THE SEXUAL SELF (2)

Heterosexuality
Heterosexuality

Appealing in sexual intercourse often is perceived as reaching one

of life's major milestones for heterosexuals. Sexual attraction and
behavior directed to the other sex consists of far more than male-
female contact is called heterosexuality. Caressing, kissing,
massaging, and other kinds of sex play are all components of
heterosexual behavior. Still, the act of intercourse, particularly in
terms of its first occurrence and its frequency, has been the center
of the sex researchers’.
PREMARITAL SEX
Considered one of the major taboos in our society, at least
for women, was premarital sexual intercourse. By tradition,
the society warned women that “nice girls don’t do it,”; but
men have been told that premarital sex is okay for them,
although they should marry virgins. This view is called
double standard in which premarital sex is acceptable for
males but not for females
Alterations in attitudes toward premarital sex were matched
by changes in indefinite rates of premarital sexual activity.
For instance, more than one-half of women between the ages
of 15 and 19 have had premarital sexual intercourse. These
figures are close to double the number of women in the same
age range who reported having intercourse in 1970. More
women engaging in premarital love in the last several
decades has been toward sexual activity
Although the increase has not been as dramatic as it has been
for females— most likely because the rates for males were
higher, to begin with, males, too, have shown an increase in the
incidence of premarital sexual intercourse. For instance, the
first surveys of premarital intercourse carried out in the 1940s
showed an incidence of 84% across males of all ages; recent
figures are closer to 95%. Moreover, the average age of males’
first sexual experience declines steadily.
Almost half of the males have had sexual intercourse
by the age of 18; by the time they reach age 20, 88%
have had intercourse. 70% of teens have had
intercourse by their 19th birthday, for both men and
women.
The patterns of premarital sex show a convergence of male and
female attitudes and behavior that makes it most interesting about.
But is the change sufficient to signal an end to the double
standard? Probably. The double standard has been succeeded by a
new view: permissiveness with affection, for many people,
particularly younger individuals. Premarital intercourse is
permissible for both men and women if it occurs within a long-
term, committed, or loving relationship, according to those
holding this view.
Furthermore, there are considerable cultural differences regarding
the incidence and suitability of premarital intercourse. For
instance, the proportions of male teenagers who have intercourse
before their 17th birthday in Jamaica, the United States, and Brazil
are about ten times the level reported in the Philippines. And in
some cultures, such as those in sub-Saharan Africa, although this
may be due to the fact that they marry at a younger age than men,
women become sexually active at an earlier age than men.
MARITAL SEX
To judge by the number of articles about sex in
heterosexual marriages, one would think that sexual
behavior was the number one criterion by which
marital enjoyment is measured. Having too little sex,
too much sex, or the wrong kind of sex, are often
concerns of married couples.
The frequency of sexual intercourse is one certainly, although there are
many different dimensions along which sex in marriage is measured. What
is typical? There is no easy answer to the question because there are such
wide variations in patterns between individuals, as with most other types of
sexual activities. We do know that 43% of married couples have sexual
intercourse a few times a month and 36% of couples have it two or three
times a week. The frequency of intercourse declines with increasing age and
length of the marriage. Still, sex continues into late adulthood, with almost
half of people reporting that they engage in high-quality sexual activity at
least once a month.
The present reality appears to be otherwise, although early
research found extramarital sex to be widespread. 85% of
married women and more than 75% of married men are faithful
to their spouses, according to surveys. Furthermore, the median
number of sex partners inside and outside of marriage since the
age of 18 was six for men and two for women. Accompanying
these numbers is a high, consistent degree of disapproval of
extramarital sex, with nine of ten people saying that it is
“always” or “almost always” wrong.
Homosexuality and
Bisexuality
Sexually attracted to members of their own sex are called
