB 219
Conflict Resolution 219
9 Sexual Expression 223

SEXUAL ATTRACTIVENESS 225
A Cross-Cultural Analysis 225
Evolutionary Mating Perspectives 227
■ Think About It WHY COLLEGE STUDENTS HAVE SEX 228
Hooking Up and College Students 232

■ Think About It ”HOOKING UP” AMONG COLLEGE STUDENTS: AS SIMPLE AS ONE MIGHT THINK? 234
Sexual Desire 235
©Tom Merton/Getty Images
SEXUAL SCRIPTS 236
Cultural Scripting 236
Intrapersonal Scripting 237
Interpersonal Scripting 237
AUTOEROTICISM 238
Sexual Fantasies and Dreams 239
Masturbation 241
■ Practically Speaking ASSESSING YOUR ATTITUDE TOWARD MASTURBATION 245
SEXUAL BEHAVIOR WITH OTHERS 246

Most Recent Partnered Sex 247
■ Think About It YOU WOULD SAY YOU “HAD SEX” IF YOU . . . 248
Frequency and Duration of Sex 249

Couple Sexual Styles 250
Touching 251
■ Think About It THE FREQUENCY OF SEX: THE MORE, THE BETTER? 252
Kissing 253
Oral-Genital Sex 254
■ Think About It THE FIRST KISS: A DEAL-BREAKER? 255
Sexual Intercourse 257

Anal Eroticism 260
Health Benefits of Sexual Activity 261
10 Variations in Sexual Behavior 264

SEXUAL VARIATIONS AND PARAPHILIC BEHAVIOR 265
What Are Sexual Variations? 265
What Is Paraphilia? 266
■ Think About It CLASSIFYING VARIANT SEXUAL BEHAVIORS AS PARAPHILIA: THE CHANGING VIEWS
OF PSYCHOLOGY 266
©Mark Wragg/Getty Images

x Contents
The Frequency of Paraphilia Behaviors and Desire 268
■ Think About It ”SEXUAL ADDICTION”: REPRESSIVE MORALITY IN A NEW GUISE? 269
TYPES OF PARAPHILIAS 272

Fetishism 272
Transvestism 273
Zoophilia 274
Voyeurism 275
■ Think About It WOULD YOU WATCH? COLLEGE STUDENTS AND VOYEURISM 276
Exhibitionism 277
Telephone Scatologia 278
Frotteurism 278
Necrophilia 279
Pedophilia 279
BDSM, Sexual Masochism, and Sexual Sadism 280
ORIGINS AND TREATMENT OF PARAPHILIAS 284
11 Contraception and Abortion 288

RISK AND RESPONSIBILITY 289
Women, Men, and Contraception: Who Is Responsible? 290
Access to Contraception 291
METHODS OF CONTRACEPTION 292

Choosing a Method 293
Sexual Abstinence 295
Withdrawal (Coitus Interruptus) 295
Hormonal Methods 295 ©Rafe Swan/Cultura/Getty Images
Barrier Methods 300
■ Practically Speaking TIPS FOR EFFECTIVE CONDOM USE 302
■ Practically Speaking CORRECT CONDOM USE SELF-EFFICACY SCALE 303

Intrauterine Devices (IUDs) 306
Long-Acting Reversible Contraception (LARC) 307
Fertility Awareness–Based Methods 308
Lactational Amenorrhea Method (LAM) 309
Sterilization 309
Emergency Contraception (EC) 311
ABORTION 312
Methods of Abortion 312
Safety of Abortion 313
Women and Abortion 314
Men and Abortion 315
The Abortion Debate 315
RESEARCH ISSUES 316

■ Think About It RISKY BUSINESS: WHY COUPLES FAIL TO USE CONTRACEPTION 317
Contents xi
12 Conception, Pregnancy, and Childbirth 321
FERTILIZATION AND FETAL DEVELOPMENT 323
The Fertilization Process 323
Development of the Conceptus 324
PREGNANCY 327
Preconception Health 327
Pregnancy Detection 327
Adjustments and Psychological Changes in Women During Pregnancy 328
Complications of Pregnancy and Dangers to the Fetus 329
■ Think About It SEXUAL BEHAVIOR DURING PREGNANCY 330
Diagnosing Fetal Abnormalities 335

Pregnancy Loss 336
INFERTILITY 338
Female Infertility 338
Male Infertility 338
Emotional Responses to Infertility 339
Infertility Treatment 339
GIVING BIRTH 341

©ballyscanlon/Getty Images
Labor and Delivery 341
Choices in Childbirth 343
■ Practically Speaking MAKING A BIRTH PLAN 345
Breastfeeding 346
POSTPARTUM AND BEYOND 346

■ Practically Speaking BREAST VERSUS BOTTLE: WHICH IS BETTER FOR YOU AND YOUR CHILD? 347
13 The Sexual Body in Health and Illness 351

LIVING IN OUR BODIES: THE QUEST FOR PHYSICAL PERFECTION 352
Eating Disorders 353
■ Think About It BODY MODIFICATION: YOU’RE DOING WHAT, WHERE? 354
ALCOHOL, DRUGS, AND SEXUALITY 355

Alcohol Use and Sexuality 355
Other Drug Use and Sexuality 357
SEXUALITY AND DISABILITY 359

Physical Limitations and Changing Expectations 359
Vision and Hearing Impairment 361
Chronic Illness 361
Developmental Disabilities 362
The Sexual Rights of People With Disabilities 363
©Goodshoot/Getty Images SEXUALITY AND CANCER 363

Women and Cancer 364
Men and Cancer 370
Anal Cancer in Men and Women 374
xii Contents
ADDITIONAL SEXUAL HEALTH ISSUES 374
Toxic Shock Syndrome 374
Vulvodynia 375
Endometriosis 375
Prostatitis 375
SEXUAL ORIENTATION AND HEALTH 376
14 Sexual Function Difficulties, Dissatisfaction,

Enhancement, and Therapy 380
SEXUAL FUNCTION DIFFICULTIES: DEFINITIONS, TYPES, AND PREVALENCE 382
Defining Sexual Function Difficulties: Different Perspectives 382
Prevalence and Cofactors 385
Disorders of Sexual Desire 389
■ Practically Speaking SEXUAL DESIRE: WHEN APPETITES DIFFER 390
Orgasmic Disorders 394

■ Think About It ORGASM, THAT SIMPLE? YOUNG ADULTS’ EXPERIENCES OF ORGASM AND SEXUAL
PLEASURE 396 ©Radius Images/Alamy Stock Photo

Sexual Pain Disorders 397
Substance/Medication-Induced Sexual Dysfunction 399
Other Disorders 399
PHYSICAL CAUSES OF SEXUAL FUNCTION DIFFICULTIES AND DISSATISFACTION 399

Physical Causes in Men 399
Physical Causes in Women 400
PSYCHOLOGICAL CAUSES OF SEXUAL FUNCTION DIFFICULTIES AND

DISSATISFACTION 400
Immediate Causes 400
Conflict Within the Self 401
Relationship Causes 402
SEXUAL FUNCTION ENHANCEMENT 402

Developing Self-Awareness 402
■ Practically Speaking KEGEL EXERCISES FOR WOMEN AND MEN 404
Intensifying Erotic Pleasure 405

■ Think About It MY PARTNER COULD BE A BETTER LOVER IF . . . : WHAT MEN AND WOMEN WANT
FROM THEIR SEXUAL PARTNERS 406

■ Think About It SEXUAL TURN-ONS AND TURN-OFFS: WHAT COLLEGE STUDENTS REPORT 409
TREATING SEXUAL FUNCTION DIFFICULTIES 409

Masters and Johnson: A Cognitive-Behavioral Approach 410
Kaplan: Psychosexual Therapy 412
Other Nonmedical Approaches 412
Medical Approaches 413
Lesbian, Gay, Bisexual, Transgender, and Queer Sex Therapy 415
■ Practically Speaking SEEKING PROFESSIONAL ASSISTANCE 416
When Treatment Fails 416
Contents xiii
15 Sexually Transmitted Infections 421
THE STI EPIDEMIC 422
STIs: The Most Common Reportable Infectious Diseases 423
Who Is Affected: Disparities Among Groups 424
Factors Contributing to the Spread of STIs 426
■ Practically Speaking PREVENTING STIs: THE ROLE OF MALE CONDOMS, FEMALE CONDOMS, AND
DENTAL DAMS 428

■ Think About It ACCURATELY JUDGING IF A POTENTIAL SEXUAL PARTNER IS INFECTED WITH AN STI:
©Peter Dazeley/Photographer’s Choice/
EASILY DONE? 430
Getty Images
■ Practically Speaking STI ATTITUDE SCALE 432
Consequences of STIs 433
PRINCIPAL BACTERIAL STIs 433

Chlamydia 433
Gonorrhea 436
Urinary Tract Infections 437
Syphilis 437
PRINCIPAL VIRAL STIs 439

HIV and AIDS 439
Genital Herpes 439
■ Think About It THE TUSKEGEE SYPHILIS STUDY: A TRAGEDY OF RACE AND MEDICINE 440
Genital Human Papillomavirus Infection 441
Viral Hepatitis 443
Zika 444
VAGINAL INFECTIONS 445

Bacterial Vaginosis 445
Genital Candidiasis 446
Trichomoniasis 446
OTHER STIs 447
ECTOPARASITIC INFESTATIONS 447

Scabies 447
Pubic Lice 448
STIs AND WOMEN 448

Pelvic Inflammatory Disease (PID) 448
Cervicitis 449
Cystitis 449
PREVENTING STIs 450

Avoiding STIs 450
Treating STIs 451
■ Practically Speaking SAFER AND UNSAFE SEX BEHAVIORS 452
xiv Contents
16 HIV and AIDS 456
WHAT IS AIDS? 458
Conditions Associated With AIDS 458
■ Think About It THE STIGMATIZATION OF HIV AND OTHER STIs 459
Symptoms of HIV Infection and AIDS 460
Understanding AIDS: The Immune System and HIV 460
The Virus 461
AIDS Pathogenesis: How the Disease Progresses 462
©Mandel Ngan/AFP/Getty Images
THE EPIDEMIOLOGY AND TRANSMISSION OF HIV 463
The Epidemiology of HIV/AIDS in the United States 464
Modes and Myths of Transmission 467
Sexual Transmission 469
Substance and Injection Drug Use 471
Mother-to-Child Transmission 472
AIDS DEMOGRAPHICS 473

Minority Races/Ethnicities and HIV 473
The Gay Community 477
Women and HIV/AIDS 478
Transgender People and HIV 479
Children and HIV/AIDS 480
HIV/AIDS Among Youth 480
Older Adults and HIV/AIDS 482
Geographic Region and HIV 483
PREVENTION AND TREATMENT 484

Protecting Ourselves 484
■ Think About It WHICH STRATEGIES WOULD YOU USE TO REDUCE YOUR RISK OF STI/HIV? WHAT ONE
GROUP OF WOMEN DID 485

■ Think About It “DO YOU KNOW WHAT YOU ARE DOING?” COMMON CONDOM-USE MISTAKES AMONG
COLLEGE STUDENTS 488
Saving Lives Through Prevention 489
HIV Testing 490
Treatments 492
LIVING WITH HIV OR AIDS 494

If You Are HIV-Positive 494
17 Sexual Assault and Sexual Misconduct 498

SEXUAL HARASSMENT 500
What Is Sexual Harassment? 500
Flirtation Versus Harassment 502
Harassment in School and College 504
Harassment in the Workplace 506
Gender-Based Harassment in Public Spaces 508
©Mario Mitsis/Alamy Stock Photo
Contents xv
HARASSMENT AND DISCRIMINATION AGAINST LESBIAN, GAY, BISEXUAL,
TRANSGENDER, AND QUEER PEOPLE 509
Heterosexual Bias 509
Prejudice, Discrimination, and Violence 509
Ending Anti-Gay Prejudice and Enactment of Antidiscrimination Laws 512
SEXUAL ASSAULT 514

Campus Sexual Assault 516
■ Think About It DATE RAPE DRUGS: AN INCREASING THREAT 518
Myths About Rape 519

■ Practically Speaking WHAT CAN YOU DO TO PREVENT SEXUAL ASSAULT? BE A “BYSTANDER” 520
■ Practically Speaking BEING SAFE: STRATEGIES FOR AVOIDING BEING SEXUALLY ASSAULTED 521
Confusion Over Sexual Consent 522

■ Think About It VERBALLY CONSENTING TO SEX: AS SIMPLE AS ONE MIGHT THINK? 524
The Aftermath of Rape 526

