Human Sexuality and Its Problems

549 Pages·2009·10.4 MB·English

by  John Bancroft

THIRD EDITION
HUMAN
SEXUALITY
and its
PROBLEMS
John Bancroft
MD FRCP FRCPE FRCPsych
Formerly Director and currently Senior Research Fellow,
The Kinsey Institute for Research in Sex, Gender and Reproduction,
Bloomington, Indiana, USA
EDINBURGH LONDON NEWYORK OXFORD PHILADELPHIA STLOUIS SYDNEY TORONTO 2009
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Preface
Thislong-awaitedthirdeditionprovidesacomprehensive medicalpractice,HIV,AIDSandothersexuallytransmit-
and authoritative cross-disciplinary approach to under- tedinfections,sexualaspectsofcontraceptionandinfertil-
standinghumansexualitythatisunusualintheliterature. ity,and sexualoffences.
Closeattentionispaidtothefollowing:the physiological It is 20 years since the last edition of this book, and
mechanisms central to sexual experience and the psy- there has been a huge increase in the research and
chologicalprocessesthatprecedeandreacttothem; how evidencethatneedstobeconsidered.Asaconsequence,
these psychophysiological interactions fit into sexual major revision has been required. A new feature is the
relationships; the influence of socio-cultural factors, the emphasis on theory and its role in sex research, and a
sexual development of young people and how sexuality theoretical framework is used to organize much of the
changes with ageing. In addition to heterosexuality, book.
variations in sexual expression, including homosexuality This book is written principally for academics
andtransgender,areconsidered.Arecurringthemeisthe and clinicians who deal with human sexuality in
comparisonofmaleandfemalesexuality,theirsimilarities their professional work, but it is written in a clear and
anddifferences. straightforwardmannerthatwillbeofvaluetograduate
In the second half of the book, the principal problems studentsandanyoneelsewithascholarlyinterestinthe
related to sexuality are closely examined, and detailed subject.
guidelines provided for their clinical assessment and
treatment. Further chapters cover sexual aspects of J.B. 2008
v
Acknowledgements
I am very grateful to a large number of friends and Eric Vilain, Gorm Wagner, Kim Wallen, Kay Wellings,
colleagues who have promptly responded to my FredWu,ClaireYangandKenZucker.
e-mail questions and requests. They include, in alpha- I am also indebted to my colleagues at the Kinsey
betical order, Henry Burger, Jacques Buvat, Susan Institute,whohavehelpedmeinmanyways;inparticu-
Davis, Lorain Dennerstein, Alan Dixson, Anke lar Shawn Wilson, Tom Albright, Liana Zhou, Erick
Ehrhardt, Paul Federoff, Richard Green, Don Grubin, Janssen and Julia Heiman.
Dean Hamer, Elaine Hatfield, Keith Hawton, Joe Cynthia Graham has given me valuable feedback on
Herbert, Melissa Hines, Roger Ingham, Anne Johnson, much of this book, and, in particular, I want to thank
Barry Keverne, Barry Komisaruk, Prakash Kothari, her and our two children, Rosie and Jack, for coping
Ellen Laan, Ed Laumann, Sandy Leiblum, Roy Levin, with my almost total preoccupation with this book over
BillMarshall,ArnoldMelman,HeinoMeyer-Bahlburg, the past 3 years.
Brian Mustanski, Ebo Neischlag, Richard Parker, Jim I am also grateful to Vaughn Call, Cynthia Graham,
Pfaus, Ray Rosen, David Rubinow, Ben Sachs, Peter Roger Gorski, Erick Janssen, Tillmann Kru¨ger, Helen
Schmidt, Koos Slob, Serge Stoleru, Aleksander Stulho- O’ConnellandClaireYangfortheirpermissiontorepro-
fer,LeonoreTiefer,MartinTovee,RandolphTrumbach, duce or adapt figures from their publications.
ix
1
Introduction
The thread of sexuality is woven densely into the fabric the particular vulnerabilities of heterosexual women, an
of human existence. There are few people for whom important demonstration of the consequences of gender
sex has not been important at some time and many for inequality in human societies (see Chapter 14). We have
whom it has played a dominant part in their lives. Sex also seen how HIV infection is characterized by rela-
isamotiveforceleadingtwo peopletointimatecontact. tively low infectivity, a long latency, but a major health
They may have nothing in common except mutual consequence, AIDS. This is in striking contrast to the
sexual interest. Their encounter may be brief or it may event-related and usually treatable nature of other sexu-
lead on to the principal relationship in their lives, and ally transmitted infections (STIs), and has added further
often the formation of a family. complexitytothe issues of responsible sexual behaviour.
