Table Of ContentHuman Sexuality
in a Changing World
TenTh ediTion
Spencer A. Rathus
The College of New Jersey
Jeffrey S. Nevid
St. John’s University
Lois Fichner-Rathus
The College of New Jersey
330 Hudson Street, NY NY 10013
VP, Editorial: Eric Stano
Marketing Manager: Christopher Brown
Program Manager: Erin Bosco
Managing Editor: Marita Bley
Project Coordination, Text Design,
and Electronic Page Makeup: Integra Software Services, Inc.
Cover Designer: JayBird Design
Cover Art: Piotr Marcinski/Fotolia
Manufacturing Buyer: Carol Melville
Printer/Binder: R.R. Donnelley Roanoke
Cover Printer: Lehigh Phoenix Color/Hagerstown
Acknowledgments of third-party content appear on pages 583–584, which constitute an extension of this copy-
right page.
PEARSON, ALWAYS LEARNING, and REVEL are exclusive trademarks in the United States and/or other
countries owned by Pearson Education, Inc., or its affiliates.
Unless otherwise indicated herein, any third-party trademarks that may appear in this work are the property
of their respective owners and any references to third-party trademarks, logos, or other trade dress are for
demonstrative or descriptive purposes only. Such references are not intended to imply any sponsorship,
endorsement, authorization, or promotion of Pearson’s products by the owners of such marks, or any
relationship between the owner and Pearson Education, Inc., or its affiliates, authors, licensees, or distributors.
Library of Congress Cataloging-in-Publication Data
Names: Rathus, Spencer A., author. | Nevid, Jeffrey S., author. |
Fichner-Rathus, Lois, 1953- author.
Title: Human sexuality in a changing world/Spencer A. Rathus, Jeffrey S.
Nevid, Lois Fichner-Rathus.
Description: Hoboken, NJ : Pearson Higher Education, [2018]
Identifiers: LCCN 2016041031| ISBN 9780134525068 | ISBN 013452506X
Subjects: LCSH: Sex.
Classification: LCC HQ21 .R23 2018 | DDC 306.7—dc23 LC record
available at https://lccn.loc.gov/2016041031
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All Rights Reserved. Printed in the United States of
America. This publication is protected by copyright, and permission should be obtained from the publisher prior
to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, elec-
tronic, mechanical, photocopying, recording, or otherwise. For information regarding permissions, request forms
and the appropriate contacts within the Pearson Education Global Rights & Permissions Department, please visit
www.pearsoned.com/permissions/.
1 17
Student Edition
ISBN 10: 0-134-52506-X
www.pearsonhighered.com ISBN 13: 978-0-134-52506-8
Dedicated to Our Children
Brief Contents
1 What Is Human Sexuality? 1 9 Conception, Pregnancy,
and Childbirth 265
2 Female Sexual Anatomy
and Physiology 40 10 Contraception and Abortion 306
3 Male Sexual Anatomy 11 Sexuality Through the Lifespan 343
and Physiology 79
12 Sexual Problems and Solutions 383
4 Gender: Identity, Roles,
Differences 106
13 Sexually Transmitted Infections 413
5 Sexual Orientation 139
14 Atypical Sexual Variations 449
6 Attraction and Love 174
15 Sexual Coercion 476
7 Sexual Response and Sexual
Behavior 200 16 Selling Sex 512
8 Relationships and Communication 241
Contents
Feature Boxes xi The Urethral Opening 45
Preface xiii The Vaginal Opening 46
The Perineum 47
1 What Is Human Sexuality? 1
Structures That Underlie the External Sex Organs 47
Learning Objectives 1 Internal Sex Organs 48
The Science of Human Sexuality 4 The Vagina 48
The Study of Human Sexuality 4
A Closer Look The G Spot and Female Ejaculation:
Sexuality and Values 5 Realities or Myths? 49
Value Systems for Making Sexual Decisions 5 The Cervix 51
Thinking Critically about Human Sexuality 6 The Uterus 52