■ Think About It HOW COLLEGE STUDENTS INDICATE AND INTERPRET CONSENT TO HAVE SEX 527
CHILD SEXUAL ABUSE 528

■ Practically Speaking SUPPORTING SOMEONE WHO HAS BEEN RAPED 529
■ Practically Speaking HAVING SEX AGAIN AFTER BEING SEXUALLY ASSAULTED: RECLAIMING ONE’S
SEXUALITY 530
Effects of Child Sexual Abuse 532
Treatment Programs 533
Preventing Child Sexual Abuse 533
18 Sexually Explicit Materials, Sex Workers,

and Sex Laws 537
SEXUALLY EXPLICIT MATERIAL IN CONTEMPORARY AMERICA 538
Pornography or Erotica: Which Is It? 538
Sexually Explicit Material and Popular Culture 539
The Consumption of Sexually Explicit Materials 540
■ Think About It WHO WATCHES THE DIFFERENT TYPES OF SEXUALLY EXPLICIT VIDEOS? 541
Themes, Content, and Actors of SEV 542
©David Angel/Alamy Stock Photo
The Effects of SEV 544
■ Think About It SEXUALLY EXPLICIT VIDEO USE IN ROMANTIC COUPLES: BENEFICIAL OR
HARMFUL? 546
Censorship, Sexually Explicit Material, and the Law 548
■ Think About It WHAT POPULAR MEDIA SAYS ABOUT SEXUALLY EXPLICIT VIDEOS AND RELATIONSHIPS:
SUPPORTED BY RESEARCH? 550
SEX WORK AND SEX TRAFFICKING 552

The Prevalence of Sex Work 553
■ Think About It SEX TRAFFICKING: A MODERN-DAY SLAVERY 554
Male Sex Workers 558

Sex Work and the Law 560
The Impact of HIV/AIDS and Other STIs on Sex Work 560
xvi Contents
SEXUALITY AND THE LAW 561
Legalizing Private, Consensual Sexual Behavior 561
■ Think About It SHOULD SEX WORK BE DECRIMINALIZED AND LEGALIZED? 562
Same-Sex Marriage 563
Advocating Sexual Rights 564
GLOSSARY G-1
REFERENCES R-1
NAME INDEX NI-1
SUBJECT INDEX SI-1
McGraw-Hill Education Psychology APA Documentation Style Guide
Contents xvii
Preface
Celebrating Sexual Diversity in Contemporary Society

Since the first edition, Human Sexuality: Diversity in Contemporary Society has presented
students with a nonjudgmental and affirming view of human sexuality while encouraging
them to embrace their own sexuality. More recently, our discussion of human sexuality has
increasingly cited research studies and writings from countries beyond America, thus broad-
ening student understanding of the diverse meanings and expressions of human sexuality.
The desire to reflect these changes prompted us to alter the title of our book to Human
Sexuality: Diversity in Contemporary Society.
Nine editions later, Human Sexuality: Diversity in Contemporary Society continues to be a
pioneering text in many ways. The sexual affirmation approach encourages students to become
proactive in and about their own sexual well-being and includes an emphasis on the importance
of embracing intimacy, pleasuring, and mutual satisfaction in sexual expression. It also strives to
represent the contemporary, diverse society that students encounter inside and outside the class-
room. And with McGraw-Hill Education Connect for Human Sexuality, students embark on a
personalized digital learning program, which allows them to study more effectively and efficiently.
Health and Well-Being

As one fundamental component of the human condition, sexuality can impact personal
well-being. When balanced with other life needs, sexuality contributes positively to personal
health and happiness. When expressed in destructive ways, it can impair health. We believe
that studying human sexuality is one way of increasing the healthy lifestyle of students.
Integrated into all chapter are discussions, research, questions, and prompts that interrelate
students’ well-being and their sexuality.
Thinking Critically About Human Sexuality

Each chapter contains multiple Think About
It features that prompt students to think
critically about topics in sexuality such as
am I normal, the science of love, hooking
up, what behaviors constitute having had
sex, orgasm and pleasure, and how college
students indicate and interpret consent to
have sex.
xviii
Speaking Practically about Human Sexuality
The Practically Speaking feature asks students to examine their own values and the ways they
express their sexuality. Topics include sexual communication, effective condom use, having
sex again after sexual assault, and a glossary on sex, gender, and gender variation terms. These
features help students apply the concepts presented in the book to their own lives.
The Significance of Ethnicity

Until relatively recently, Americans have ignored race and ethnicity as a factor in studying
human sexuality. We have acted as if being White, African American, Latino, Asian American,
or Native American made no difference in terms of sexual attitudes, behaviors, and values. But
there are significant differences, and it is important to examine these differences within their
cultural context. Ethnic differences, therefore, should not be interpreted as “good” or “bad,”
“healthy” or “deficient,” but as reflections of the diversity in our culture. Our understanding
of the role of race and ethnicity in sexuality, however, is a still evolving area of research.
Celebrating sexual diversity, however, is only part of the story. Through an integrated, per-
sonalized digital learning program, students gain the insight they need to study smarter and
improve performance. McGraw-Hill Education Connect is a digital assignment and assessment
platform that strengthens the link between faculty, students, and course work, helping everyone
accomplish more in less time. Connect for Human Sexuality includes assignable and assessable
animations, quizzes, exercises, and interactivities, all associated with learning objectives.
Students Study More Effectively with Connect®

and SmartBook®
■■ SmartBook helps students study more efficiently by highlighting where in the chapter to
focus, asking review questions, and pointing them to resources until they understand.
■■ Connect’s assignments help students contextualize what they’ve learned through
application, so they can better understand the material and think critically.
■■ Connect will create a personalized study path customized to individual student needs.
■■ Connect reports deliver information regarding performance, study behavior, and effort,
so instructors can quickly identify students who are having issues or focus on material
that the class hasn’t mastered.
Human Sexuality: Diversity in Contemporary Society harnesses the power of data to improve
the instructor and student experiences.
Preface xix
Heat Map and the Power of Student Data
For this edition, data were analyzed to identify the concepts students found to be the most
difficult, allowing for expansion upon the discussion, practice, and assessment of challenging
topics. The revision process for a new edition used to begin with gathering information from
instructors about what they would change and what they would keep. Experts in the field
were asked to provide comments that pointed out new material to add and dated material
to review. Using all these reviews, authors would revise the material. But now a new tool has
revolutionized that model.
McGraw-Hill Education authors now have access to student performance data to analyze
and inform their revisions. This data is anonymously collected from the many students who
use SmartBook, the adaptive learning system that provides students with individualized
assessment of their own progress. Because virtually every text paragraph is tied to several
questions that students answer while using the SmartBook, the specific concepts with which
students are having the most difficulty are easily pinpointed through empirical data in the
form of a “heat map” report.
Here’s how the “heat map” works:
STEP 1. Over the course of three years, data points showing concepts that caused students
the most difficulty were anonymously collected from SmartBook for Human Sexuality:
Diversity in Contemporary America, 9e.
STEP 2. The data was provided to the authors in the form of a Heat Map, which graphi-
cally illustrated “hot spots” in the text that impacted student learning.
STEP 3. The authors used the Heat Map data to refine the content and reinforce student
comprehension in the new edition. Additional quiz questions and assignable activities were
created for use in Connect for Human Sexuality to further support student success.
RESULT: Because the Heat Map gave the authors empirically based feedback at the para-
graph and even sentence levels, they were able to develop the new edition using precise
student data that pinpointed concepts that caused students the most difficulty.
Powerful Reporting
Whether a class is face-to-face, hybrid, or entirely online, M
cGraw-Hill Connect provides the
tools needed to reduce the amount of time and energy instructors spend administering their
courses. Easy-to-use course management tools allow instructors to spend less time adminis-
tering and more time teaching, while reports allow students to monitor their progress and
optimize their study time.
■■ The At-Risk Student Report provides instructors with one-click access to a dashboard
that identifies students who are at risk of dropping out of the course due to low
engagement levels.
■■ The Category Analysis Report details student performance relative to specific learning
objectives and goals, including APA learning goals and outcomes and levels of
Bloom’s taxonomy.
■■ Connect Insight is a one-of-a-kind visual analytics dashboard—now available for both
instructors and students—that provides at-a-glance information regarding student
performance.
■■ The LearnSmart Reports allow instructors and students to easily monitor progress and
pinpoint areas of weakness, giving each student a personalized study plan to achieve
success.
xx Preface
New to the tenth edition, Power of Process, now available in McGraw-Hill Connect, guides
students through the process of critical reading, analysis, and writing. Faculty can select or
upload their own content, such as journal articles, and assign analysis strategies to gain
insight into students’ application of the scientific method. For students, Power of Process
offers a guided visual approach to exercising critical thinking strategies to apply before,
during, and after reading published research. Additionally, utilizing the relevant and engaging
research articles built into Power of Process, students are supported in becoming critical
consumers of research.
Concept Clips help students comprehend some of the most difficult concepts in human
sexuality. Colorful graphics and stimulating animations describe core concepts in a step-by-
step manner, engaging students and aiding in retention. Concept Clips can be used as a
presentation tool in the classroom or for student assessment. New in the tenth edition,
Concept Clips are embedded in the eBook to offer an alternative presentation of these chal-
lenging topics. New clips cover topics such as attraction, mate selection, and learning gender
roles.
Interactivities, assignable through Connect, engage students with content through experi-
ential activities. Topics include first impressions and attraction.
Through the connection of human sexuality to students’ own lives, concepts become more
relevant and understandable. Powered by McGraw-Hill Education’s Connect for Human Sex-
uality, NewsFlash exercises tie current news stories to key psychological principles and learn-
ing objectives. After interacting with a contemporary news story, students are assessed on
their ability to make the link between real life and research findings.
At the Apply and Analyze level of Bloom’s, Scientific Reasoning Exercises, now available
in Connect, offer in-depth arguments to sharpen students’ critical thinking skills and prepare
them to be more discerning consumers regarding information in their everyday lives. For
each chapter, there are multiple sets of arguments related to topics in the Human Sexuality
course, accompanied by autograded assignments that ask students to think critically about
claims presented as facts. These exercises can also be used as group activities or for
discussion.
And McGraw-Hill Education Psychology’s APA Documentation Style Guide helps s tudents
properly cite and document their writing assignments.
The Instructor Resources have been updated to reflect changes to the new edition. These
can be accessed by faculty through Connect. Resources include the test bank, instructor’s
manual, PowerPoint presentation, and image gallery.
Preface xxi
Supporting Instructors with Technology
With McGraw-Hill Education, you can develop and tailor the course you want to teach.
McGraw-Hill Campus (www.mhcampus.com) provides faculty with true

single sign-on access to all of McGraw-Hill’s course content, digital tools,
and other high-quality learning resources from any learning management
system. McGraw-Hill Campus includes access to McGraw-Hill’s entire content library, including
eBooks, assessment tools, presentation slides, and multimedia content, among other resources,
providing faculty open, unlimited access to prepare for class, create tests/quizzes, develop lecture
material, integrate interactive content, and more.
With Tegrity, you can capture lessons and lectures in a searchable for-
mat and use them in traditional, hybrid, “flipped classes,” and online
courses. With Tegrity’s personalized learning features, you can make
study time efficient. Its ability to affordably scale brings this benefit to every student on campus.
Patented search technology and real-time learning management system (LMS) integrations make
Tegrity the market-leading solution and service.
Easily rearrange chapters, combine material from other content

sources, and quickly upload content you have written, such as your
course syllabus or teaching notes, using McGraw-Hill Education’s
Create. Find the content you need by searching through thousands of leading McGraw-Hill
Education textbooks. Arrange your book to fit your teaching style. Create even allows you to
personalize your book’s appearance by selecting the cover and adding your name, school, and
course information. Order a Create book, and you will receive a complimentary print review
copy in three to five business days or a complimentary electronic review copy via email in
about an hour. Experience how McGraw-Hill Education empowers you to teach your students
your way at http://create.mheducation.com.
Trusted Service and Support

McGraw-Hill Education’s Connect offers comprehensive service, support, and training
throughout every phase of your implementation. If you’re looking for some guidance on how
to use Connect or want to learn tips and tricks from super users, you can find tutorials as
you work. Our Digital Faculty Consultants and Student Ambassadors offer insight into how
to achieve the results you want with Connect.
Integration with Your Learning Management System

McGraw-Hill integrates your digital products from McGraw-Hill Education with your school
learning management system (LMS) for quick and easy access to best-in-class content and
learning tools. Build an effective digital course, enroll students with ease and discover how
powerful digital teaching can be.
Available with Connect, integration is a pairing between an institution’s LMS and Connect
at the assignment level. It shares assignment information, grades, and calendar items from
Connect into the LMS automatically, creating an easy-to-manage course for instructors and
simple navigation for students. Our assignment-level integration is available with Blackboard
Learn, Canvas by Instructure, and Brightspace by D2L, giving you access to registration,
attendance, assignments, grades, and course resources in real time, in one location.
Annual Editions: Human Sexualities

This volume offers diverse topics on sex and sexuality with regard to the human experience.
Learning Outcomes, Critical Thinking questions, and Internet References accompany each
article to further enhance learning. Customize this title via McGraw-Hill Create at http://
create.mheducation.com.
xxii Preface
Taking Sides: Clashing Views in Human Sexuality
This debate-style reader both reinforces and challenges students’ viewpoints on the most cru-
cial issues in human sexuality today. Each topic offers current and lively pro and con essays
that represent the arguments of leading scholars and commentators in their fields. Learning
Outcomes, an Issue Summary, and an Issue Introduction set the stage for each debate topic.
Following each issue is the Exploring the Issue section with Critical Thinking and Reflection
questions, Is There Common Ground? commentary, Additional Resources, and Internet References
all designed to stimulate and challenge the student’s thinking and to further explore the topic.
Customize this title via McGraw-Hill Education Create at http://create.mheducation.com.
Chapter-by-Chapter Changes
The research on sexuality is ever increasing, thereby providing the material to allow this new
edition to be current and relevant. Not only does our book incorporate the latest research
on sexual diversity and expression, but it also reflects current social and cultural trends in
sexuality that are pertinent to the development of a healthy and pleasurable sexuality. Below
are listed the major additions and changes to the tenth edition of Human Sexuality: Diversity
in Contemporary Society.
Chapter 1: Perspectives on Human Sexuality