The preceding paragraph opened the introduction to Thenewphaseofsexsurveyresearch,reviewedinthis
the last edition of this book in 1989. Twenty years later volume, has been largely driven by this pandemic.
itisnolessrelevant.Sexualitycontinuestoplayafunda- Whereas it remains very difficult to obtain funding for
mental part in the lives of many of us. However, there sex research in general, the need to carry out large-scale
are ongoing changes in the sexual world. Interestingly, surveys that would be informative about behaviours
a turning point relating to these changes happened and attitudes relevant to HIV transmission has been
around the date of the second edition of this book. In acknowledged. This, however, has not gone unchal-
the two to three decades before 1989 there had been lenged;thecontinuingpoliticaloppositiontosexresearch
noticeable changes, most marked in the sexuality of isconsideredinChapter6andisreviewedmorecompre-
women. It seemed that the longstanding societal repres- hensively in Bancroft (2004). The view that it is better to
sion of women’s sexuality was lessening, enabling them ignore sex than to attempt to understand it, for fear that
toexpresstheirsexualitiesmoreopenly,andrevealinga in the process you somehow encourage it, has persisted
much greater variability among women than had previ- invariousforms, particularlyinthe USA.
ously been apparent. This pattern and the challenge of The final phase of my career brought me into close
comparing and contrasting the sexuality of men and contact with this ‘sex negativism’. In 1995 I moved to
women is an important theme in this third edition, and the USA to become Director of the Kinsey Institute for
I have ventured into potential political incorrectness in Research in Sex, Gender and Reproduction at Indiana
my attempts to theorize about this gender comparison. University. From the first day, I was contending with
Since 1989 we have not seen any reversal of this change the ongoing anti-Kinsey campaign. Kinsey had become
in relation to women’s sexuality, but in general the a scapegoat for what these campaigners regarded as a
previous phase of increasing sexual permissiveness, decline in sexual morality (Bancroft 2004).
described as the era of sexual liberation or revolution, Fortunately,beyondthat,mytimeattheKinseyInsti-
dependingonone’sperspective,hasnotbeensoevident. tute had many positive consequences for me. I became
This is most noticeably apparent in the cessation and to muchmoreawareofKinsey’sworkonindividualvaria-
some extent reversal of the trend towards younger bility, a central theme in much of my research in the
ageatsexualinitiation(seeChapter5,p.155).Thetrend subsequent 10 years. Through the amazing collections
towardsmorepremaritalsexualexperience,ontheother attheKinseyInstitute,Iexperiencedthemanywaysthat
hand, has continued, at least in the Western world, sexuality has been expressed in the arts and literature.
largelybecausepeoplearegettingmarriedlaterandless Above all, I had 10 years of working with a wonderful
often (see Chapter 6, p. 205), and sexuality has become team of colleagues at the Institute. Only since retiring
accepted as a manifestation of a ‘sexual relationship’ from that wholehearted investment, and returning to
rather than of marriage per se. the UK, have I been able to work on this third edition.
By 1989, HIV and AIDS were having a major impact The past 20 years have influenced my thinking in
andhavecontinuedtodosoeversince.Intheearlydays many ways that will be evident in this new edition.
ofthisepidemic,attentionwasfocusedonAIDSasa‘gay Therehasbeenahugeincreaseintheliteraturerelatingto
disease’, with an associated intensification of anti-homo- humansexualityanditsproblems.Giventhattheobjective
sexual attitudes. The subsequent worldwide pandemic, of this book is to provide a broad cross-disciplinary
however, has shown this to be a predominantly hetero- perspective,theliteraturehasbeenclosetooverwhelming.