Perspectives on Human Sexuality 7 The Fallopian Tubes 53
The Historical Perspective 7 The Ovaries 54
The Pelvic Examination 55
Sex in the Digital Age Thinking Critically about
The Breasts 56
Sexual Advice on the Internet 8
Breast Cancer 58
Sex in A World of Diversity “Boy Play” in Afghanistan 11
The Biological Perspective 16 A Closer Look Breast Self-Examination 60
The Evolutionary Perspective 16 Sex in A World of Diversity African American
The Cross-Species Perspective 17 Women and Breast Cancer 62
Sociological Perspectives 17 The Menstrual Cycle 62
A Closer Look The 13 Basic Reasons for Having Sex 18 Sex in A World of Diversity Historical and
Psychological Perspectives 20 Cross-Cultural Perspectives on Menstruation 63
Feminist Theory 21 Regulation of the Menstrual Cycle 64
Queer Theory 22 Phases of the Menstrual Cycle 65
Multiple Perspectives on Human Sexuality 23 Sex During Menstruation 69
Research Methods in Human Sexuality 24 Menopause, Perimenopause, and the Climacteric 69
The Scientific Method 24
Sex in the Digital Age Experiencing The Symptoms
Populations and Samples: Representing
of Menopause? There’s an App for That 70
the World of Diversity 25
Hormone Replacement Therapy: Good Medicine
Methods of Observation 27
or Menace? 71
A Closer Look Although Viagra Works for Women,
A Closer Look Myths about Menopause 72
It Doesn’t Work for Women 33
Menstrual Problems 73
Correlation 34
Dysmenorrhea 73
The Experimental Method 35
Amenorrhea 74
Ethics in Research on Human Sexuality 36
Premenstrual Syndrome (PMS) and Premenstrual
Chapter Review 38 • Test Your Learning 39
Dysphoric Disorder (PMDD) 74
2 Female Sexual Anatomy How to Handle Menstrual Discomfort 75
Chapter Review 77 • Test Your Learning 78
and Physiology 40
3 Male Sexual Anatomy and Physiology 79
Learning Objectives 40
External Sex Organs 41 Learning Objectives 79
The Mons Veneris 42 External Sex Organs 81
The Labia Majora 42 The Penis 81
The Labia Minora 43
Sex in the Digital Age Sexinfo Online—Penis Enlargement? 86
The Clitoris 43
The Scrotum 87
Sex in A World of Diversity Female Genital Mutilation 44 Internal Sex Organs 87
The Vestibule 44
The Testes 87
v
vi Contents
The Vas Deferens 89 Psychological Androgyny and the Reconstruction of
The Seminal Vesicles 90 Masculinity–Femininity: The More Traits, the Merrier? 135
The Prostate Gland 90 Chapter Review 137 • Test Your Learning 138
A Closer Look Low T, Andropause, or Male 5 Sexual Orientation 139
Menopause? Age-Related Male Hypogonadism
By Any Other Name Is Just As Unsettling 91 Learning Objectives 139
Cowper’s Glands 92
Getting Oriented toward Sexual Orientation 140
Semen 92
Coming to Terms with Terms 141
Health Problems of the Urogenital System 92 Sexual Orientation, Sexual Identity,
Urethritis 92 and Heteronormativity 141
Cancer of the Testes 93 Classification of Sexual Orientation: Is Yes
Benign Prostatic Hyperplasia (BPH) 94 or No Enough? 142
Prostatitis 94 How Many People, Then, Are Heterosexual,
Homosexual, and Bisexual? 144
Cancer of the Prostate 95
A Challenge to the Kinsey Continuum: How Many
A Closer Look Prostate Cancer: Treat It or Wait Dimensions of Sexual Orientation Are There? 147
It Out? 98
Bisexuality 148
Male Sexual Functions 98
Perspectives on Sexual Orientation 149
Erection 98
Historical Perspectives 149
Spinal Reflexes and Sexual Response 99
Cross-Cultural Perspectives 150
Ejaculation 102
Cross-Species Perspectives 150
Chapter Review 104 • Test Your Learning 105
Sex in A World of Diversity Ethnicity and Sexual
4 Gender: Identity, Roles, Differences 106 Orientation: A Matter of Belonging 151
Biological Perspectives 152
Learning Objectives 106
A Closer Look Pheromones and Sexual Orientation 155