■■ New research on media use and young people
■■ New data on media and sexual consent, gender, and sexual roles
■■ Added contemporary key terms, examples of popular media, and inclusion of popular
personalities
■■ New Think About It box: “Online Dating: Asset or Liability?”
■■ Expanded and updated discussion on sexting
■■ Updated and expanded definitions of sexuality behaviors and variations
■■ New section on gender role expectations
Chapter 2: Studying Human Sexuality

■■ New material on the importance and need for further replication of sexuality-related research
■■ New research on the influence of normative gender role expectations for both men
and women in self-reporting sexual behavior on research questionnaires
■■ New Practically Speaking box: “Answering a Sex Research Questionnaire: Motives for
Feigning Orgasms Scale”
■■ New Think About It box: “A Continued Challenge Facing Sex Researchers: Selecting
the Best Way to Accurately Measure Sexual Behavior and Sexual Orientation”
■■ Findings of the latest Centers for Disease Control and Prevention Youth Risk
Behavior Survey
■■ Findings of the latest American College Health Association on research on college
student sexual behavior
Chapter 3: Female Sexual Anatomy, Physiology, and Response

■■ New Think About It box: “The Grooming of Pubic Hair: Nuisance or Novelty?”
■■ Updated and expanded discussion of internal female sexual anatomy, including the G-spot
■■ Expanded discussion on the hormones that affect women’s growth and maturation
■■ Updated figure and explanation of ovarian cycle
■■ New research on menstrual taboos and stereotypes of menstruating women
■■ Updated information and explanation of menstrual problems
Preface xxiii
■■ New section on menstrual products
■■ Expanded discussion on human sexual response
■■ New approach to material on desire and arousal
■■ New (to this chapter) Think About It box: “Female Genital Mutilation/Cutting: Human
Rights Violation or Cultural and Social Norm?”
Chapter 4: Male Sexual Anatomy, Physiology, and Response

■■ New Think About It box: “The Question of Male Circumcision”
■■ New Think About It box: “Does Penis Size Matter?”
■■ Revised and updated Think About It box: “Sexual and Reproductive Health Care:
What Do Men Need?”
■■ New research from the testosterone trials
■■ Expanded explanation and discussion of erections and ejaculation
■■ New Think About It box: “Men and Sexual Desire: It’s More Complex Than We
Might Think”
Chapter 5: Gender and Gender Roles

■■ Expanded and updated section on sex and gender identity
■■ New Think About It box: “Sexual Fluidity: Women’s and Men’s Variable Sexual
Attractions”
■■ New discussion on gender equity and millennials
■■ New Practically Speaking box: “A Quick Glossary on Sex, Gender, and Gender Variations”
■■ New approach to the transgender phenomenon, including what it means to be gender
variant
■■ A new look at transgender children and youth
■■ Updated Think About It box: “Gender-Confirmimg Surgery: Psychological and
Physiological Needs”
■■ Expanded discussion around disorders of sex development
■■ New guidelines for educators about equal treatment of transgender students
■■ New Think About It box: “Transgender People and Bathroom Access: What’s the Deal?”
Chapter 6: Sexuality in Childhood and Adolescence

■■ Expanded and updated section on the roles and challenges that parents have in
communicating and educating about sexuality
■■ New research on who and what influences young people about sex
■■ New material on sexual minority youth
■■ New data on teen sexuality, pregnancy, and parenting
■■ Revised Think About It box: “Virginity—Whatever That Means”
■■ New to this chapter Think About It box: “Good Enough Sex: The Way to Lifetime
Couple Satisfaction”
■■ Updated status and best practices of comprehensive sexuality education programs
Chapter 7: Sexuality in Adulthood

■■ Updated and expanded discussion on the definitions of sexual orientation
■■ New and expanded discussion of sexual fluidity
■■ New results from a Match.com study on sexual minority and heterosexual singles
■■ New Think About It box: “Singles in America: Dating Trends, Rituals, and Social Media”
■■ Expanded discussion and new trends in cohabitation and marriage
xxiv Preface
■■ New research and discussion on same-sex marriage
■■ A new data on sexual frequency, by age
■■ New to this chapter and updated Think About It box: “Are Same-Sex Couples and
Families Any Different from Heterosexual Ones?”
■■ Expanded discussion on sex in middle and late adulthood
■■ New research on biological changes in late adulthood and recommendations on
menopausal hormone therapy
Chapter 8: Love and Communication in Intimate Relationships

■■ Updated discussion about attraction between best friends
■■ Expanded discussion on the connections between friendship and love
■■ New research on frequency of sex and happiness
■■ Explanation and expanded discussion on the role of neurochemicals on lust and love
■■ New approach and material on extrarelational sex and its role in marriage and partnerships
■■ Updated and expanded discussion of sexual communication, especially related to
gender and peers
Chapter 9: Sexual Expression

■■ New discussion on concerns about penis size and research on preferred penis size
■■ Updated and expanded Think About It box: “Why College Students Have Sex”
■■ Updated discussion of post-coital affection
■■ Updated discussion of mate poaching
■■ Updated Think About It box: “Hooking Up” Among College Students: As Simple as
One Might Think?
■■ New research findings on the duration and frequency of sex
■■ New Think About It box: “The Frequency of Sex: The More, the Better?”
■■ New research on the diverse range of sexual behaviors during the most recent partnered sex
■■ Updated research findings on oral sex among college students
Chapter 10: Variations in Sexual Behavior

■■ New research on the frequency of paraphilia behaviors
■■ New research on the frequency of paraphilia desire
■■ Expanded discussion of fetishism
■■ New research on the prevalence of having sex with someone in a public place
■■ New research on the prevalence of masochism and sadism
■■ Updated discussion of autoerotic asphyxia
Chapter 11: Contraception and Abortion

■■ Expanded explanation of risk and responsibility related to contraception
■■ Updated discussion on Title X and Affordable Care Act’s preventive services
■■ Introduction to discussion about reproductive justice
■■ Expanded explanation of fertility awareness-based method and lactational amenorrhea
method
■■ Updated material on contraceptive methods, including their use, advantages,
disadvantages, and contraceptive failure rates.
■■ Expanded and updated material on sterilization
■■ Updated discussion on methods of abortion and the abortion debate
Preface xxv
Chapter 12: Conception, Pregnancy, and Childbirth
■■ Reexamination and data on pregnancy as a choice
■■ New research on preconception health
■■ Expanded discussion and data on sexual patterns during pregnancy
■■ Clarification of the nature and effects of teratogens during pregnancy, including new
material on the Zika virus
■■ Updated material on infertility, including causes and methods for treating it in both
males and females
■■ New and expanded material on breastfeeding verses bottle-feeding
■■ Expanded discussion of the postpartum period
Chapter 13: The Sexual Body in Health and Illness

■■ Updated discussion on eating disorders
■■ New Think About It box: “Body Modification: You’re Doing What, Where?”
■■ New research on alcohol, marijuana, and prescription drug use and their role in
college dating and sexuality
■■ Revised discussion on sexuality and disability, especially related to sexual self-image
and functioning
■■ Updated material on diagnostic recommendations and screenings for breast, cervical,
and prostate cancer
■■ New material on sexuality and types of cancer
■■ Expanded explanation of hysterectomy and its effects on sexuality
■■ Updated and expanded discussions on sexual health issues including TSS, vulvodynia,
endometriosis, and prostatitis
■■ New research on sexual orientation and health
Chapter 14: Sexual Function Difficulties, Dissatisfaction,

Enhancement, and Therapy
■■ Expanded discussion of female sexual desire
■■ Expanded discussion of sexual desire discrepancy among couples
■■ New Think About It box: “Orgasm, That Simple? Young Adults’ Experiences of
Orgasm and Sexual Pleasure”
■■ New research on why some women orgasm more frequently than other women
■■ Updated research on men and women faking orgasm
■■ New research on strategies couples use to maintain sexual passion
■■ Updated discussion of a newly approved drug designed to increase female sexual desire
Chapter 15: Sexually Transmitted Infections

■■ Updated data on the prevalence and incidence of major sexually transmitted infections
■■ Updated medical information on the major STIs
■■ Expanded discussion on the role of male condoms, females condoms, and dental
dams in STIs
■■ New Think About It box: “Accurately Judging If a Potential Sexual Partner Is Infected
With an STI: Easily Done?”
■■ Updated research on the efficacy of male circumcision on preventing HIV and other STIs
■■ Updated information on HPV vaccination
■■ New material on Zika virus disease
xxvi Preface
Chapter 16: HIV and AIDS
■■ New material for the Think About It box: “The Stigmatization of HIV and Other STIs”
■■ Updated information on the prevalence and incidence of HIV/AIDS in the United
States and worldwide
■■ Updated research on the lifetime risk for HIV diagnosis in the United States by
transmission category, race/ethnicity, and men who have sex by race/ethnicity
■■ New material of the estimated probability of acquiring HIV from an infected source
during one episode of a specific behavior
■■ Updated and expanded discussion of HIV/AIDS among minority races/ethnicities and
sexual minorities such as transgender individuals
■■ New Think About It box: “Which Strategies Would You Use to Reduce Your Risk of
STI/HIV? What One Group of Women Did”
■■ Expanded discussion of pre-exposure prophylaxis and new material on post-exposure
prophylaxis
■■ New and updated information on HIV/AIDS testing, diagnosis, and treatment
■■ New material for the Think About It box: “‘Do You Know What You Are Doing?’
Common Condom-Use Mistakes Among College Students”
Chapter 17: Sexual Assault and Misconduct

■■ Expanded discussion and updated research on sexual assault and misconduct on
college campuses
■■ New and expanded discussion of sexual harassment in school and college, in the
workplace, and in public places
■■ Updated information on harassment, discrimination, legal equality, and rejection of
LGBTQ persons
■■ Expanded discussion on sexual consent
■■ New Practically Speaking box: “What Can You Do to Prevent Sexual Assault?:
Be a ‘Bystander’”
■■ New Practically Speaking box: “Being Safe: Strategies for Avoiding Being Sexually
Assaulted”
■■ New Think About It box: “Verbally Consenting to Sex: As Simple As One Might Think?”
■■ New Practically Speaking box: “Having Sex Again After Being Sexually Assaulted:
Reclaiming One’s Sexuality”
Chapter 18: Sexually Explicit Materials, Sex Workers, and Sex Laws
■■ New research on the percentage of adults who report having watched sexually explicit
videos and utilized various sexually explicit materials
■■ New material on the challenges of research on sexually explicit materials
■■ New Think About It box: “Who Watches the Different Types of Sexually Explicit
Videos?”
■■ Renamed and new material for the Think About It box: “Sexually Explicit Video Use
in Romantic Couples: Beneficial or Harmful?”
■■ New Think About It box: “What Popular Media Says About Sexually Explicit Videos
and Relationships: Supported by Research?”
■■ Updating of the Think About It box: “Sex Trafficking: A Modern-Day Slavery”
■■ Renamed prostitution as sex work
■■ New Think About It box: “Should Sex Work Be Decriminalized and Legalized?”
■■ Update on the number of countries that have legalized same-sex marriage
Preface xxvii
Acknowledgments
In addition to student-user feedback through McGraw-Hill Education’s LearnSmart, feedback
from instructor reviews were instrumental in guiding this revision. Special thanks to the
following:
Gretchen Blycker, University of Rhode Island
Meghan Brodie, Valencia College
Lisa Hoopis, Rhode Island College
Nathan Matza, California State University, Long Beach
Brent Powell, California State University, Stanislaus
Melissa Schreiber, Valencia College
Laurie Wagner, Kent State University
Jay Warden, Cape Cod Community College
Michelle Worley, Saddleback College
We would also like to thank our team at McGraw-Hill Education: Senior Portfolio Manager
Nancy Welcher, Lead Product Developer Dawn Groundwater, Senior Product Developer Sara
Gordus, Product Developer Joni Fraser, Senior Marketing Manager AJ Laferrera, C ontent
Production Manager Sandy Wille, Content Licensing Specialists Ann Marie Jannette and
Designer, David Hash. Additional thanks go out to Rebecca Ryan, personal assistant and
input editor, Martha Ghent, freelance proofreader, and David Tietz, freelance photo researcher.
xxviii Preface
Letter From the Authors
“Sex is like dynamite. . . . It can be the cement of a relationship,