sexual problem, with more recent attention focused on Thereare,Ihavenodoubt,manyimportantgapsinthenext
1
1
2 Human sexuality and its problems
15chapters, andtothosescholarsand researchers whose As with the previous two editions, I have struggled
workIhaveinadequatelyaddressed,Icanonlyapologize. over the best way of structuring this book. This reflects
Ihave,however,experiencedamajortransformationthatI the core theme; that human sexuality results from an
will try to explain. In the last edition I wrote that interaction between the psychobiological mechanisms
human sexuality was an enigma or a riddle. Since then inherent in the individual and the culture in which he
this enigma has become endowed with even more sig- or she lives. To some extent, it is possible to focus on
nificance for me. Scientific progress, while it may bring thefundamentallybiologicalprocessofsexualdifferentia-
clear practical benefits, more often than not makes the tion, as in Chapter 3, and on the psychobiological
human condition more rather than less difficult to mechanisms involved in sexual response, as in Chapter
understand. No doubt there are exceptions, but in my 4.Butthedevelopmentofgenderidentity,sexualidentity
experience they have been few. One particularly telling and our emerging patterns of sexual behaviour require
example, which I will revisit at several points in this moreattentiontosocio-culturalfactors.Ihaveconsidered
book, is brain imaging. We may use brain imaging to thesemorecloselyinChapters5and6,andinrelationto
study what happens in the brain when we become sex- homosexual identityinChapter8.
ually aroused, or to compare and contrast individuals There are two other chapters that are new. HIV and
with normal and low levels of sexual desire. What we AIDS, together with other STIs, now have a chapter to
find is a multiplicity of interactive brain functions that themselves (Chapter 14), as do transgender and gender
do not slot easily into our preconceived concepts of non-conformity (Chapter 10). The assessment of sexual
‘sexual arousal’ or ‘sexual desire’. And why should problems, previously a separate chapter, is now incor-
they? The common assumption that we can work out, porated into the chapter on their treatment (Chapter 12).
with our brains, how those brains work, is one aspect This reflects changes in this clinical field. With the intro-
of the arrogance of human beings. There are many, duction of the ‘Viagra era’ there has been a major shift
beyond the field of brain science, who believe that it is awayfromsurgicalinterventionsforerectiledysfunction.
only a matter of time before science gets everything This has resulted in much less use of the physiological
worked out. This has not made me nihilistic about sci- methods of assessment (e.g. arteriography) that had pre-
entific research, far from it; the practical benefits of viously been considered appropriate to demonstrate the
research continue to be considerable. But it has made organic nature of an erectile problem before embarking
me more humble, and in the process has intensified on irreversible surgical procedures to correct it. In paral-
my sense of spirituality. lel, there has been a shift towards integration of psycho-
As part of this process, it has become clearer to me logical and pharmacological approaches to treatment
that, rather than pursuing the ‘truth’ or the ‘reality’ of (see Chapter 12), which has reinforced my view that the
brainfunction,orhormonefunction,orneurotransmitter earlystagesofpsychological‘sextherapy’areparticularly
function,orbycontrast,theimpactofculture,weshould effectiveatassessingthelikelycausesofthesexualprob-
endeavour to devise simplified models of reality. Their lem,and hence the bestapproachto treatment.
purpose is not only to help us grapple with the seem- There have been some direct and striking impacts of
inglyendlessincreaseincomplexity,ofhumansexuality information technology on the writing process. When I
and a lot more besides, but also to have heuristic value wrote the first edition of this book, published in 1983,
invariousways,suchasmakingiteasiertowriteabook I had a typewriter and a box full of index cards to help
likethis,andhopefullyforthereadertomakesenseofit. meorganizethereferences.WhenIwrotethesecondedi-
When we look back over the history of science we can tion,publishedin1989,Ihadawordprocessor;abigdiffer-
find many examples of such models, which served to ence.Forthisthirdedition,aswellasthemanyadvantages
helptheprocessof makingsense,but afterawhilegave ofamodernlaptopandawealthofhelpfulsoftwarepro-
way to new models which could better deal with the grammes, I have had access to the Internet. As I am no
next stage. In the field of medicine, where scientific longerattheKinseyInstitute,withitsuniquelibraryand
understanding is of particular importance, and its heu- wonderfullibrariansjustupthestairs,Ihavebeenamazed
ristic value readily demonstrated, this process has been how many of the papers I need can be obtained online.
very evident. Increasingly, I find myself searching less through books
I have therefore become more theoretical, which has onmyshelvestofindtheanswertoaquestion,andturning
not only influenced my research over the past 10 years, toGoogleinstead.AndthenIhavehade-mail.Ithasbeen
but also the structuring and writing of this third wonderful how responsive my friends and colleagues
edition. This is explored closely in Chapter 2, one of around the world have been, answering my questions
the new components of this book. Through the other andsendingpapersandreferencesalmostassoonasIdis-
chapters the reader will encounter a variety of theories, patchedmymessagetothem.Alonglistoftheirnamesis
ranging from testable hypotheses, to models intended givenintheacknowledgments.