homosexuals, whereas bisexuals are sexually attracted to
people of the same sex and the other sex. Many male
homosexuals like better the term gay, and female
homosexuals like better the term lesbian because they refer
to a broader array of attitudes and lifestyles than the term
homosexual, which focuses on the sexual act.
The number of people who prefer same-sex sexual partners at one
time or another is considerable. Around 20–25% of males and about
15% of females have had at least one gay or lesbian experience
during adulthood, as suggested by estimates. The exact number of
people who identify themselves as exclusively homosexual has
proved difficult to gauge; some estimates are as low as 1.1% and
some as high as 10%. 5–10% of both men and women are
exclusively gay or lesbian during extended periods of their lives, as
suggested by most experts.
The issue is not that simple, although people often
view homosexuality and heterosexuality as two
completely distinct sexual orientations. Pioneering sex
researcher Alfred Kinsey acknowledged this when he
considered sexual orientation along a scale or
continuum with “exclusively homosexual” at one end
and “exclusively heterosexual” at the other.
DETERMINING THE CAUSES
OF SEXUAL ORIENTATION
What concludes whether people turn out to be
homosexual or heterosexual? None has proved
completely satisfactory, although there are a number
of theories. It is suggested that there are genetic causes
in some explanations for sexual orientation being
biological. Studies of identical twins give evidence for
a genetic source of sexual orientation.
When one twin identified himself or herself as
homosexual, the occurrence of homosexuality in the
other twin was higher than it was in the general
population, based on studies. Such results occur even
for twins who have been separated early in life and
who therefore are not necessarily raised in similar
social environments.
Hormones also may play a role in determining sexual
orientation. For example, research shows that women
exposed before birth to DES (diethylstilbestrol—a
drug their mothers took to avoid miscarriage) were
more likely to be homosexual or bisexual.
Some evidence suggests that differences in brain structures may
be related to sexual orientation. For instance, the structure of
the anterior hypothalamus, an area of the brain that governs
sexual behavior, differs in male homosexuals and
heterosexuals. Similarly, other research shows that, compared
with heterosexual men or women, gay men have a larger
anterior commissure, which is a bundle of neurons connecting
the right and left hemispheres of the brain.
However, research signifying that biological causes are at
the origin of homosexuality is not definite because most
findings are based on only small samples of individuals.
Still, the possibility is real that some inherited or
biological factor exists that predisposes people toward
homosexuality if certain environmental conditions are
met.
Although proponents of psychoanalytic theories once
argued that the nature of the parent-child relationship
could produce homosexuality (e.g., Freud, 1922/1959),
research evidence does not support such an explanation.
Virtually no scientific proof suggests that sexual
orientation is brought about by child-rearing practices or
family dynamics.
Another explanation for sexual orientation rests on learning
theory (Masters &Johnson, 1979). Sexual orientation is
learned through rewards and punishments in much the same
way that we may learn to prefer swimming over tennis,
according to this view. For example, a young adolescent
might develop disagreeable associations with the other sex if
he or she had an unpleasant heterosexual experience.
If the same person had a worthwhile, pleasant gay or lesbian
experience, homosexuality might be incorporated into his or
her sexual fantasies. They may be positively reinforced
through orgasm, and the association of homosexual behavior
and sexual pleasure eventually may cause homosexuality to
become the preferred form of sexual behavior if such
fantasies are used during later sexual activities—such as
masturbation.
Several difficulties rule it out as a definitive explanation, although
the learning theory explanation is plausible. One ought to expect
that the negative treatment of homosexual behavior would
outweigh the rewards attached to it because our society has
traditionally held homosexuality in low esteem. Furthermore,
children growing up with a gay or lesbian parent are statistically
unlikely to become homosexual, which thus contradicts the notion
that homosexual behavior may be learned from others
• We can’t definitively answer the question of what determines it, because