but it can be the lever that breaks people apart.”
—Joseph Fletcher
(1905–1991)
Since its first edition, we have focused on making our book relevant to the diverse and
contemporary students we teach and have expanded our reach to a broader representation
of students from around the world. With better access to global research and scholarship,
our discussion of human sexuality has increasingly cited research studies and writings from
countries beyond America, thus broadening student understanding of the diverse meanings
and expressions of human sexuality. The desire to reflect these changes has prompted us to
alter the title of our textbook to Human Sexuality: Diversity in Contemporary Society. We hope
that this title and updated content helps you explore new and varied perspectives and increase
your understanding and appreciation of human sexuality in the contemporary society we all
share.
We have found that when students first enter a human sexuality class, they may feel
excited, nervous, and uncomfortable, all at the same time. These feelings are common. This
is because the more an area of life is judged “off limits” to public and private discussion,
the less likely it is to be understood and embraced. Yet sex surrounds us and impacts our
lives every day from the provocative billboard ad on the highway, to the steamy social media
images of the body, to men’s and women’s fashions, and to prime-time television dramas.
People want to learn about the role and meaning of human sexuality in their lives and how
to live healthy psychologically and physically, yet they often do not know whom to ask or
what sources to trust. In our quest for knowledge and understanding, we need to maintain
an intellectual curiosity. Author William Arthur Ward observes, “Curiosity is the wick in the
candle of learning.”
Students begin studying sexuality for many reasons: to gain insights into their sexuality
and relationships, to become more comfortable with their sexuality, to learn how to enhance
sexual pleasure for themselves and their partners, to explore personal sexual issues, to dispel
anxieties and doubts, to validate their sexual identity, to avoid and resolve traumatic sexual
experiences, and to learn how to avoid STIs and unintended pregnancies. Many students
find the study of human sexuality empowering: They become more free to explore and dis-
cover their sexuality, and they develop the ability to make intelligent sexual choices based
on reputable information and their own needs, desires, and values rather than on stereotyp-
ical, unreliable, incomplete, or unrealistic information; guilt; fear; or conformity. They learn
to differentiate between what they have been told about their own sexuality and what they
truly believe; that is, they begin to own their sexuality and develop a sexuality that fits them.
Those studying this subject often report that they feel more appreciative and less apologetic,
defensive, or shameful about their sexual feelings, attractions, and desires.
The study of human sexuality calls for us to be open-minded: to be receptive to new ideas
and to various perspectives; to respect those with different experiences, values, orientations,
ages, abilities, and ethnicities; to seek to understand what we have not understood before;
xxix
to reexamine old assumptions, ideas, and beliefs; and to embrace and accept the humanness
and uniqueness in each of us.
Sexuality can be a source of great pleasure and, yes, the “cement” of a relationship.
Through it, we can reveal ourselves, connect with others on the most intimate levels, create
strong bonds, and bring new life into the world. Paradoxically, though, sexuality can also be
a source of guilt and confusion, anger and disappointment, a pathway to infection, and a
means of exploitation and aggression. We hope that by examining the multiple aspects of
human sexuality presented in this book, you will come to understand, embrace, and appre-
ciate your own sexuality and the unique individuality of sexuality among others; to learn how
to make healthy sexual choices for yourself; to integrate and balance your sexuality into your
life as a natural health-enhancing component; and to express your sexuality with partners in
sharing, nonexploitive, and nurturing ways.
William L. Yarber
Barbara W. Sayad
xxx Letter From the Authors

About the Authors
WILLIAM L. YARBER is senior scientist at The Kinsey Institute and Provost Professor in
the Indiana University School of Public Health–Bloomington. He is also senior director of
the Rural Center for AIDS/STD Prevention and affiliated faculty member in the Department
of Gender Studies at IU.
Dr. Yarber, who received his doctorate from Indiana University, has authored and co-
authored numerous scientific reports on sexual risk behavior and AIDS/STD prevention in
professional journals and has received federal and state grants to support his research and
prevention activities. He is a member of the international Kinsey Institute Condom Use
Research Team that has for two decades investigated male condom use errors and problems
and developed behavioral interventions designed to improve correct and consistent
condom use.
At the request of the U.S. Centers for Disease Control and Prevention, Dr. Yarber
authored the country’s first secondary school AIDS prevention education curriculum, AIDS:
What Young People Should Know (1987, 1989). He is founder and co-editor of the Handbook
of Sexuality-Related Measures, Fourth Edition (2019). Dr. Yarber and Dr. Sayad’s textbook,
Human Sexuality: Diversity in Contemporary Society (McGraw-Hill), which is used in colleges
William L. Yarber and universities throughout the United States, was published in 2012 by the Beijing World
©Charles Rondot Publishing Company as the most up-to-date text on human sexuality published in China in
the past half century. Also in 2012, the text was published in Korea and in 2018 it was
published in Taiwan.
Dr. Yarber chaired the National Guidelines Task Force, which developed the Guidelines
for Comprehensive Sexuality Education: Kindergarten–12th Grade (1991, 1996, 2004), pub-
lished by the Sexuality Information and Education Council of the United States (SIECUS)
and adapted in six countries worldwide. Dr. Yarber is past president of The Society for the
Scientific Study of Sexuality (SSSS) and a past chair of the SIECUS board of directors. His
awards include the SSSS Distinguished Scientific Achievement Award; the Professional Stan-
dard of Excellence Award from the American Association of Sex Educators, Counselors, and
Therapists; the Indiana University President’s Award for Distinguished Teaching; and the
inaugural Graduate Student Outstanding Faculty Mentor Award at Indiana University.
Dr. Yarber has been a consultant to the World Health Organization Global Program on
AIDS as well as sexuality-related organizations in Brazil, China, Jamaica, Poland, Portugal,
and Taiwan. He regularly teaches undergraduate and graduate courses in human sexuality.
He was previously a faculty member at Purdue University and the University of Minnesota,
as well as a public high school health science and biology teacher. Dr. Yarber endowed, for
perpetuity, at Indiana University the world’s first professorship in sexual health, the W
illiam L.
Yarber Professorship in Sexual Health and the annual Ryan White & William L. Yarber Lecture.
xxxi
BARBARA WERNER SAYAD is a teacher, trainer, writer, and consultant in the field of
human sexuality. As a retired faculty member from California State University, Monterey
Bay, Dr. Sayad has taught a wide variety of courses ranging from human sexuality to multi-
cultural health education and promotion. Her work among students and in the classroom
has earned her several teaching awards, each of which she is most proud. Additionally, she
has chaired university committees, spoken at dozens of university-related events, trained and
collaborated with other faculty members and colleagues, and helped to raise monies for both
national and international non-profit organizations.
Dr. Sayad has presented her work at a variety of institutions, the most significant of
which has focused on comprehensive sexuality education. One that she is most proud of is
her alliance with Aibai, the largest LGTBQ organization in China, where she twice traveled
to present to the Asian Conference on Sexual Education in Beijing and Changdu. There she
also led workshops and roundtables with and for American delegates and Chinese scholars
at the U.S. Embassy, U.S. State Department, and UNESCO and was invited to present at
Xixi, the equivalent of a TED Talk, in Shanghai. Most recently, Dr. Sayad helped to facilitate
Barbara Werner Sayad
a trip to Cuba, where she collaborated with colleagues and met with delegates from CENE-
©Robert Sayad
SEX, Cuba’s government-sponsored sexuality education and gender equity organization.
The vast majority of Dr. Sayad’s 35-year career has been connected to issues of social
justice: women’s reproductive rights, sexuality education and advocacy, and health access.
Her commitment to social justice has fueled all of her professional work, including her con-
tributions to health-related texts, curricular guides, publications, training programs and con-
ference presentations.
Dr. Sayad holds a Bachelor of Science degree in Foods and Nutrition, a Master’s degree
in Public Health, and a PhD in Health Services.
Above all, Dr. Sayad is most proud of her three children, two young grandchildren, and
extended family. She is also eternally grateful and happy to be married for 40 years to
Dr. Robert Sayad.
xxxii About the Authors

chapter
1
Perspectives
on Human Sexuality
©Peopleimages/iStock/Getty Images
CHAPTER OUTLINE
Studying Human Sexuality Sexuality Across Cultures and Times
Sexuality, Popular Culture, and the Media Societal Norms and Sexuality
1
©Rawpixel.com/Shutterstock
“The media, especially magazines and stomach was as hard and flat as a board,
television, has had an influence on shaping with their flawless skin and perfectly coifed
my sexual identity. Ever since I was a little girl, hair. I cringed when I realized that my legs
I have watched the women on TV and hoped seemed to have an extra ‘wiggle-jiggle’ when I
I would grow up to look sexy and beautiful walked. All I could do was watch the television
like them. I feel that because of the constant and feel abashed at the differences in their
Student Voices barrage of images of beautiful women on TV bodies compared to mine. When magazines
and in magazines young girls like me grow up and films tell me that for my age I should
with unrealistic expectations of what beauty is weigh no more than a hundred pounds,
and are doomed to feel they have not met I feel like saying, ‘Well, gee, it’s no wonder
this exaggerated standard.” I finally turned to laxatives with all these
—21-year-old female pressures to be thin surrounding me.’
I ached to be model-thin and pretty. This
“The phone, television, and Internet became fixation to be as beautiful and coveted as
my best friends. I never missed an episode of these models so preoccupied me that I had
any of the latest shows, and I knew all the no time to even think about anyone or
words to every new song. And when anything else.”
Facebook entered my life, I finally felt —18-year-old female
connected. At school, we would talk about
status updates: whom we thought was cute, “I am aware that I may be lacking in certain
relationship status, and outrageous photos. All areas of my sexual self-esteem, but I am
of the things we saw were all of the things we cognizant of my shortcomings and am willing
fantasized about. These are the things we to work on them. A person’s sexual
would talk about.” self-esteem isn’t something that is detached
—23-year-old female from his or her daily life. It is intertwined in
every aspect of life and how one views his or
“Though I firmly believe that we are our own her self: emotionally, physically, and mentally.
harshest critics, I also believe that the media For my own sake, as well as my daughter’s, I
have a large role in influencing how we think feel it is important for me to develop and
of ourselves. I felt like ripping my hair out model a healthy sexual self-esteem.”
every time I saw a skinny model whose —28-year-old male
“Nature is to be reverenced, not

blushed at.”
—Tertullian (c. 155 ce–c. 220 ce)
S exuality was once hidden from view in our culture: Fig leaves covered the “private
parts” of nudes; poultry breasts were renamed “white meat”; censors prohibited the
publication of the works of D. H. Lawrence, James Joyce, and Henry Miller; and homosex-
uality was called “the love that dares not speak its name.” But over the past few generations,
sexuality has become more open. In recent years, popular culture and the media have trans-
formed what we “know” about sexuality. Not only is sexuality not hidden from view; it often
seems to surround and embed itself into all aspects of our lives.
In this chapter, we discuss why we study human sexuality and examine popular culture
and the media to see how they shape our ideas about sexuality. Then we look at how sexuality
has been conceptualized in different cultures and at different times in history. Finally, we
examine how society defines various aspects of our sexuality as natural or normal.
“Educating the mind without educating

•• Studying Human Sexuality
The study of human sexuality differs from the studies of accounting, plant biology, and medi-
the heart is no education at all.” eval history, for example, because human sexuality is surrounded by a vast array of taboos,
—Aristotle (384 bce–322 bce) fears, prejudices, and hypocrisy. For many, sexuality creates ambivalent feelings. It is linked
not only with intimacy and pleasure but also with shame, guilt, and discomfort. As a result,
you may find yourself confronted with society’s mixed feelings about sexuality as you study
it. You may find, for example, that others perceive you as somehow “unique” or “different”
for taking this course. Some may feel threatened in a vague, undefined way. Parents, partners,
or spouses (or your own children, if you are a parent) may wonder why you want to take a
2 Chapter 1 Perspectives on Human Sexuality

“sex class”; they may want to know why you don’t take something more “serious”—as if sex-
uality were not one of the most important issues we face as individuals and as a society.
Sometimes this uneasiness manifests itself in humor, one of the ways in which we deal with
ambivalent feelings: “You mean you have to take a class on sex?” “Are there labs?” “Why don’t
you let me show you?”
Ironically, despite societal ambivalence, you may quickly find that your human sexuality text
or ebook becomes the most popular book in your dormitory or apartment. “I can never find my
textbook when I need it,” one of our students complained. “My roommates are always reading it.
And they’re not even taking the course!” Another student observed: “My friends used to kid me
about taking the class, but now the first thing they ask when they see me is what we discussed in
class.” “People borrow my book so often without asking,” writes one student, “that I hide it now.”
As you study human sexuality, you will find yourself exploring topics not ordinarily discussed
in other classes. Sometimes they are rarely talked about even among friends. They may be pro-
hibited by family, religious, or cultural teaching. For this reason, behaviors such as masturbation
and sexual fantasizing are often the source of considerable guilt and shame. But in your human
sexuality course, these topics will be examined objectively. You may be surprised to discover, in
fact, that part of your learning involves unlearning myths, factual errors, distortions, biases, and
prejudices you learned previously.
Sexuality may be the most taboo subject you study as an undergraduate, but your comfort
level in class will probably increase as you recognize that you and your fellow students have a
common purpose in learning about sexuality. Your sense of ease may also increase as you and Taking a course in human
your classmates get to know one another and discuss sexuality, both inside and outside the class. sexuality is like no other college
You may find that, as you become accustomed to using the accepted sexual vocabulary, you are experience. It requires that
more comfortable discussing various topics. For example, your communication with a partner students examine their sexual
may improve, which will strengthen your relationship and increase sexual satisfaction for both beliefs and behaviors in the
of you. You may never before have used the word masturbation, clitoris, or penis in a class setting context of a wide variety
of social and cultural factors and
or any kind of setting, for that matter. But after a while, using these and other terms may become
incorporate this new perspective
second nature to you. You may discover that discussing sexuality academically becomes as easy
into their sexual lives and
as talking about computer science, astronomy, or literature. You may even find yourself, as many well-being.
students do, sharing with your friends what you learned in class while on a bus or in a restaurant, ©Andersen Ross/Getty Images
as other passengers or diners gasp in surprise or lean toward you to hear better!
Studying sexuality requires respect for your fellow students. You’ll discover that the experi-
ences and values of your classmates vary greatly. Some have little sexual experience, while others
have a lot of experience; some students hold progressive sexual values, while others hold con-
servative ones. Some students are lesbian, gay, bisexual, transgender, queer, q uestioning, intersex,
asexual or another identity (LGBTQ+). This plus sign represents inclusiveness of all identities
and will be implied whenever we discuss sexual orientations or identities. Most students are
young, others middle-aged, some older—each in a different stage of life and with different devel-
opmental tasks before them. Furthermore, the presence of students from any of the numerous
religious and ethnic groups in the United States reminds us that there is no single behavior,
attitude, value, or sexual norm that encompasses sexuality in contemporary society. Finally, as
your sexuality evolves you will find that you will become more accepting of yourself as a sexual
human being with your own “sexual voice.” From this, you will truly “own” your sexuality.
•• Sexuality, Popular Culture, and the Media