to aid in the organization of our thinking. I feel some- The Internet, however, is of much more significance
whatfrustrated,asthislateemergenceofamoretheoret- than helping authors write their books. It is a major
ical approach has generated numerous researchable new factor in the modern sexual world, crossing age,
questionswhenitistoolateformetoattempttoanswer cultural and geographic boundaries, and with effects
them. Ihave included manyof them in this book, in the onhumansexuality,bothbadandgood,whichwehave
hope that others might want to pursue them. hardly begun to understand (see Chapter 6).
Introduction 3
Personal statement
intimacy, and such relationships have often shown
themselves to be difficult to maintain (see Chapter 6). I
This new introduction has been something of a personal
can also understand that poverty drives some indivi-
statement from start to finish, reflecting increased intro-
duals to use sex for material gain, and I can only wish
spection as I age. But the importance of being explicit
that there were better solutions for their poverty. I have
aboutmyvalues,sothatthosereadingthisbookarebetter
onceagainfailedtoaddresstheimportantissueofpros-
able to judge how they might have influenced or biased
titution in this edition, which probably reflects my diffi-
myanalysisandpresentationoftheevidence,isasimpor-
culty in getting it into perspective.
tantasever.
I continue to hold my somewhat idiosyncratic view
Inmostrespects,littlehaschangedinmyvaluesystem.
of the binding effect of sexuality. Whereas the shared
TheimportanceofresponsibilityinoursexuallivesIseeas
experience of sexual pleasure strengthens a sexual rela-
paramount. In the human species, sexuality has come to
tionship, I see the vulnerability inherent in the sexual
servemorethanthereproductivefunction.Ifeelpositively
interaction as equally, if not more, important. To enjoy
about some of these non-reproductive functions, but not
sex requires us to let go, to become abandoned to a
all.Thewaysthatsexcanbindacoupleandfosterintimacy
degree, undefended. In such a state we are vulnerable.
are,forme,themostpositivenon-reproductiveaspectsof
For many species this vulnerability is probably an
sexuality.Ihavenoproblemwithsexasasourceofpleas-
important reason why sexual behaviour is biologically
ure,providingthatthepleasureismutualandisresponsi-
controlled and limited to the minimum time required
blyobtained.Iamnotcomfortablewiththeuseofsexasa
for the purposes of reproduction; otherwise animals
way of asserting one’s masculinity or femininity. That is
would be exposing themselves to undue danger. For
nottosuggestthatwhatweneedisaneliminationofgen-
humans,itisnotphysicalbutpsychologicaloremotional
der differences,evenifthat were possible. Itmay bethat
hazards that are most likely — the risks of being
forbothmenandwomentoenjoythefullnon-reproductive
exploited, rejected or humiliated. These are some of the
benefits ofbeing sexual,some distinction between ‘male-
badconsequencesofsex.Buttobeabletoexposeoneself
ness’ and ‘femaleness’ will continue to be an advantage,
tosuchariskandyetremainsafereinforcesthefeelings
atleastasfarasheterosexualsexisconcerned.Thisisone
ofsecurityinarelationship,andhasabindingeffect.To
example of gender differences, which, if used appropri-
a considerable extent, the emotional security of a sexual
ately, complement each other. But any way in which sex
relationship is undermined when sex is used for other
is used to reinforce stereotypes of masculine dominance
purposes such as asserting masculinity or dominance,
andexploitationcausesmeconcern.
or bolstering self-esteem, or even as a mood regulator.