Prenatal Sexual Differentiation 107
Psychological Perspectives 156
Genetic Factors in Sexual Differentiation 109
Gender Nonconformity 157
The Role of Sex Hormones in Sexual Differentiation 110
Sexual Orientation in Contemporary Society 158
Descent of the Testes and the Ovaries 110
Sexual Orientation and the Law 159
Sex Chromosomal Abnormalities 111
Activism 159
Gender Identity 111
Stereotypes and Sexual Behavior 160
Nature and Nurture in Gender Identity 112
Sex in the Digital Age Grindr 161
A Closer Look XY Boys Who Are Reared As Girls 114
Adjustment of Lesbians and Gay Males 162
Being Transgender 115
Gender Reassignment 117 A Closer Look Lesbian and Gay Male Parents
and Their Families 163
Sex in the Digital Age Gender-Hacking On OkCupid 119
Homophobia 164
Gender Roles and Stereotypes 119
“Treatment” of Gay Male and Lesbian
Sexism 120
Sexual Orientations 165
Gender Roles and Sexual Behavior 121
Coming Out 165
Sex in A World of Diversity Third Gender/Third Sex 122 Same-Sex Marriage 168
Gender Differences 123 Following the Supreme Court Decision . . . 169
Differences in Cognitive Abilities 123 Changing Attitudes toward Same-Sex Marriage 170
Chapter Review 172 • Test Your Learning 173
Sex in A World of Diversity Women in STEM Fields 126
Differences in Personality 126 6 Attraction and Love 174
Differences in Social Behavior 127
Gender Typing: Origins of Gender Differences 127 Learning Objectives 174
Biological Perspectives: It’s Only Natural 128 Physical Attractiveness: Flooding the Senses
with Attraction 175
Sex in A World of Diversity The Eye That Roves
Is Beauty in the Eye of the Beholder? 176
Around The World? 130
Psychological Perspectives 130 Sex in A World of Diversity Wide-Eyed with . . . Beauty? 177
Contents vii
A Closer Look The Allure of the Color Red 178 The Female-Superior (Woman-on-Top) Position 233
The Lateral-Entry (Side-Entry) Position 234
A Closer Look Thin May Be In, But Not With Bust Size 180
The Rear-Entry Position 235
Smell: Does the Nose Know Best? 181
Anal Intercourse 235
A Closer Look Strippers: A Treat for The Eyes
Sexual Fantasies 236
or The Nose? 182
Chapter Review 239 • Test Your Learning 240
Nonphysical Traits Affect Feelings of Attraction 184
The Attraction–Similarity Hypothesis: Who is “Right” 8 Relationships and Communication 241
for You? 185
Attitudes: Do “Opposites Attract” or Do “Birds of Learning Objectives 241
a Feather Flock Together”? 186 Beginning Relationships 243
Hooking Up 245
Sex in the Digital Age For Nice Jewish Boys,
Developing Intimacy: Sharing Innermost Thoughts
Swipe Right 187
and Feelings 247
Love: “The Morning and the Evening Star”? 188
Romantic Love 189 Sex in the Digital Age Swiping Right to Hook Up:
Infatuation versus “True Love”: Will Time Tell? 190 Are We Heading Toward A Dating Apocalypse? 248
Contemporary Models of Love: Dare Science Jealousy: Is the World a Real-Life Temptation Island? 251
Intrude? 190 Jealousy and Evolutionary Theory 251
Biological Mechanisms 190 Lack of Sex Differences in Responses to Affairs
Among Gay Males and Lesbians 252
Love as Appraisal of Arousal 191
A Cognitive Perspective on Jealousy 252
Styles of Love 191
Communicative Responses to Jealousy 252
Sternberg’s Triangular Theory of Love 192
Loneliness 253
Self-Assessment Sternberg’s Triangular Love Scale 196
Effects of Loneliness 253
Chapter Review 198 • Test Your Learning 199
Sexual Communication 254
7 Sexual Response and Sexual Conflict Resolution 255
Behavior 200 Communication Skills for Enhancing Relationships:
How to Do It 255
Learning Objectives 200
Sex in A World of Diversity Relationship Satisfaction
Sexual Response 201 Among LBGT Couples 256
The Four-Phase Masters and Johnson Sexual Chapter Review 263 • Test Your Learning 264