Much of sexuality is influenced and shaped by popular culture, especially the mass media. Popular
culture presents us with myriad images of what it means to be sexual. But what kinds of sexuality
do the media portray for our consumption?
Media Portrayals of Sexuality

What messages do the media send about sexuality to children, adolescents, adults, and older “One picture is worth more than a
people? To men and women and to those of varied races, ethnicities, and sexual orientations? thousand words.”
Perhaps as important as what the media portray sexually is what is not portrayed—mastur- —Chinese proverb
bation, condom use, and older adults’ sexuality, for example.
Sexuality, Popular Culture, and the Media 3

Digital 5:43
Desktop/laptop 2:11
Mobile (nonvoice) 3:06
Other connected 0:26
devices
TV 4:07
Radio 1:27
Print 0:28
Newspapers 0:16
Magazines 0:12
Other 0:22
Total 12:05
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Hr/Min per day
• FIGURE 1
Average Time Spent Per Day in the United States With Media, Aged 18+ and Over, 2016.
Source: www.eMarketer.com [June 2016]
The media are among the most powerful forces in people’s lives today. Adults ages 18 and over
spend more time engaging with the media than in any other activity—an average of 12 hours per
day, 7 days per week (see Figure 1). Watching TV, playing video games, texting, listening to music,
and searching the Internet provide a constant stream of messages, images, expectations, and values
about which few (if any) of us can resist. Whether and how this exposure is related to sexual out-
comes is complex and debatable, depending on the population studied. However, the data that are
available may provide an impetus for policymakers who are forming media policies, parents who
Images of sexuality permeate

our society, sexualizing our
environment. Think about the
sexual images you see or hear in
a 24-hour period. What messages
do they communicate about
sexuality?
©Raymond Hall/GC Images/Getty Images

are trying to support their children’s identity and learning, and educators and advocates who are
concerned about the impact of media on youth and who wish to underscore the potential impact
of media in individuals’ lives. For those concerned about promoting sexual health and well-being,
understanding media’s prominence and role in people’s lives is essential.
Mass-media depictions of sexuality are meant not only to entertain and exploit, but in
some cases to educate. As a result, the media often do not present us with “real” depictions
of sexuality. Sexual activities, for example, are usually not explicitly acted out or described
in mainstream media, nor is interracial dating often portrayed. The social and cultural taboos
that are still part of mainstream U.S. culture remain embedded in the media. Thus the various
media present the social context of sexuality; that is, the programs, plots, movies, stories,
articles, newscasts, and vignettes tell us what behaviors are appropriate (e.g., kissing, sexual
intercourse), with whom they are appropriate (e.g., girlfriend/boyfriend, partner, heterosex-
ual), and why they are appropriate (e.g., attraction, love, to avoid loneliness).
Probably nothing has revolutionized sexuality the way that access to the Internet has. “Would you like to come back to my
A click on a website link provides sex on demand. The Internet’s contributions to the avail- place and do what I’m going to tell my
friends we did anyway?”
ability and commercialization of sex include live images and chats, personalized pages and
—Spanky
ads, and links to potential or virtual sex partners. The spread of the web has made it easy
to obtain information, solidify social ties, and provide sexual gratification.
It’s common knowledge that most of us have thoroughly integrated media into our lives.
Mainstream media not only entertains, but it also has become a significant source of sexual
information and provides examples of sexual health. High school students spend approxi-
mately 3 hours per day on media and communications activities, including watching TV,
playing video and computer games, surfing the Internet, listening to or playing music, and
using cell phones to call or text friends and others—many of these at the same time (Office
of Adolescent Health, 2016). While high school males spend more time on the computer
than high school females, all adolescents spend most of their media/communications time
watching TV and videos. For school-aged children and adolescents, the American Academy
of Pediatrics [AAP] (2016) suggests that parents teach young people to balance media use
with other healthy behaviors; no small endeavor considering the powerful draw and influence
of the media.
The music industry is awash with sexual images too. Contemporary pop music, from rock
’n’ roll to rap, is filled with lyrics about sexuality mixed with messages about love, rejection,
violence, and loneliness. Research has found that increased exposure to sexualized music
lyrics has the potential to negatively impact the development of healthy and equitable sexual
attitudes of adolescent males and females (Hall, West, & Hill, 2011). Because of censorship
issues, the most overtly sexual music is not played on the radio but is more often streamed
through the Internet via YouTube and other sites.
Magazines, tabloids, and books contribute to the sexualization of our society as well. For
example, popular romance novels, and self-help books disseminate ideas and values about
sexuality and body image. Men’s magazines have been singled out for their sexual emphasis.
Playboy, Men’s Health, and Maxim, with their Playmates of the Month, sex tips, and other
advice, are among the most popular magazines in the world. Sports Illustrated’s annual swim-
suit edition, which is now a $1 billion empire, excites millions of readers who await the
once-a-year feature (Spector, 2013). But it would be a mistake to think that only male-
oriented magazines focus on sex.
Women’s magazines such as Cosmopolitan and Elle have their own sexual content. These
magazines feature romantic photographs of lovers to illustrate stories with such titles as
“Sizzling Sex Secrets of the World’s Sexiest Women,” “Making Love Last: If Your Partner
Women’s magazines such as
Is a Premature Ejaculator,” and “Turn on Your Man with Your Breasts (Even If They Are
Cosmopolitan, Women’s Health,
Small).” Preadolescents and young teens are not exempt from sexual images and articles in and Elle use sex to sell their
magazines such as Seventeen and J-14. Given their heavy emphasis on looks, it’s not surpris- publications. How do these
ing that for those who read a lot of women-focused magazines, they are more likely to have magazines differ from men’s
internalized the thin ideal, have negative views of their appearance, and engage in restricted magazines such as Men’s Health,
eating and bulimic behaviors (Northrup, 2013). Playboy, and Maxim in their
In the absence of alternative resources to guide their decisions concerning sexual relation- treatment of sexuality?
ships, college students often rely on sexual scripts conveyed through mass media (Hust et al., ©Consumer Trends/Alamy Stock Photo

2014). Given that many if not most men’s magazines promote men as sexual aggressors, it
is not surprising that many men internalize this message. As a result, readers of men’s mag-
azines report lower intentions to ask their sexual partner for consent for sexual activity and
are less likely to adhere to sexual consent decisions by their partner (Hust et al., 2014).
Other researchers have reported that men exposed to magazine images of sexualized women
felt less confidence in their own romantic capabilities and had more anxiety about their own
appearance than did men without this exposure (Aubrey & Taylor, 2009). Regarding women’s
exposure to women’s magazines, Ward (2016) found that their exposure was positively asso-
ciated with their ability to refuse unwanted sexual activity. The relationship between magazine
viewing among women and gender-stereotypical attitudes and behaviors, however, is not as
optimistic.
Advertising in all media uses the sexual sell, promising sex, romance, popularity, and
fulfillment if the consumer will only purchase the right soap, perfume, cigarettes, alcohol,
toothpaste, jeans, or automobile. In reality, not only does one not become “sexy” or popular
by consuming a certain product, but the product may actually be detrimental to one’s sexual
well-being, as in the case of cigarettes or alcohol.
Throughout the world, the media have assumed an increasingly significant role in shaping
perspectives toward gender and sexual roles. In a review of 135 peer-reviewed studies in the
United States between 1995 and 2015, the findings proved consistent evidence that both
laboratory exposure and everyday exposure to mainstream media are directly associated with
higher levels of body dissatisfaction, greater self-objectification, or evaluating oneself based on
appearance; greater support of sexist beliefs; and greater tolerance of sexual violence toward
women (Ward, 2016). In addition, experimental exposure to media has led both women and
men to have a diminished view of women’s competence, morality, and humanity. This evi-
dence, however, varies depending on the genres of media we consume and our preexisting
beliefs, identities, and experiences.
Though much research has focused on the impact of media on female development, media
Reality shows, such as The undoubtedly has an impact on men as well. What has been found is that men’s frequent
Bachelorette, frequently highlight
consumption of sexually objectifying media (i.e., TV, films, and videos) was associated with
idealized and sexual themes.
greater objectification of their romantic partners, which in turn was linked to lower levels of
What are some of the most
popular reality shows? Do they relationship and sexual satisfaction (Zurbriggen, Ramsey, & Jaworski, 2011).
differ according to ethnicity? It’s important to note that sexualization is not the same as sex or sexuality; rather sexu-
©Raymond Hall/GC Images/Getty Images alization is a form of sexism that narrows a frame of a person’s worth and value (Ward,
2016). The sexualization of individuals sees value and worth only as sexual body
parts for others’ sexual pleasure.
Media images of sexuality permeate a variety of areas in people’s lives. They can
produce sexual arousal and emotional reactions, provide social connection, entertain,
increase sexual behaviors, and be a source of sex information. On the other hand,
unmonitored Internet access among youth raises significant concerns about its risks.
Given the fact that teens now spend up to nine hours a day on social media
platforms, it’s clear that media consumption and exposure play a significant role in
their lives (Asano, 2017). Currently, the total time spent on social media beats time
spent eating and drinking, socializing, and grooming.
Of concern around adolescents’ heavy media use is their viewing of sexually
explicit videos. Because of its easy access along with the potential risks associated
with its use, understanding its implications is important for parents, partners, as well
as the rest of us.
Television and Digital Media

Among all types of media, television and digital (online and mobile) have been the
most prevalent, pervasive, and vexing icons, saturating every corner of public and
private space, shaping consciousness, defining reality, and entertaining the masses
(see Figure 2). It may not be surprising to note that emerging adults, those aged 18
to 25, spend approximately 12 hours per day using media (Coyne, Padilla-Walker, &
Howard, 2013). While the frequency of TV and digital viewing has been increasing,

• FIGURE 2
Average Audience Composition by
All adults 4% 20% 9% 6% 18% 43%
Platform, 2016.
Source: The Nielsen Company, 2017
Age 18−34 5% 29% 9% 11% 17% 28%
Age 35−49 6% 23% 11% 6% 18% 36%
Age 50+ 3% 14% 8% 3% 18% 54%
0 10 20 30 40 50 60 70 80 90 100
Tablet Smartphone PC TV-Connected devices Radio TV