Using sex to bolster self-esteem is potentially prob-
Theneedforsexualitytobeexpressedanddealtwith
lematic. The quality of sexual attractiveness has a wide
responsibly is profoundly important. This book docu-
influence. In the materialistic societies of the modern
ments many of the negative consequences of irresponsi-
world, sex is used to impart appeal to non-sexual
ble sexual behaviour, including unwanted pregnancies,
objects; the commercial exploitation of sex is all around
sexuallytransmittedinfections,andemotionalandphys-
us. This stems from the powerful link between sexual
ical trauma. I was privileged to be part of a multidisci-
attractiveness and self-esteem. For many, sexual appeal
plinary group of advisors organized by the Surgeon
willbeorwillbeseentobethemostpowerfulassetthey
General of the US Government in 2000, Dr David
possess. That is all the more reason for them to use it
Satcher. The group process was informative because it
responsibly. Given that we are all, including our chil-
involved individuals with a wide range of values relat-
dren, bombarded with sexual messages, mainly from
ingtosexualbehaviour,yetitprovedpossible,withsuf-
the media and from advertising, it is crucial that there
ficient discussion, to reach consensus about the basic
are counterbalancing messages emphasizing the impor-
requirements for responsible sexual behaviour. This
tanceofresponsibilityinoursexuallives,combinedwith
resulted in the Surgeon General’s Call to Action to Pro-
goodinformation.Therecontinuestobemuchignorance
mote Sexual Health and Responsible Sexual Behavior issued
andmisinformationaboutsex.Sexeducationisnotonly
in July 2001 (Satcher 2001). The following is an extract
important for the young adolescent.
from the introduction:
Sex as an expression of hostility is clearly unaccept-
able. The complex relationships between anger, sexual
arousal and sexual violence are explored in Chapters 4 Sexualresponsibilityshouldbeunderstoodinthebroadest
and16.Theuseofsexasamoodregulatorisnowreceiv- sense.Whilepersonalresponsibility iscrucialtoany
ing research attention, and is increasingly being seen as individual’shealthstatus, communitiesalso haveimportant
potentially problematic. This is considered more closely responsibilities.Individualresponsibility includesunderstanding
in Chapters 4 and 11. andawareness ofone’ssexualityand sexualdevelopment:
Sex for material gain raises complex issues. Tradi- respectforoneselfand one’spartner;avoidanceofphysicalor
tional ‘arranged’ marriages, in most cultures, entail a emotionalharmtoeither oneselforone’spartner;ensuringthat
complex set of motives, in which the ‘bartering’ of sex pregnancyoccursonlywhen welcomed;and recognitionand
for non-sexual benefits, while not explicit, cannot be toleranceofthediversityofsexualvalueswithinanycommunity.
excluded. Only with the emergence of the ‘companion- Communityresponsibility includesassurancethatitsmembers
atemarriage’inthe20thcenturywereweabletoassume haveaccesstodevelopmentallyand culturallyappropriate
that sexuality was primarily for mutual pleasure and sexualityeducation,aswellassexualandreproductivehealth
1
4 Human sexuality and its problems
careandcounseling;thelatitudetomakeappropriatesexual beyond the simple message that it is something that
andreproductivechoices; respectfordiversity; andfreedom should be postponed until marriage, and the more spe-
fromstigmatization andviolence onthebasisofgender,race, cificguidanceisdirectedattheyoungfemalesmorethan
ethnicity,religionorsexualorientation (p.1) themales.Withthe clearincreaseinthe ageatmarriage
and lowering of the age at puberty and hence the onset
This Call to Action (CTA) highlights that sexual
of fertility as well as increased sexual arousability, this
responsibility has to be considered at two levels: the
issue has increased in importance. The relevance to sex
individual and the community. It is appropriate to
education is considered further in Chapter 5.
expect the individual to take responsibility as long as
Inasocialspeciessuchasours,sociallyimposedlim-
the community does as well. The crucial issue of diver-
itsforsexualbehaviourarenecessary.Theculturalasser-
sity is also raised. It becomes easier to accept diversity
tion of sexual morality is an important way to set such
of sexual expression providing that it is expressed
limits. But sexual morality may be ‘good’ or ‘bad’ and
responsibly. The intention of the Surgeon General was
thehistoryofhumansocietiesshowsusmanybadexam-
to use this CTA to ‘stimulate respectful, thoughtful,
ples, often reflecting the difficulties that the societal or
and mature discussion in our communities and in our
religious system had in acknowledging the existence of
homes. While sexuality may be difficult to discuss for
sexuality.Thussexisgrudginglyacceptedonthegrounds
some, and there are certainly many different views and
that it is necessary for reproduction, an inescapable part
beliefs regarding it, we cannot afford the consequences
of God’s plan, and with the condition that it is restricted
of continued or selective silence’ (p. 2).