Response Cycle 201
Kaplan’s Three Stages of Sexual Response: 9 Conception, Pregnancy,
An Alternative Model 207
and Childbirth 265
Controversies about Orgasm 207
Effects of Drugs on Sexual Arousal 209 Learning Objectives 265
Erogenous Zones and the Brain 213 Conception: Against All Odds 267
Sex Hormones and Sexual Response 215 Optimizing the Chances of Conception 268
Sex without a Partner 218
Sex in the Digital Age Fertility and Period
Historical Medical Views of Masturbation 219
Trackers 269
A Closer Look Good Vibes 220 Selecting the Sex of Your Child 269
Masturbation Techniques 222 Infertility and Assisted Reproductive Technology 270
Techniques Used by Females 223 Male Fertility Problems 270
Female Fertility Problems 272
Sex in the Digital Age Sex With Her 223
Sex with a Partner 225 Sex in A World of Diversity LGBT Family Building 273
Precoital and Noncoital Partnered Sex 225 Pregnancy 275
Kissing 226 Early Signs of Pregnancy 275
Touching 227 Pregnancy Tests 275
Stimulation of the Breasts 228 Early Effects of Pregnancy 276
Oral–Genital Stimulation 228 Miscarriage 276
Sexual Intercourse: Positions and Techniques 231 Sex During Pregnancy 277
The Male-Superior (Man-on-Top) Position 233 Psychological Changes During Pregnancy 277
viii Contents
Prenatal Development 279 Sterilization 327
Stages of Prenatal Development 279 Male Sterilization 327
Environmental Influences on Prenatal Development 283 Female Sterilization 328
Advantages and Disadvantages of Sterilization 329
A Closer Look Preventing Your Baby From Being
Infected with HIV 285 A Closer Look Selecting a Method of Contraception 330
Chromosomal and Genetic Abnormalities 289 “Non-Methods” of Contraception 331
A Closer Look The Effects of Parents’ Age on Children: Douching 331
Do Men Really Have All The Time in The World? 291 The Withdrawal Method 332
Childbirth 291 Abortion 332
Stages of Childbirth 292 Perspectives on Abortion 333
Methods of Childbirth 294
Self-Assessment Pro-Choice or Pro-Life?
Birth Problems 297 Where Do You Stand? 334
Sex in A World of Diversity Maternal and Infant When Does Human Life Begin? 335
Mortality Around the World 298 Attitudes Toward Legalized Abortion: A Nation
Divided 335
The Postpartum Period 300
Methods of Abortion 337
Psychological Issues Women Encounter During
the Postpartum Period 300 Vacuum Aspiration 337
Breastfeeding Versus Bottle-Feeding 301 Dilation And Curettage (D&C) 337
Resumption of Ovulation and Menstruation 303 Dilation And Evacuation (D&E) 338
Resumption of Sexual Activity 303 Inducing Labor by Intra-Amniotic Infusion 338
Chapter Review 304 • Test Your Learning 305
A Closer Look The Political Battle Over Partial-Birth
Abortion 339
10 Contraception and Abortion 306
Hysterotomy 339
Learning Objectives 306 Abortion Drugs 339
Chapter Review 341 • Test Your Learning 342
Contraception 308
Contraception in the United States: The Political
Battle 309 11 Sexuality Through the Lifespan 343
Methods of Contraception 309
Hormonal Methods of Contraception 310 Learning Objectives 343
Oral Contraceptives (“The Pill”) 310 Childhood 344
The “Morning-After” Pill: The “Emergency Infants’ Sexual Response 344
Contraceptive” 313 Co-Sleeping 345
The Contraceptive Patch 314 Early Childhood (3 to 8 Years) 346
Injectable Contraceptives 314
A Closer Look How Should Parents React
Intrauterine Contraception (IUC) Devices 314
When Children Masturbate? 347
Under-the-Skin Implants 316
Preadolescence (9 to 13 Years) 347
Barrier Methods of Contraception 316
Masturbation 348
The Diaphragm 316
Male–Female Sexual Behavior 348
Spermicides 318
Male–Male and Female–Female Sexual Behavior 348
The Contraceptive Sponge 319
Sex Education 349
The Cervical Cap 319