(DVD, Game console,
Multimedia device, VCR)
so has been the number of sexual references in programming. To understand the impact of “The vast wasteland of TV is not
interested in producing a better
this phenomenon, it is important to recognize its prevalence. In prime-time television alone, mousetrap but in producing a worse
sexually objectifying portrayals of women have been noted to appear among 46% of young mouse.”
adult female characters (Smith, Choueiti, Prescott, & Pieper, 2012) and among 50% of female —Laurence Coughlin
cast members in reality television programs (Flynn, Park, Morin, & Stana, 2015). Because
reality programs (e.g., The Bachelor and America’s Next Top Model) and social media feature
“real” people (as opposed to actors), it is possible that exposure to their objectifying content Watching female icons such as
can have even a more significant impact than other types of programming. Add to the list Rihanna dance in a provocative
of media genres the images and verbal references in music videos, advertising, video games, manner has become mainstream
in most music videos.
and magazines, and it becomes apparent that sexualized women are often the dominant way
©The Image Gate/Getty Images
that girls and women are represented in the media (Ward, 2016).
While it is apparent that exposure to television does not affect all people in the same way,
it is clear that the sexual double standard that does exist taps into our national ambivalence
about sex, equality, morality, and violence. In spite of this, television is making strides to
educate teens and young adults about sexuality and parenting. Programs such as Teen Mom,
13 Reasons Why, Andi Mack, The Mindy Project, and The Fosters have consulted with profes-
sional organizations to help educate viewers. This type of alliance is good for all of us.
Unlike the film industry, which uses a single ratings board to regulate all American
releases, television has been governed by an informal consensus. In 1997, networks began to
rely on watchdog standards and practices departments to rate their shows; however, these
divisions have few, if any, hard-and-fast rules. While the Federal Communication Commission
(FCC) does not offer clear guidelines about what is and is not permissible on the airwaves,
the agency does permit looser interpretations of its decency standards for broadcasts between
10 p.m. and 6 a.m. Additionally, in 2006, the television industry launched a large campaign
to educate parents about TV ratings and the V-chip, technology that allows the blocking of
programs based on their rating category.
Music and Game Videos MTV, MTV2, VH1, BET, and music Internet programs are
very popular among adolescents and young adults. Unlike audio-recorded music, music videos
play to the ear and the eye. At the same time, young female artists such as Beyoncé, Lady
Gaga, and Selina Gomez have brought energy, sexuality, and individualism to the young
music audience. Male artists such as Justin Timberlake, Drake, and The Weeknd provide
young audiences with a steady dose of sexuality, power, and rhythm. On the other hand,
music videos have also objectified and degraded women by stripping them of any sense of
power and individualism and focusing strictly on their sexuality.
Video games that promote sexist and violent attitudes toward women have filled the aisles
of stores across the country. Pushing the line between obscenity and amusement, games often

provide images of unrealistically shaped and submissive women mouthing sexy dialogues in
degrading scenes. Men, in contrast, are often revealed as unrealistic, violent figures whose
primary purpose is to destroy and conquer. Though many of these video games are rated
“M” (mature) by the Entertainment Software Ratings Board, they are both popular with and
accessible to young people.
Recently, however, the masculine culture of the gaming industry has been challenged by
an outcry against sexism in both video games and in the workplace that produces them
(Lynch, Tompkins, van Driel, & Fritz, 2016). The nature of female representations in games,
most significantly the sexualization and stereotyping of female characters, has decreased
since 2006. The decline has been attributed to an increasing female interest in gaming cou-
pled with the heightened criticism directed at the gaming industry. This is not to say that
the sexualization that does exist is nonproblematic, but rather the trend toward portraying
The Academy Award–winning film female characters as competent, strong, and attractive without overt sexualization may even-
Moonlight presented its main tually help to achieve gender parity, at least in the game culture.
character, a gay man, as a
struggling yet fully realized
Feature-Length Films
human being.
©Atlaspix/Alamy Stock Photo From their very inception, motion pictures have dealt with sexuality. In 1896, a film titled
The Kiss outraged moral guardians when it showed a couple stealing a quick kiss. “Absolutely
disgusting,” complained one critic. “The performance comes near being indecent in its
emphasized indecency. Such things call for police action” (quoted in Webb, 1983). Today,
in contrast, film critics use “sexy,” a word independent of artistic value, to praise a film.
“Sexy” films are movies in which the requisite “sex scenes” are sufficiently titillating to
overcome their lack of aesthetic merit. What is clear is that movies are similar to television
in their portrayal of the consequences of unprotected sex, such as unplanned pregnancies or
sexually transmitted infections (STIs), including HIV/AIDS.
The notion of “true love” in dramas and romantic comedies has come to represent the
idealized belief of some that love conquers all. Stories about love, including those in books,
magazines, music, television, and the Internet, are often so stereotypical and idealized that it
is difficult for people to separate these unrealistic representations from what is normal or rea-
sonable in their romantic relationships. As a result, it has been found that among young adults,
increased movie-viewing frequency correlates with idealized expectations about love and
romance, greater expectations for intimacy, and endorsement of the eros (i.e., romantic, erotic,
passionate) love style (Galloway, Engstrom, & Emmers-Sommer, 2015). (For more information
about styles of love, see Chapter 8). To help balance these notions, it is important to have
authentic personal experiences, mentors in one’s life, honesty with oneself, and peers who will
reveal that sex is often imperfect and that disagreements and communication difficulties are
normal.
Lesbian, Gay, Bisexual, Transgender, and Queer People

in Film and Television
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are slowly being inte-
grated into mainstream films and television. However, when gay men and lesbian women do
appear, they are frequently defined in terms of their sexual orientation, as if there were nothing
more to their lives than sexuality. Though the situation is changing, gay men are generally
stereotyped as effeminate or flighty or they may be closeted. Lesbian women are often stereo-
typed as either super-feminine or super-masculine. And queer individuals often appear as odd.
“Coming out” stories are now the standard for television programs that deal with gay and
transgender characters. However, what has recently changed is that the age of these charac-
ters has become younger. Teen coming-out stories seem relevant in that they reflect the
identity issues of being gay, transgender, queer, questioning, or unsure about their sexual
identity and expose the vulnerability most young people in junior high and high school feel
about being bullied. Different from stories in which gay people are marginalized and stereo-
typed, the messages in many of the shows for younger audiences are quite consistent: that
you will be accepted for who you are. Still, television and mainstream media have a long way
to go in terms of normalizing healthy sexual relationships between gay, trans, and queer

Writers in television and film are finally giving gay characters prominence beyond
their sexuality. These include Andrew Rannells (Girls) (shown), Cameron Monaghan
(Shameless), Naya Rivera (Glee), and Sarah Paulson (American Horror Story: Asylum).
©Dpa picture alliance/Alamy Stock Photo
people. The biggest hurdle remains in showing adults, particularly two males, kissing on
screen as their heterosexual counterparts would. While teen shows may have somewhat
overcome this barrier, most “adult” programs have not.
More frequent in movies is what has been referred to as queerbating, a term used to
describe media where the creators integrate homoeroticism between two characters to lure
in LGBTQ and liberal audiences, yet never fully include actual representation for fear of
alienating a wider audience (Lawler, 2017). For example, in Disney’s remake of Beauty and
the Beast there’s a momentary shot that shows Le Fou dancing with another man, along with
coded words about his feelings for Gaston. This bait-and-switch technique leaves many
LGBTQ fans disappointed not to see themselves represented in meaningful ways that shed
For anyone with a computer,
light on their lives and relationships. social networks provide readily
accessible friends and potential
Online Social Networks partners, help maintain
friendships, and shape sexual
Using the Internet is a major recreational activity that has altered the ways in which individ-
culture.
uals communicate and carry on interpersonal relationships. Though social theorists have long
©Dean Mitchell/Getty Images
been concerned with the alienating effects of technology, the Internet appears quite different
from other communication technologies. Its efficacy, power, and influence, along with the
anonymity and depersonalization that accompany its use, have made it possible for users to
more easily obtain and distribute sexual materials and information, as well as to interact
sexually in different ways.
It is apparent that social networking sites like Facebook, Instagram, and Twitter are well
integrated into the daily lives of most people around the world. Their popularity cannot be
underestimated: Facebook alone reports to have nearly 2 billion global users (Statista, 2017).
Add this to the additional 8 billion users with other or supplemental platforms, and it’s
obvious that the digital landscape has taken over the globe.
Social networking sites provide an opportunity for many to display their identities: religious,
political, ideological, work-related, and sexual orientation, to name a few. While doing so, indi-
viduals can also gain feedback from peers and strengthen their bonds of friendship. At the

think
about it
Online Dating: Asset or Liability?
The popularity and accessibility of digital media and tech- mobile dating sites or apps, compared with 11% who reported
nology, including Internet social networking sites (SNS), have doing so in 2013 (see Figure 3). And since 2013, usage by 18- to
allowed individuals to present themselves publicly in ways that 24-year-olds has increased nearly threefold, while usage by 55- to
were previously never possible. In fact, text messaging and social 64-year-olds has doubled.
networking sites are the most popular means of digital communi- Just how successful or risky are these sites and apps? After all,
cation among young adults (Champion & Pedersen, 2015). Dating once the work of creating a profile is complete, can getting a date
sites such as Tinder, Match.com, and Grindr, along with platforms really be that difficult? To some degree, that depends on what it is
such as Facebook, Twitter, and Snapchat enable individuals to that people want—to hook up or have casual sex, to date casually,
find potential partners in just minutes with the simple click on or to date as a way of actively pursuing a relationship. No doubt,
an app or website. Social media facilitate communication and the use of the Internet by any age provides a means of avoiding the
support, play a prominent role in navigating and documenting pitfalls inherent in relying solely on real-world meetings and experi-
romantic relationships, provide an outlet for sexual exploration ences. Most users believe that technology has enhanced their ability
and expression and, for a small minority, are a means to exploit to find a date and in doing so, fulfilled their desire to flirt, date, and
another. Using technology, individuals negotiate over when, with in some cases, find a suitable life partner (Goluboff, 2015; Hobbs,
whom, and how to meet and interact. Owen, & Gerber, 2016; Meenagh, 2015). For the isolated, underrep-
Over time, traditional sites and avenues for meeting singles, resented, and disenfranchised individuals, many of whom hide their
including universities, clubs, and workplaces, have been partially sexual identities from others, Internet dating sites may play an even
replaced by the Internet, thereby allowing people to meet and more prominent and useful role in navigating romantic relationships
form relationships with others with whom they have no knowledge because it allows them to be honest about who they are.
or social connections. According to the Pew Research Center Even as online daters themselves give the experience high
(2016), 15% of adults surveyed in 2015 reported using online or marks, many recognize or have experienced its downsides. Given
11
Total
15
10
18–24
27
22
25–34
22
17
Age
35–44
21
8
45–54
13
6
55–64
12
3 2013 2015
65+
3
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
Percentage
• FIGURE 3
Percentage of Those Who Have Ever Used Online Dating Sites or Mobile Apps, by Age.
Source: Adapted from Pew Research Internet Project, 2016

that online dating has replaced more traditional ways of meeting of researchers to develop a “scientific” approach to dating, some
partners, such as through friends or in social venues, 44% of online dating sites purport to produce matches superior to tradi-
online dating users recognize that it is more dangerous than other tional methods of dating. However, studies reveal that online dating
ways of meeting people (Pew Research Internet Project, 2016). sites can only measure and provide information about personal
Others express concern about the possibility that dating apps characteristics (Finkel et al., 2012). To date, claims by dating sites to
reduce people to “commodities in a marketplace of romantic produce superior outcomes as compared to more traditional means
options and that exchanges are too strategic” (Hobbs et al., 2016). of finding a partner are still being debated.
To put this into perspective, however, one could argue that dating Despite the risks associated with dating apps and sites, most
in general is a strategic dance. Another pitfall is the view that in customers view them as welcome agents in their search for com-
the endless array of online partners, sometimes referred to the panionship, love, sex, and intimacy (Hobbs et al., 2016). Users of
paradox of choice, one tends to be less satisfied with their choice the sites feel that technology provides them with more romantic
(Beck, 2016). This could be compared to going to a frozen yogurt and relationship possibilities than previous generations and
shop, seeing 15 delicious options, choosing 1, and feeling less enhances their social capital to find a partner with whom to build a
satisfied because of all the flavors they could have had instead. mutually fulfilling relationship.
Outcomes related to this level of frustration include the belief that
technology has made finding a mate more difficult, and in doing
so may delay or even suppress the desire to establish a deeper
relationship or marry (Match.com, 2015; Paul, 2014; Pew Research Think Critically
Internet Project, 2016). As a result, both the selection process and 1. Would you consider participating in or have you
the process of self-presentation have, in some people’s experi- posted or created a dating site? If so, how did you
ence, brought about a kind of dating-app fatigue (Beck, 2016). describe yourself? If you would not consider creating
Perhaps the problem here is that apps and online dating sites or responding on a site, what prevents you from
don’t provide guidance on how to date; rather, they only offer a doing so?
means of communication.
2. Do you believe that Internet sites should be censored?
A feature of some online dating sites facilitates what is called
Why or why not?
“assortative matching.” This use of matching algorithms attempts
to match people of equal desirability, such as internal attractive- 3. What are your thoughts about dating sites being
ness. Other sites use surveys to assess traits and attributes, while commodities in a marketplace of romantic options?
others examine domains of personality. Relying on the expertise
same time, social networking can be a place of “relationship drama.”