to marriage. This is usually combined with the rejection
It is uncertain to what extent it has succeeded in this
ofhomosexualrelationshipsonthegroundsthattheycan-
respect. Not long after this CTA was issued there was a
notreproduce.Therearemanyheterosexualwomen,and
changeofgovernment,fromDemocrattoRepublican.Per-
perhapssomemen,whoareonlycomfortablewithsexif
hapsnotsurprisingly,therehasbeennofurtherevidence
there is some possibility that reproduction might result.
of government involvement. However, David Satcher,
In any case, God’s plan, in this respect, has apparently
since leaving his government post, has continued his
changedas,withthegrowingworldpopulation,theneed
effortstobuildonthisinitiative.AfterbecomingDirector
for our species nowisless reproductionnot more.
of the National Center for Primary Care at Morehouse
According to my values, we need a new form of sex-
School of Medicine, in Atlanta, Georgia, he established
ual morality based on responsibility and gender equal-
the Center of Excellence for Sexual Health, with funding
ity, and the acceptance of responsible diversity. This
fromtheFordFoundation.Thishasbroughttogetherlea-
would,itishoped,involveamorehonestformofsexual
dersofvariousdiversegroupsintheUSAtocontinuethis
constraint that would not only steer our teenagers away
discussion, resulting in the ongoing National Consensus
from sexual danger without spoiling their unfolding joy
ProcessonSexualHealthandResponsibleSexualBehavior
ofsexualintimacy,butalsohelpustoavoidmuchofthe
(Satcher2006).Hopefully,theywillmakeprogress.
distress and bitterness that accompanies the breakdown
Therearetwospecificissuesthatare,accordingtomy
ofsexualrelationships.Forsexualrelationshipsbetween
value system, in particular need of change. One is the
menandwomen,Iwouldhopeforaresponsibleattitude
tendency, reinforced by patriarchal societies in various
toparenthoodbybothpartners,sothatchildrenwillnot
ways, for men to see the need for sexual containment
be born because ‘that is the normal thing to do’ or
and the prevention of unwanted pregnancies as the
because no suitable alternative to parenthood is avail-
responsibilities of women. Men and women should be
able,or becausetaking contraceptive precautions would
equally responsible in their sexual lives. There are no
indicate an unacceptable degree of sexual intention, but
grounds for maintaining that the status quo is justified
because two people have a genuine and shared desire
for biological or evolutionary reasons. Given the history
to experience parenthood.
ofpatriarchalsocieties,itissurprisingthattheyhavenot
yeteliminatedthemselves.Ifthehumanspecieshasany
potential for adaptation, then a shift towards more gen- REFERENCES
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gov/library/sexualhealth/default.htm
astheyenteradolescence.Thisisdealtwithtoavariable
SatcherD2006TheNationalConsensusProcessonSexualHealthand
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ResponsibleSexualBehavior.InterimReport.MorehouseSchoolof
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2
Models of human sexuality:
the role of theory
IMERPTRnhsoeetoseladriedtoluiiinctnecdytadltiu.siali.ov.clc.inios.tdo.iimf.suor.rm.hane.a.luc...n..v.tm...nd..e....er..a...st.s..hn.u..s...e.s..s........tse....o....o...x.l....ec...u....r.i...eaa........tn.l...yi....ct.....y....e.....:..........o.....s.....f.....o.....u.....m.....n..........ce.........e..........re.....t.....xa..........ia.....n.....m.....t.....y.........p.............l......e............s.................................................................................................................................................................................5677858...................................... WSSTThheeheexxauubDtaaiullgisasspltcrhiCraciuptoteumtnigrnteayrgon.t.lt.hh.ms.ee.eo.oo.xr.dr.yuy.e..a...l.......l....i....t....y........?.........................................................................................................................................................................................................................................................................................1111.03588
Introduction
address each theme. The four themes covered were sex-
ualityacrossthelifecycle,sexualorientation,individual
differences in sexual risk taking and adolescent sexual-
In 1998, The Journal of Sex Research published a special
ity. The proceedings of this meeting, including edited
issue on the use of theory in sex research and scholar-
versions of the extensive discussion, were published as
ship. In his introductory paper, Weis (1998a), having
abook(Bancroft2000a).Thecontrastswereveryevident
reviewed the evidence, concluded that the majority of
both in the papers and the discussion, and the book
the sex research literature had no explicit theoretical
includes an overview and my personal conclusions as
base.Inhisconcludingpaper,Weis(1998b)gavehisper-
organizer and editor.
sonal evaluation of a wide range of theoretical models
A number of themes emerged from this meeting that
which were of potential relevance to sex research.
will be examined closely.