of the difficulty in finding a consistent explanation for sexual orientation.
It seems unlikely that any single factor orients a person toward
homosexuality or heterosexuality.
• Instead, a combination of biological and environmental factors appears
reasonable to assume. One thing is clear, although we don’t know exactly
why people develop a certain sexual orientation: Despite increasingly
positive attitudes toward homosexuality, many gays and lesbians face
antigay attitudes and discrimination, and it can take a toll.
• Lesbians and gays have higher rates of depression and
suicide than their straight counterparts. There are even
physical health disparities due to prejudice that gays and
lesbians may experience. Because of this, the American
Psychological Association and other major mental health
organizations have endorsed efforts to eliminate
discrimination against gays and lesbians
Sexually Transmitted
Infections (STIs)
Sexually transmitted infections (STIs) are
also called sexually transmitted diseases, or
STDs. STIs are usually spread by having
vaginal, oral, or anal sex. Women often have
more serious health problems from STIs than
men, including infertility.
Major STIs
• Chlamydia. This is a disease that in
women at first produces no symptoms
and in men causes a burning sensation
during urination and a discharge from
the penis and it is the most widespread
STI. Chlamydia can lead to pelvic
inflammation, urethral damage, arthritis,
and even sterility if it is left untreated.
• Genital herpes. It is a virus related to the cold
sores that sometimes appear around the
mouth. Herpes first comes out as small
blisters or sores in the region of the genitals
that later break open, causing harsh pain. The
disease usually reappears typically four or five
times in the year following infection, even
though these sores heal after a few weeks.
Later outbreaks are less frequent, but the
infection, which cannot be cured, often causes
psychological distress for those who know
they are infected.
• Trichomoniasis. It is a vagina or
penis infection caused by a parasite;
it is often without symptoms,
especially in men. Eventually, it can
cause painful urination and
intercourse, discharge from the
vagina, itching, and an unpleasant
odor. The 5 million cases reported
each year could be treated with
antibiotics.
• Gonorrhea. It often has no symptoms
but can produce a burning sensation
during urination or a discharge from
the penis or vagina. The infection can
lead to fertility problems and, in
women, pelvic inflammatory disease.
A number of drugresistant strains of
the disease are growing, making
treatment more difficult, although
antibiotics usually can cure gonorrhea.
• Syphilis. It first reveals itself through a
small sore at the point of sexual
contact. In its secondary stage, it may
include a rash. Syphilis can be treated
successfully with antibiotics if it is
diagnosed early enough. If untreated,
it may affect the brain, the heart, and
a developing fetus. It can even be
fatal.
Genital warts. It is caused by the human
papillomavirus. Genital warts are small,
lumpy warts that form on or near the
penis or vagina. The warts are easy to
diagnose because of their distinctive
appearance: They look like small
cauliflower bulbs. HPV vaccines are now
available for males and females to
protect against the types of HPV that
most commonly cause health problems.
AIDS. In the last two decades, no sexually
transmitted infection has had a greater
impact on sexual behavior—and society
as a whole—than acquired immune
deficiency syndrome (AIDS). It has
spread to other populations, such as
intravenous drug users and
heterosexuals, although in the United
States, AIDS at first was found primarily
in gay men.
Contraception
When choosing the most suitable contraceptive method, many
elements need to be considered by women, men, or couples at any
given point in their lifetimes. These elements include effectiveness,
availability (including accessibility and affordability), safety, and
acceptability. When appropriate, voluntary informed choice of
contraceptive methods is a necessary guiding principle, and
contraceptive counseling might be a significant contributor to the
successful use of contraceptive methods.
Dual protection from the simultaneous risk for HIV and other
STDs also should be considered in choosing a method of
contraception. Although hormonal contraceptives and IUDs are
highly effective at preventing pregnancy, they do not protect
against STDs, including HIV. Consistent and correct use of the
male latex condom reduces the risk for HIV infection and other
STDs, including chlamydia infection, gonococcal infection,
and trichomoniasis.
Reversible Methods of Birth Control
Intrauterine Contraception

• Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is a

small Tshaped device like the Copper T IUD. With the help of a doctor, it
is placed inside the uterus. It releases a small amount of progestin each day
to keep you from getting pregnant. It stays in your uterus for up to 3 to 6
years, depending on the device.
• Copper T intrauterine device (IUD)—This IUD is a small device that is
shaped in the form of a “T.” Your doctor places it inside the uterus to
prevent pregnancy. It can stay in your uterus for up to 10 years.
Intrauterine Contraception
Hormonal Methods

• Implant— is a single, thin rod that is inserted under the skin of a woman's upper
arm. The rod contains a progestin that is released into the body over 3 years.
• Injection or “shot”—Women get shots of the hormone progestin in the buttocks
or arm every three months from their doctor.
• Combined oral contraceptives—Also called “the pill,” it is prescribed by a
doctor and it contains the hormones estrogen and progestin. A pill is taken at the
same time each day. If you are older than 35 years and smoke, have a history of
blood clots or breast cancer, your doctor may advise you not to take the pill.
Hormonal Methods

• Progestin-only pill—Instead of both estrogen and progestin, the progestin

only pill (sometimes called the mini-pill) only has one hormone, progestin
and it is prescribed by a doctor. It is taken at the same time each day. It
may be a good option for women who can’t take estrogen.
• Patch—This method is prescribed by a doctor and it releases hormones
progestin and estrogen into the bloodstream. This skin patch is worn on
the lower abdomen, buttocks, or upper body (but not on the breasts). You
put on a new patch once a week for three weeks. During the fourth week,
you do not wear a patch, so you can have a menstrual period.
• Hormonal vaginal contraceptive
ring
— You place the ring inside your
vagina in which the ring releases the
hormones progestin and estrogen.
You wear the ring for three weeks;
take it out for the week you have
your period, and then put in a new
ring.
Barrier Methods

Male condom—Worn by the man, a male condom keeps sperm from

getting into a woman’s body. Condoms can only be used once. Latex
condoms, the most common type, help prevent pregnancy, and HIV
and other STDs, as do the newer synthetic condoms. Typical use failure
rate: 13%. You can buy condoms, KY jelly, or water-based lubricants at
a drug store. Do not use oilbased lubricants such as massage oils, baby
oil, lotions, or petroleum jelly with latex condoms. They will weaken
the condom, causing it to tear or break.
Barrier Methods

• Female condom—The female condom helps keep sperm from getting into
her body in which it is worn by the woman. It is packaged with a lubricant
and is available at drug stores. It can be inserted up to eight hours before
sexual intercourse.
• Spermicides—These products work by killing sperm and come in several
forms like foam, gel, cream, film, suppository, or tablet. No more than one
hour before intercourse, they should be placed in the vagina. You leave
them in place at least six to eight hours after intercourse. You can use a
spermicide in addition to a male condom, diaphragm, or cervical cap. They
can be purchased at drug stores.
Barrier Methods
Fertility Awareness-Based Methods

Fertility awareness-based methods—When you are planning to get

pregnant or avoid getting pregnant, understanding your monthly fertility
pattern, the external icon can help. Your fertility pattern is the number of
days in the month when you are fertile (able to get pregnant), days when
you are infertile, and days when fertility is unlikely but possible. If you have
a regular menstrual cycle, you have about nine or more fertile days each
month. If you do not want to get pregnant, you do not have sex on the
days you are fertile, or you use a barrier method of birth control on those
days. Failure rates vary across these methods.
Fertility Awareness-Based Methods
Emergency Contraception
Emergency contraception can be used after no birth control was used during sex,
or if the birth control method failed, such as if a condom broke. It is NOT a regular
method of birth control.

• Copper IUD—Women can have the copper T IUD inserted within five days of
unprotected sex.

• Emergency contraceptive pills— Up to 5 days after unprotected sex, women

can take emergency contraceptive pills, but the sooner the pills are taken, the
better they will work. Some emergency contraceptive pills are available over the
counter.
Emergency Contraception
Permanent Methods of Birth Control

• Female Sterilization—Tubal ligation or “tying tubes”— This

procedure can be done in a hospital or in an outpatient
surgical center wherein a woman can have her fallopian
tubes tied (or closed) so that sperm and eggs cannot meet
for fertilization. You can go home the same day of the surgery
and resume your normal activities within a few days. This
method is effective immediately.
Permanent Methods of Birth Control
• Female Sterilization—Tubal ligation or “tying tubes”
Permanent Methods of Birth Control

• Male Sterilization–Vasectomy—This operation is done to keep a

man’s sperm from going to his penis, so his ejaculate never has any
sperm in it that can fertilize an egg. The procedure is typically done at
an outpatient surgical center. The man can go home the same day.
Recovery time is less than one week. After the operation, a man visits
his doctor for tests to count his sperm and to make sure the sperm
count has dropped to zero; this takes about 12 weeks. Another form
of birth control should be used until the man’s sperm count has
dropped to zero.
Permanent Methods of Birth Control
• Male Sterilization–Vasectomy