By posting details or pictures from a date on a social networking site
such as Instagram or Snapchat, individuals share every gory detail of
their relationship with anyone willing to take the time to view or read
about it. While many who use the Internet to flirt with others have
largely positive opinions and experiences, significant numbers of other
users have negative ones. Many social networking users report having
unfriended or blocked someone who was flirting in a way that made
them feel uncomfortable, while others have unfriended someone they
are no longer dating. Some have also used these sites to check up on
someone they previously dated or to research potential romantic part-
ners. Not surprising, many realize that these sites can serve as an
unwanted reminder that relationships have ended and, maybe worse,
that their previous beloved one is now dating someone else.
Like other forms of media, the Internet does not simply provide
sexual culture; it also shapes sexual culture. With the widespread use
of online dating sites, the medium has become an accepted means Congressman Anthony Weiner
by which numerous individuals meet new partners for dating, matchmaking, and/or sex (see resigned from the House of
the “Think About It” box “Online Dating: Asset or Liability?”). Representatives after sending to
With thousands of sexual health sites maintained online, new forms of media are also multiple women sexually
powerful tools for learning. When credible sources are located, these media have become suggestive pictures of himself.
©Timothy A. Clary/AFP/Getty Images
convenient avenues by which people can get important sexual health information. There are,
however, two significant concerns associated with using new media to learn about sexuality
and sexual health: the possibility that the information is inaccurate or misleading, and the
possibility that those who turn to the media may turn away from real people in their lives.
For many users, the Internet provides a fascinating venue for experiencing sex. For some
users, however, porn consumption gets them in trouble: maxed-out credit cards, neglected
responsibility, and overlooked loved ones. There are both online and community resources

for those who desire counseling. While searching for such sources, however, consumers and
professionals must be aware of the differences between therapy, consultation, and entertain-
ment. Additionally, because entrepreneurs can make more money from hype and misinfor-
mation than from high-quality therapy and education, consumers must remain vigilant in
assessing the background of the therapist and the source of the information.
One occurrence associated with the drastically changing culture of interpersonal commu-
nication is what is called sexting—the sending or receiving suggestive or explicit texts, photos,
or video messages via computers or mobile devices. The wide array of accessible media
provides the opportunity for choosing different purposes for sending and receiving sexts,
including sexual self-expression, experimentation, self-definition, and education. At the same
time, it has become clear that expectations of privacy in the digital world are being challenged
related to ownership of sexual messages and images, sharing and trafficking of sexual material
without consent, and potential social and psychological health consequences of shared texts
(Garcia et al., 2016).
When looking at the relationship status of those who send and receive sexts, the landscape
is quite varied. Three common scenarios for sexting are: (1) the exchange of images solely
between two romantic partners, (2) exchanges between a partner and someone outside the
relationship, and (3) exchanges between people who are not yet in a relationship but at least
one person hopes to be. In a sample of over 5,800 single adults, 21% reported sending and
28% reported receiving sexually explicit text messages (Garcia et al., 2016). When surveyed
about their reasons for sending sexts, most stated that they wanted to give their partner a
sexy present, use it to enhance their relationship, or respond to a sext that was given to them
(Champion & Pedersen, 2015).
The most damaging aspect of the sharing of sexts occurs when they go beyond the
intended recipient and are trafficked to others for whom they were not intended. Sexting can
hurt one’s reputation, career, self-esteem, and current relationships and friendships. It can
also cause shame and guilt to the victim of such a transgression. And the potential of “sex-
tortion,” or coaxing victims into taking explicit photos and videos and then threatening to
distribute them to their Facebook or Skype contacts if they don’t pay them, is becoming
increasingly common among scammers (Dewey, 2015; Murphy, 2016). It probably comes as
no surprise that females are far more likely to send sexts than males, to feel more pressure
to do so, and as a result to suffer greater adverse consequences, including bullying, sexual
harassment, and stigmatization (Rhode, 2014). As many as 20% of sexters are coerced into
sending sexual texts by threats or manipulation from their partner. Psychologist Michelle
Drouin believes this to be so traumatic to its victims that it constitutes a new form of intimate
partner violence (Drouin, Ross, & Tobin, 2015). In response to teen sexting, some states
have brought felony charges under child exploitation laws, while in other places prosecutors
can require young people to take courses on the dangers of social media instead of charging
them with a crime. The struggle to reconcile digital eroticism with real-world consequences
is inherent when using technology to facilitate human interactions.
Because of the high volume of sexual discussions and material available on the Internet,
there is an increasing demand for government regulation. In 1996, Congress passed the
Communications Decency Act, which made it illegal to use computer networks to transmit
“obscene” materials or place “indecent” words or images where children might read or see
them. However, courts have declared this legislation a violation of freedom of speech.
While one might argue that it is unwise to confuse entertainment with education, media
use is not without its consequences on health. Studies find that high levels of media use
among young people is associated with academic problems, sleep deprivation, obesity, risky
behaviors, and more (American Academy of Pediatricians [AAP], 2016). Recognizing the
ubiquitous role of media in children’s lives, AAP has released policy recommendations to
help families maintain healthy media usage, which includes:
■■ Some high-quality programming beginning at around 18–24 months of age, watched
with their children
■■ One hour of high-quality programming per day for children aged 2–5 years
■■ Limits on time and type of media for children 6 and older, along with media-free
times together and ongoing communication about online citizenship and safety.