Although he found many of them relevant, very little
use had been made of them by sex researchers. This
widespread lack of a theoretical base can be regarded Essentialism and the tolerance
as a major limitation to the field. This chapter is not of uncertainty
intended to review the relevant theoretical models, but
rather to explore the role that theory can play in sex Much of the epistemological divide in the field of sex
research, and provide a rationale for the theoretical research stems from a postmodern reaction to the
approaches used in this book. alleged ‘certainty’ of conventional science. This divide
In 1993 Paul Abramson, Gilbert Herdt and Steven has typically been characterized as a conflict between
Pinkerton organized a conference entitled ‘Theorizing essentialism and social constructionism. However, as
sexuality: evolution, culture and development’. Papers DeLamater & Hyde (1998) pointed out, the concept of
were circulated in advance, and the conference was essentialism,inmuchoftherelevantliterature,hascome
spent discussing them. Most of the papers from this tobeusedinanill-definedandvariablefashion,oftenby
meeting were published as a book, Sexual Nature, Sexual those critical of mainstream sex research, including the
Culture (Abramson & Pinkerton 1995), which included postmodernists. Essentialism in science, which can be
an overview of the discussions by Okami & Pendleton regarded as the search for the ‘truth’, forms only part
(1995). It had been the organizers’ hope to ‘move past ofmainstreamsexualscience.Popper(1957,1977)distin-
the influence of constricting dichotomies of sex/gender guished between methodological nominalists and meth-
(biology/culture) and essentialism/constructionism’ odologicalessentialists.Thenominalistseeksconjectural
(p.388),andfacilitateaparadigmshifttowardsabroader explanation, and tests the conjecture by exploring its
interdisciplinary study of human sexuality, which consequences,awareofthefactthatanysuchconjecture
attaches appropriate importance to non-reproductive or assumption can never be proved correct, or ‘estab-
sex. In considering non-reproductive sex they pointed lished’asPopperputit(1977).Themethodoftheessen-
out the neglect of scholarly attention to sexual pleasure. tialist, in sharp contrast, is ‘the intuitive grasp of the
Clearly, there was vigorous debate and little agreement. essence...here intuition implies infallible insight’
Tuzin (1995), one of the anthropologist participants, (Popper1977,p.172).Iwouldargue,however,thatboth
stood out as someone advocating an interactionist types of researcher are to be found amongst conven-
perspective, seeing human sexuality as an interaction tional andsocial constructionist sex researchers.The fac-
between biological mechanisms and cultural processes. tors that lead to an individual becoming a conventional
In 1998, a workshop was held at The Kinsey Institute researcher or social constructionist are of interest, and
on‘TheRoleofTheoryinSexResearch’.Inthiscase,the Weis (1998b) listed them on his research agenda for the
objective was to select a series of themes and to invite future. But I am also intrigued by what determines
participants with contrasting theoretical perspectives to whether an individual is a nominalist or an essentialist.
5
2
6 Human sexuality and its problems
Is it a matter of disciplinary background and influence, differences.’(Lillie1939,p.3).Thisstatementisstillper-
personality, cognitive style or, more specifically, toler- tinent today and, interestingly, is as pertinent to a bio-
ance of uncertainty? logical as it is to a social constructionist perspective.
This confronts us with different kinds of knowledge.
Reality Harris (1979), in his anthropological conceptualization
of culture (cultural materialism), proposed the distinc-
Stemmingfromessentialismistheissueofreality.What tion between ‘emic’ knowledge, that ‘the native accepts
is‘real’andhowitisrecognizedassuchhasbeenoneof asreal,meaningfulandappropriate’,and‘etic’,referring
the most fundamental issues in philosophy. In recent to concepts and categories used by the expert or scien-
years we have seen a growing divide between conven- tist. This distinction has given way in anthropology to
tional sex researchers and social constructionists. the insider versus outsider distinction of Geertz (1983).