Adolescence 350
The Condom 320
Puberty 351
A Closer Look Errors in Using Condoms 321
Sex in A World of Diversity The Many Meanings
A Closer Look Don’t Like Your Condom? Try of Menarche 353
the “Condom Buffet” 323
Sex in the Digital Age Sexting: Of Cell Phones,
Fertility Awareness Methods of Contraception 324 Sex, and Death 355
The Calendar Method 324 Types of Sexual Behaviors in Adolescence 356
The Basal Body Temperature (BBT) Method 325 Teenage Pregnancy 359
The Cervical Mucus (Ovulation) Method 325
Adulthood 360
Sex in the Digital Age Using Apps to Predict Being Single 360
Safe Periods for Sex 326 Cohabitation: Living Together 362
Contents ix
Marriage: Tying the Knot 364 A Closer Look Preventing HIV Infection
Infidelity 370 with Truvada 435
Genital Herpes 436
Sex in the Digital Age What Happens When Your
Human Papillomavirus 438
Extramarital Affair Becomes Exposed to 7 Billion
Viral Hepatitis 440
People, Give or Take a Few? 372
Zika 441
Divorce: Breaking Bonds 373
Molluscum Contagiosum 441
Sex in the Later Years 375
Physical Changes 375 Ectoparasitic Infestations 441
Patterns of Sexual Activity 378 Pediculosis 441
Scabies 442
Sex and Disability 378
Physical Disabilities 379 Preventing STIs: It’s More Than Safer Sex 443
Chapter Review 381 • Test Your Learning 382 Abstinence or Monogamy 443
Know About the Risks 443
12 Sexual Problems and Solutions 383 Stay Sober 444
Inspect Yourself and Your Partner 444
Learning Objectives 383 Use Latex Condoms 444
Types of Sexual Problems 386 Use Barrier Devices During Oral Sex 445
Sexual Problems Relating to Lack of Interest or Desire 386 Avoid Risky Sex 445
Sexual Problems Relating to Becoming Aroused 387 Wash the Genitals Before and After Sex 445
Sexual Problems Relating to Orgasm 388 Have Regular Medical Checkups 445
Sexual Pain 390 Discuss Whether You and Your Partner Should
Origins of Sexual Problems 392 Be Tested Before Having Sex 445
Biological Factors 392 Engage in Forms of Sex Other than Intercourse
and Oral–Genital Contact 446
Psychosocial Factors 396
Talk to a Doctor If You Suspect That You Have
Solutions 399
Been Exposed to an STI 446
The Masters and Johnson Approach 399
Get to Know Your Partner Before Having Sex 446
Integration of Sex Therapy and Psychotherapy 400
Avoid Other High-Risk Behaviors 446
The Treatment of Specific Sexual Problems 400
Chapter Review 447 • Test Your Learning 448
A Closer Look The “Little Pink Pill” for Women 401
Sex in the Digital Age Thinking Critically About 14 Atypical Sexual Variations 449
Buying Viagra, Cialis, and Other Drugs Online 405
Learning Objectives 449
A Closer Look Is Viagra for Women? 409
Normal Versus Deviant Sexual Behavior 451
Sexual Pain 410
Paraphilic Disorders 452
Chapter Review 411 • Test Your Learning 412
Fetishistic Disorder 453
Exhibitionistic Disorder 455
13 Sexually Transmitted Infections 413
Voyeuristic Disorder 458
Sexual Masochism Disorder 459
Learning Objectives 413
Bacterial Infections 416 Sex in the Digital Age Total Web Cam Domination 460
Gonorrhea 416 Sexual Sadism Disorder 461
Syphilis 419 Frotteuristic Disorder 463
Chlamydia 423
A Closer Look Women from the “Kink” Community 463
Other Bacterial Diseases 425
Other Paraphilic Disorders 464
A Closer Look Sex and the Single (Infected) Senior 425 Theoretical Perspectives 465
Vaginal Infections 426
Sex in the Digital Age Cybersex Addiction:
Bacterial Vaginosis 427
For Some, Sex Is Nothing But ‘Net 466
Candidiasis 427
Biological Perspectives 466
Trichomoniasis 428
Psychoanalytic Perspectives 468
Viral Infections 428
Cognitive-Behavioral Perspectives 469
HIV/AIDS 428
Sociological Perspectives 470
A Closer Look Is Kissing Safe? 434 An Integrated Perspective: The “Lovemap” 470