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117. Ad Att. vii. 3.
118. Horace, Sat. II. 3, 239.
119. Ad Att. xi. 25.
120. Ad fam. iv. 5.
121. Ad Att. iv. 6.
122. Ad Att. x. 8.
123. Plin. Hist. nat. xiv. 22.
124. Ad fam. xvi. 21.
125. Brut. ad Cic. ii. 3.
126. De offic. ii. 7.
127. Ad Att. i. 12.
128. Ad fam. xiii. 77.
129. Ad fam. xvi. 22.
130. A. Gell. vii. 3.
131. Ad fam. xvi. 10.
132. Ibid. xvi. 21.
133. Ad fam. xvi. 18.
134. Ad fam. xvi. 3, 4.
135. A. Gell. xiii. 20.
136. Plin. Epist. viii. 16.
137. Virgil, however, always faithful to ancient traditions, places, in Tartarus,
the patron who had deceived his client beside the son who had struck his father.
138. De petit. cons. 9.
140. Ad Quint. i. 1.
142. Ibid. vii. 31.
143. Ad Att. vi. 1.
144. I have endeavoured to prove this with more detail in a memoir published
by the Revue archéologique, entitled, Atticus, éditeur de Cicéron.
145. Ad Att. iv. 4, 8.
146. Ad Att. i. 13.
147. Ibid. i. 19.
148. De Leg. i. 7. He is still faithful to this part of an amateur in philosophy,
when he says further on (i. 21), that Antiochus had made him take a few steps in
the Academy, deduxit in Academiam perpauculis passibus. He never penetrated
further.
149. T. Pomp. Att. 13. All the preceding details are taken from the life of
Atticus by Cornelius Nepos.
150. Ad Att. vi. 1.
151. Ad Att. iv. 9.
152. Ibid. vi. 1.
153. Ad Att. vii. 8: soles conglutinare amicitias.
154. It is the saying of Tacitus: pessimum veri affectus venenum sua cuique
utilitas.
155. Ad Att. xiii. 33.
156. It must be remarked, however, that the last letter that we have from
Cicero to Atticus (xvi. 16) contains a proof of the very active steps that Cicero took
to save a part of the fortune of Atticus which was endangered after the death of
Caesar.
157. Ad Att. iv. 8.
158. Ad Att. ii. 1.
159. Ad Att. i. 14.
160. Ibid. xvi. 3.
161. Ibid. xii. 3.
162. Ad Att. xii. 51.
163. Ibid. i. 18.
164. Ibid. xii. 14.
165. Cui potest esse vita vitalis, ut ait Ennius, qui non in amici mutua
benevolentia conquiescat? (Cicero, De Amicit. 6.)
166. T. Liv. xxi. 63: Quaestus omnibus patribus indecorus visus
167. Scipio says so in the Republic (i. 22): Quum mihi sit unum opus hoc a
parentibus majoribusque meis relictum, atque administrate rei publicae, etc.
168. Corn. Nep. Attic. 7: Usus es aetatis vacatione.
169. Nep. Attic. 6.
170. Ad Att. xiv. 10.
171. Ibid. viii. 2.
172. Ibid. x. 15.
173. Ad Att. x. 16.
174. Ad Att. i. 17. See also de Offic. i. 21, and especially i. 26. This last passage
evidently contains an allusion to Atticus.
175. Epist. Brut. i. 17.
176. De Rep. i. 2.
178. Attic. 10.
179. De Orat. 34.
180. In the time of the Gracchi, the Censor Metellus thus expressed himself in
a speech in which he vigorously attacked bachelors: “Citizens, if we could live
without wives we should all dispense with that encumbrance (omnes ea molestia
careremus); but, as nature has willed it to be as impossible to do without them as it
is disagreeable to live with them, let us sacrifice the charms of so short a life to the
interests of the republic, which must always endure.” This way of encouraging men
to marry seemed apparently very efficacious, since, at the time when men married
less than ever, Augustus thought he ought to have the speech of old Metellus read
to the people.
181. Liv. xxxiv. 3.
182. Pro Muraen. 12.
183. Schol. Bob. p. Sext. ed. Or. p. 304.
184. Schwab. Quaest. Catull. p. 77.
185. All these details, and those that follow, are taken from the Pro Caelio of
Cicero.
186. Macr. Sat. ii. 10.
187. Ovid, Trist. ii. 427.
188. Apul. de Mag. 10. A learned German, M. Schwab, in a book that he has
just published on Catullus (Quaest. Catull. 1862), seems to me to have put the
truth of this assertion of Apuleius beyond doubt.
189. Catull. Carm. 26.
190. Catull. Carm. 86.
191. Cat. Carm. 5.
192. Cat. Carm. 12.
193. Cat. Carm. 70.
194. Ibid. 85.
195. Probably with some woman that Caelius loved. Cicero, in replying to this
letter, tells him that the rumour of his exploits has reached Mount Taurus. Many
suppose he means amorous exploits.
196. Ad fam. viii. 7.
197. Quint. Inst. or, iv. 2.
198. De Ira. iii. 8.
199. Ad fam. ii. 8.
201. Ibid. viii. 4.
202. Ibid. viii. 5. The sense of this phrase is altered in Orelli.
203. Ibid. viii. 14.
206. Ad fam. ii. 8.
207. See the excellent memoir of M. Th. Mommsen, entitled Die Rechtsfrage
zwischen Caesar und dem Senat. Breslau, 1857.
209. We see at the end of the eighth book De Bello Gallico, that Caesar had
eight legions in Gaul, one in Cisalpine Gaul, and two that he gave to Pompey. At
the first threat of war he ordered those that were in Gaul to approach the frontier.
After the capture of Corfinium he had three of his old legions with him.
214. Ad Att. viii. 11.
215. Ibid. ix. 6.
216. Ad Att. ix. 12.
217. Ad Att. ix. 10.
218. Ad fam. ii. 16.
219. Ibid. vi. 6.
221. De amic. 15.
222. It would be wrong to pass over the name of Matius in silence. A very fine
letter of his on the death of Caesar remains (Ad fam. xi. 28). He was a true friend
of Caesar; but it is to be remarked that he was not one of those whom he made
praetors and consuls, and whose debts he had often paid. Matius never filled any
important political office, and his name would not have come down to us if it had
not been for Cicero’s correspondence.
223. De bell. civ. iii. 53.
224. Ibid. iii. 91.
225. De amic. 15.
226. Ad Att. ix. 19.
227. Ibid. ix. 18.
228. Suet. Caes. 54.
229. Ad Att. x. 4.
231. Pro Flacco, 38.
233. A very curious detail preserved by Quintilian, shows us that Caelius
retained his levity of character and bantering humour in the midst of these grave
affairs in which he staked his life. After his curule chair had been broken he had
another made entirely of leather thongs, and took it to the consul. All the
spectators burst out laughing. The story ran that Servilius had had a strapping in
his youth.
234. Inst. orat. x. 1.
235. Pro Marcello, 9.
236. In Pis. 22.
237. Pro Dom. 28.
238. Ad Quint. ii. 1.
239. Ibid. ii. 3.
240. Pro Sext. 35.
241. Ad pop. pro red. 7.
242. Ad Att. iv. 3. Ego diaeta curari incipio, chirurgiae taedet.
243. Ad Att. iv. 2.
244. Ad Att. iv. 5.
245. Ad Att. iv. 5.
246. Ibid. iv. 6.
247. Ad fam. i. 9.
248. Ad fam. i. 9.
249. In Pis. 32.
251. Ibid. ii. 15.
252. This at least was the opinion of all the historians of antiquity. We read in
a fragment of a letter from Cicero to Q. Axius quoted by Suetonius (Caes. 9):
Caesar in consulatu confirmavit regnum de quo aedilis cogitaret.
254. Or only forty-two, if we place his birth in 654. See, on this point, an
interesting note in the Life of Caesar, by Napoleon III., Bk. II. ch. i.
255. Ad fam. vii. 5.
258. Ad fam. vii. 6: nisi te extrusissemus.
259. Ad fam. vii. 17.
260. Ibid. vii. 13.
261. Ad fam. vii. 18.
262. Ibid. vii. 10.
263. De orat. ii. 3.
265. Caes. 47.
267. Suet. Caes. 67.
268. Suet. Caes. 46, 48.
269. Ad Quint. iii. 1.
272. Ibid. ii. 16.
273. Cic. Brut. 72, and Pliny, Hist. nat. vii. 30.
274. Caesar wrote to Cicero twice from Britain. The first letter took twenty-six
days to reach Rome, and the second twenty-eight. This was quick travelling for that
time, and we see that Caesar must have organized his mail-service well.
Furthermore, we know his stay in Britain was very short.
276. De prov Cons. 13, 14.
277. M. Mommsen completely settles this in his Roman History.
278. De Arusp. resp. 25.
280. Ad Att. xi. 20. I read cognitionem instead of notionem, which does not
seem to me to have any sense.
281. Ad fam. ix. 1.
282. Ad Att. xvi. 31.
283. Ad fam. ix. 5.
284. Ad Att. ix. 20.
285. Ad Att. x. 4.
286. Bell. Afric. 88.
287. Ad Att. ix. 7.
288. The general amnesty that Suetonius speaks of did not take place till much
later.
290. It is unnecessary to say that I believe in the authenticity of this speech: it
has been disputed for reasons that seem to me futile. Further on I shall reply to
those drawn from the character of the speech, by showing that it is less base and
servile than has been asserted.
291. Pro Marc. 4.
292. Ad fam. iv. 4.
293. Pro Marc. 7.
294. Ibid. 8.
295. Philipp. iii. 11.
296. Ad fam. xv. 5.
299. Pro Mur. 36.
300. Ad Att. ii. 1.
301. Ad Att. xii. 4.
302. Ann. iv. 34.
303. Ad Att. xiii. 46.
304. Caes. Bell. civ. i. 4.
305. Philipp. ii. 32.
306. It is not easy to say what Caesar’s projects were, as his work was
interrupted by his death. Some insist that he only desired a sort of dictatorship for
life; the greater number suppose that he thought of permanently establishing
monarchical rule. The question is too grave to be entered upon incidentally, and
settled in a few words. I will simply say that perhaps he only thought at first of the
dictatorship; but in proportion as he became more powerful, the idea of founding a
monarchy seemed to take more consistency in his mind. Yet it may be inferred
from a passage in Plutarch (Brut. 7), that he was not decided on the question of an
hereditary succession when he died.
307. Ad fam. xii. 17.
308. Brut. 51.
309. Pro Rabir. 7.
310. Pro Rosc. Am. 12.
311. Ad fam. iv. 5.
312. Ibid. xiii. 68.
313. Ibid. xii. 18.
314. Ibid. vi. 9.
315. Pro Marc. 10.
316. Ad Att. xii. 45.
317. Pro Dejot. 12.
318. “All the honest men,” said Cicero (Phil. ii. 12), “in so far as they could,
have killed Caesar. Some wanted the means, others the resolution, several the
opportunity; no one wanted the will.”
319. Ann. i. 3.
320. The authenticity of these letters has been often called in question since
the last century, and has been debated in Germany quite recently with much
warmth, and a distinguished critic, F. Hermann of Göttingen, has published some
remarkable essays, to which it seems to me difficult to reply, in order to prove that
they are really letters of Brutus and Cicero. I have summed up his principal
arguments in Recherches sur la manière dont furent recueillies les lettres de
Cicéron, ch. v.
321. Ad Att. vi. 1.
322. Ad fam. iii. 11.
323. Ad Att. vi. 1.
324. Orat. 10.
325. Ad Att. xiv. 1.—A very curious statue of Brutus is to be seen at the
Campana Museum. The artist has not tried to idealize his model, and seems to
have aimed at nothing but a vulgar exactness; but we can very well recognize in it
the real Brutus. We can trace in that low forehead and the heavy bones of the face a
narrow mind and an obstinate will. The face has a feverish and sickly look; it is at
once young and old, as is the case with those who have never really been young.
Above all we perceive in it a strange sadness, that of a man overwhelmed by the
weight of a great and fateful destiny. In the fine bust of Brutus preserved in the
Museum of the Capitol, the face is fuller and handsomer. The sweetness and
sadness remain; the sickly look has disappeared. The features exactly resemble
those on the famous medal struck during Brutus’ last years, and which bears on the
reverse a Phrygian cap between two daggers, with the threatening legend, Idus
Martiae. Michael Angelo commenced a bust of Brutus, of which the admirable
rough model may be seen at the Uffizi in Florence. It was not a fancy study, and we
see that he had made use of ancient portraits while idealizing them.
326. Ad Att. xv. 1, B.
327. Ad Att. xii. 21.
328. Liv. xlv. 18.
329. Cic. Ad Quint. i. 1.
330. Ad Att. vi. 1.
332. Ad Att. vi. 1.
333. Ibid. v. 21.
334. Ad Att. xi. 4.
335. Ad fam. xv. 15.
336. Ad fam. iv. 9.
337. Cic. Brut. 96.
338. Tusc. ii. 2.
339. See on this question the very interesting work of M. Martha, Les
Moralistes sous l’Empire Romain.
340. Ad Att. xv. 2.
341. Quint. x. 1.
342. Sen. Cons. ad Helv. 9.
344. App. De bell. civ. iv. 133.
345. Plut. Brut. 12.
346. Those who employed these manœuvres well knew that they were taking
Brutus on his weak side. His descent from him who expelled the kings was much
contested. The more it was regarded as doubtful the more anxious he was to prove
it. To say to him: “No, you are not Brutus,” was to put on him the necessity or the
temptation of proving his origin by his actions.
347. Ad fam. xv. 18.
348. De Offic. ii. 7.
349. De Divin. ii. 2.
350. Brut. 97.
351. Epis. Brut. i. 17.
352. Ibid. x. 16.
353. Ibid. i. 17.
354. Quint. ix. 3.
355. It must, however, be noticed that there are several of Cassius’ letters in
Cicero’s correspondence, and that some of them are witty and very lively. There are
even puns in them.—(Ad fam. xv. 19.)
356. De Bell. civ. ii. 113. Plutarch relates the same thing, and almost in the
same words.
357. Ad Att. xv. 4.
358. De Bell. civ. ii. 120.
359. Ad Att. xiv. 10, and xv. 11.
360. De Bell. civ. iii. 42.
361. Ad Att. xv. 11.
362. Ad fam. xi. 3.
363. Philipp. x. 4.
364. Ad fam. x. 1.
365. Ad fam. xi. 7.
366. Ibid. x. 16.
367. Ad Brut. ii. 7.
368. Ad fam. xi. 23.
369. Philipp. xiii. 19.
370. Philipp. xi. 8.
371. Ad fam. xii. 2.
372. Ad Att. xiv. 20.
373. Ad Brut. i. 10.
375. Ad fam. ix. 16.
376. Ad Att. xvi. 11.
377. Ibid. xiv. 12.
378. Ad fam. xii. 25: Quem ructantem et nauseantem conjeci in Caesaris
Octaviani plagas.
379. Orelli, Fragm. Cic. p. 465.
380. Suet. Aug. 101.
381. Exploration archéologique de la Galatie, etc., par MM. Perrot, Guillaume
et Delbet. Paris, 1863. Didot. As the Galatians spoke Greek and understood Latin
ill, the official text was put in the place of honour, in the temple itself, and the
translation was placed outside where every one might read it, in order to bring the
narrative of Augustus within their reach. But the exterior of the temple has not
been any more respected than the interior. The Turks have fixed their houses
against the walls, carelessly driving their beams into the marble, and using the
solid masonry as a support for their brick and mud party-walls. All the skill of M.
Perrot and his companion M. Guillaume was required to penetrate into these
inhospitable houses. When they had entered they met with still greater difficulties.
It was necessary to demolish the walls, take away the beams and support the roofs
in order to reach the ancient wall. This was but little. The wall was hammered and
cracked, blackened by dirt and smoke. How could the inscription that covered it be
deciphered? It was necessary to remain for weeks in dark and foul rooms, or on the
straw of a loft, working by candlelight, throwing the light in every direction on the
surface of the marble, and thus gradually winning each letter by extraordinary
efforts of courage and perseverance. This painful labour was rewarded by complete
success. Of nineteen columns of Greek text, the English traveller Hamilton had
copied five completely and fragments of another; M. Perrot brings back twelve
entirely new ones. One only, the ninth, could not be read; it was behind a thick
party-wall that it was found impossible to pull down. These twelve columns,
although they have suffered much from the ravages of time, fill up in great part the
lacunae of the Latin text. They make us acquainted with entire paragraphs of which
no traces remain in the original; and even in passages where the Latin was better
preserved they rectify at almost every step mistakes that had been made in the
interpretation of the text. M. Egger, in his Examen des historiens d’Auguste, p. 412
et seq., has carefully and critically studied the inscription of Ancyra. M. Mommsen,
with the help of M. Perrot’s copy, is preparing a learned work on this inscription,
after which, no doubt, nothing will remain to be done. (M. Mommsen’s work, that
was announced in the first edition of this book, has since appeared under the title:
Res gestae divi Augusti ex monumentis Ancurano et Apolloniensi.)
382. Dio, lii. 14–40. See what M. Egger says of Dio in his Examen des hist.
d’Aug. ch. viii.
383. The figure cannot be read either in the Latin or Greek.
384. The figure cannot be read. The great number of gladiators who fought,
and no doubt perished in these bloody fêtes will be noticed. Seneca, to show how
far men can become indifferent to death, relates that, under Tiberius, a gladiator
complained of the rarity of these grand massacres; and alluding to the time of
Augustus said: “That was a good time! Quam bella aetas periit!”
385. There is some probability, according to a passage of Suetonius (Aug. 52),
that what the Greek text of the inscription calls absolute authority αὐτεξουσιὸς
ἀρχὴ was the dictatorship.
386. I have only summed up here a very curious chapter of Dio Cassius (Hist.
Rom. liii. 17). We see there clearly how the Roman constitution, in which the
separation of powers was a guarantee for liberty, became, by the sole fact of their
concentration, a formidable engine of despotism.
387. The Ancyra inscription gives most precise information on the subject of
this increase. In 725 Augustus took the census for the first time after an
interruption of forty-one years: 4,063,000 citizens were counted in this return.
Twenty-one years later, in 746, the numbers returned amounted to 4,233,000. In
767, the year of Augustus’ death, there were 4,937,000. If, to the figures that
Augustus gives, we add the number of women and children who were not
comprised in the Roman census, we shall see that in the last twenty years of his
reign the increase had reached an average of very nearly 16 per cent. This is exactly
the figure to which the increase of population in France rose, after the Revolution,
from 1800 to 1825; that is, like political circumstances produced like results. It
might be thought, indeed, that this increase of population under Augustus was due
to the introduction of foreigners into the city. But we know, from Suetonius, that
Augustus, contrary to the example and principles of Caesar, was very chary of the
title of Roman citizen.
388. Suet. Aug. 31.
389. De Clem. 9; Divus Augustus mitis fuit princeps. It is true that elsewhere
he calls his clemency a wearied-out cruelty.
390. Suet. Aug. 84.
391. See especially Velleius Pat. ii. 66.
392. Sen. Suas. 6.
TRANSCRIBER’S NOTES
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This book is dedicated to Elton John, who created the Elton

To my family, especially Bob, who provide the inspiration,

2 Studying Human Sexuality 25

3 Female Sexual Anatomy, Physiology, and Response 60

4 Male Sexual Anatomy, Physiology, and Response 91

5 Gender and Gender Roles 111

6 Sexuality in Childhood and Adolescence 142

7 Sexuality in Adulthood 167

9 Sexual Expression 223

10 Variations in Sexual Behavior 264

11 Contraception and Abortion 288

12 Conception, Pregnancy, and Childbirth 321

13 The Sexual Body in Health and Illness 351

14 Sexual Function Difficulties, Dissatisfaction, Enhancement, and Therapy 380

15 Sexually Transmitted Infections 421

16 HIV and AIDS 456

17 Sexual Assault and Sexual Misconduct 498

18 Sexually Explicit Materials, Sex Workers, and Sex Laws 537

1 Perspectives on Human Sexuality 1

SEXUALITY, POPULAR CULTURE, AND THE MEDIA 3

SEXUALITY ACROSS CULTURES AND TIMES 13

SOCIETAL NORMS AND SEXUALITY 17

FINAL THOUGHTS 22 | SUMMARY 22 | QUESTIONS FOR DISCUSSION 23 | SEX AND

2 Studying Human Sexuality 25

THINKING OBJECTIVELY ABOUT SEXUALITY 29

ACCURATELY MEASURE SEXUAL BEHAVIOR AND SEXUAL ORIENTATION 38

THE SEX RESEARCHERS 39

CONTEMPORARY RESEARCH STUDIES 43

EMERGING RESEARCH PERSPECTIVES 49

ETHNICITY AND SEXUALITY 52

FINAL THOUGHTS 56 | SUMMARY 56 | QUESTIONS FOR DISCUSSION 58 | SEX AND

3 Female Sexual Anatomy, Physiology,

HUMAN SEXUAL RESPONSE 80

AND SOCIAL NORM? 86

FEMALE SEXUAL RESPONSE 87

FINAL THOUGHTS 88 | SUMMARY 88 | QUESTIONS FOR DISCUSSION 89 | SEX AND

4 Male Sexual Anatomy, Physiology,

MALE SEXUAL PHYSIOLOGY 99

MALE SEXUAL RESPONSE 106

5 Gender and Gender Roles 111

©Jeff Gross/Getty Images

CONTEMPORARY GENDER ROLES AND SCRIPTS 123

GENDER VARIATIONS 126

■ Think About It GENDER-CONFIRMING SURGERY: PSYCHOLOGICAL AND PHYSIOLOGICAL NEEDS 130

SEXUALITY IN ADOLESCENCE (AGES 12 TO 19) 147

Teenage Pregnancy 159

7 Sexuality in Adulthood 167

Being Single 174

©Image Source/Getty Images

SEXUALITY IN MIDDLE ADULTHOOD 180

HETEROSEXUAL ONES? 182

SEXUALITY IN LATE ADULTHOOD 184

8 Love and Communication in Intimate

LOVE AND SEXUALITY 195

HOW DO I LOVE THEE? APPROACHES AND ATTITUDES RELATED TO LOVE 197

Managing Jealousy 205

MAKING LOVE LAST: FROM PASSION TO INTIMACY 207

THE NATURE OF COMMUNICATION 208

3 Female Sexual Anatomy, Physiology,

4 Male Sexual Anatomy, Physiology,

8 Love and Communication in Intimate

14 Sexual Function Difficulties, Dissatisfaction,

18 Sexually Explicit Materials, Sex Workers,