Conventional sexual scientists are alleged to attribute Escoffier (1999) proposed that vernacular knowledge,
reality to the biological basis of human sexuality. The common sense, everyday knowledge and local knowl-
social constructionists, in countering this, point to the edge were all equivalent to insider knowledge, and
social construction of sexuality and how it has changed pointedout thatthe differencebetweeninsiderandout-
through history. Popper’s (1957) views are again rele- sider knowledge is much more blurred in a modern
vant.‘Methodologicalessentialistsareinclinedtoformu- industrialsociety.HequotesGramsci:‘Everyphilosoph-
late scientific questions in such terms as “what is ical current leaves behind a sedimentation of “common
matter?”...Methodological nominalists, as opposed to sense”: this is the documentation of its historical effecti-
this, would put their problems in such terms as “how veness...Common sense is not something rigid or
doesthispieceofmatterbehave?”...thatthetaskofsci- immobile, but is continually transforming itself, enrich-
ence is only to describe how things behave.’ (p. 29). ingitselfwithscientificideasandphilosophicalopinions
Some social constructionists point out that sexuality, at that have entered everyday life’ (Gramsci 1971, p. 316).
least for humans, is a social construct, (the ‘what is’ We can look back over history and see how science
approach). It is noteworthy that in the last few years has informed common sense only to be shown to be
there has been an increased attention to the ‘what is’ wrong by later scientific progress. We should therefore
type of question among conventional sex researchers, keep in mind that whether we are a ‘native’ or a social
possibly a consequence of the social constructionist cri- constructionist, or a conventional scientist, we construct
tiques, e.g. ‘what is sexual desire’, with the somewhat our view of reality, and as a conjectural scientist, we
embarrassed acknowledgment that we can’t really say, shouldremainhumbleanduncertainaboutthat‘reality’,
although there are many related ‘how’ and ‘why’ ques- judgingitsworthnotbyitstruthbutbythebenefitsthat
tions that have been and are being addressed. We will it brings.
confront this issue explicitly later in this chapter, when As a behavioural endocrinologist, I am interested in
we ask the question, ‘What is human sexuality?’. Hope- the interface between psychological and physiological
fully, in the process, this will demonstrate that there mechanisms in human sexuality. We are increasingly
canbebenefitsfromboththeessentialistandnominalist aware of extensive discoveries in many aspects of brain
approaches provided their limitations are kept in mind. function with, for example, increasing knowledge of
Thereisgoodanthropologicalevidencethatsexuality neurotransmitters, new methods for tracking neural
and gender have been constructed differently across pathways, new techniques for identifying hormone
societies and through history (e.g. Ortner & Whitehead receptors, and the introduction of brain imaging to
1981).Butletuslookatthisconceptofconstructionmore explore localization of brain activity during response to
closely. We can see that how we have conceptualized sexual stimuli. However, from our perspective, this
most aspects of nature and our environment has been new information increases the complexity rather than
‘constructed’ dependent on the level of relevant know- ourcomprehensionofwhatwearetryingtograsp.Each
ledge available. Thus the idea that the world was flat phase of scientific progress, it would seem, uncovers a
persisteduntilconvincingevidencethatitwasnotinflu- new layer of complexity, challenging us with the ques-
encedcommonknowledge.Morerecently,andatleastin tion, ‘Will we ever really understand how our brains
more educated social groups, we can see constructs of work?’Weareawarethatthisreactiontoscientificprog-
gender difference become shaped by the accumulation ress is far from new, and is in no way an argument
ofscientificevidence,e.g.theworkofJost(1965)demon- against further scientific research. But there is a need to
strating the bi-potentiality of gender development with, counter the fragmentation that inevitably results, with
at least in the mammal, female development being the researchers becoming more and more specialized in
defaultmode.However,aslongagoas1939,FrankLillie their focus and increasingly distanced from any holistic
wroteintheintroductiontothesecondeditionofSexand view of brain function and its relationship to human
Internal Secretions, ‘There is no such biological entity as behaviour.Thereareplacesforatleasttwotypesofsex-
sex. What exists is a dimorphism...into male and ual scientist (and indeed of any scientist studying
female individuals...in any given species we recog- human behaviour), one focusing in depth on specific
nizeamaleformandafemaleform,whetherthesechar- aspects,theotherstrivingforsomebroadconceptualiza-
acters be classed as of biological, or psychological or tionofhumansexuality.Forthelatter,thereisaneedto
social orders. Sex is not a force that produces these con- seek explanatory models or ‘conceptual systems’, which
trasts.Itismerelyanameforourtotalimpressionofthe are,atbest,simplificationsofreality,andwhosevalidity