Table Of ContentSEXUALITY AND MEDICINE
Volume II
PHILOSOPHY AND MEDICINE
Editors:
H. TRISTRAM ENGELHARDT, JR.
Center for Ethics, Medicine, and Public Issues,
Baylor College of Medicine, Houston, Texas, U.S.A.
STUART F. SPIeKER
School of Medicine, University of Connecticut Health Center,
Farmington, Connecticut, U.S.A.
VOLUME 23
SEXUALITY AND
MEDICINE
Volume II: Ethical Viewpoints in Transition
Edited by
EARL E. SHELP
Institute of Religion, and
Center for Ethics, Medicine, and Public Issues,
Baylor College of Medicine,
Houston, Texas, U.S.A.
D. REIDEL PUBLISHING COMPANY
ACADEMIC PUBLISHERS GROUP
DORDRECHT/BOSTON/LANCASTER/TOKYO
Library of Congress Cataloging-in-Publication Data
(Revised for voI. 2)
Sexuality and medicine.
(Philosophy and medicine ; v. 22-23)
Includes bibJiographies and index.
Contents: v. 1. Conceptual roots - v. 2. Ethical
viewpoints in transition.
1. Sex (Psychology)-Collected works. 2. Medicine
and psychology-Collected works. 1. Shelp, Earl, E.,
1947- . II. Series.
BF692.S4347 1987 306.7 86-26201
ISBN 978-1-55608-016-6 ISBN 978-94-015-3943-2 (eBook)
DOI 10.1007/978-94-015-3943-2
Published by D. Reidel Publishing Company,
P.O. Box 17,3300 AA Dordrecht, Holland.
Sold and distributed in the U .S.A. and Canada
by Kluwer Academic Publishers,
101 Philip Orive, Norwell, MA 02061, U.S.A.
In ali other countries, sold and distributed
by Kluwer Academic Publishers Group,
P.O. Box 322, 3300 AH Dordrecht, HolIand.
AII Rights Reserved.
© 1987 by D. Reidel Publishing Company, Dordrecht, Holland
Softcover reprint of the hardcover ist edition 1987
No part of the material protected by this copyright notice may be reproduced
or utilized in any form or by any means, electronic or mechanical,
inc1uding photocopying, recording or by any information storage and
retrieval system, without written permission from the copyright owner.
TABLE OF CONTENTS
Volume II
CHRISTIE HEFNER / Foreword ix
NANCY N. DUBLER / Preface Xlll
EARL E. SHELP / Introduction xxi
SECTION I: REPRODUCTION, MEDICINE, AND
MORALS
MARY ANN GARDELL / Sexual Ethics: Some Perspectives
from the History of Philosophy 3
SARA ANN KETCHUM / Medicine and the Control of Repro-
duction 17
LISA SOWLE CAHILL / On the Connection of Sex to Repro-
duction 39
H. TRISTRAM ENGELHARDT, JR. / Having Sex and Making Love:
The Search for Morality in Eros 51
SECTION II: SOCIETY, SEXUALITY, AND MEDICINE
JOHN DuFFY / Sex, Society, Medicine: An Historical Comment 69
ROBERT BAKER / The Clinician as Sexual Philosopher 87
FREDERICK SUPPE / The Diagnostic and Statistical Manual of
the American Psychiatric Association: Classifying
Sexual Disorders 111
JOSHUA GOLDEN / Changing Life-Styles and Medical Practice 137
v
vi TABLE OF CONTENTS
NELLIE P. GROSE AND EARL E. SHELP / Human Sexuality:
Counselling and Treatment in a Family Medicine
Practice 155
J. ROBERT MEYNERS / Sex Research and Therapy: On the
Morality of the Methods, Practices and Procedures 171
SECTION III: RELIGION, MEDICINE, AND MORAL
CONTROVERSY
PAUL D. SIMMONS / Theological Approaches to Sexuality:
An Overview 199
JAMES J. MCCARTNEY / Contemporary Controversies in
Sexual Ethics: A Case Study in Post-Vatican II
Moral Theology 219
ROBERT H. SPRINGER / Transsexual Surgery: Some
Reflections on the Moral Issues Involved 233
RONALD M. GREEN / The Irrelevance of Theology for Sexual
Ethics 249
NOTES ON CONTRIBUTORS 271
INDEX 273
TABLE OF CONTENTS
Volume I
WILLIAM H. MASTERS AND VIRGINIA E. JOHNSON-MASTERs/Foreword ix
ALAN SOBLE / Preface: Changing Conceptions of Human Sexuality xi
EARL E. SHELP / Introduction xxv
SECTION I: HUMAN SEXUALITY
ROBERT C. KOLODNY / Medical and Psychiatric Perspectives on a 'Healthy
Sexuality' 3
TABLE OF CONTENTS VB
FREDERICK SUPPE / Medical and Psychiatric Perspectives on Human Sexual
Behavior 17
STEPHEN B. LEVINE/The Origins of Sexual Identity: A Clinician's View 39
LESLIE M. LOTHSTEIN / Theories of Transsexualism 55
VERN L. BULLOUGH / Sex Research and Therapy 73
FRITZ K. BELLER / A Survey of Human Reproduction, Infertility Therapy,
Fertility Control and Ethical Consequences 87
SECTION II: SEXUALITY AND SEXUAL CONCEPTS
ALAN SOBLE / Philosophy, Medicine, and Healthy Sexuality 111
JOSEPH MARGOLIS / Concepts of Disease and Sexuality 139
JEROME NEU / Freud and Perversion 153
SANDRA HARDING / The Politics of the Natural: The Case of Sex Differences 185
ROBERT C. SOLOMON / Heterosex 205
ELI COLEMAN / Bisexuality: Challenging our Understanding of Human Sexuality
and Sexual Orientation 225
PETER ROBERT BREGGIN / Sex and Love: Sexual Dysfunction as a Spiritual
Disorder 243
NOTES ON CONTRIBUTORS 267
INDEX 268
FOREWORD
It may be unnecessary to some to publish a text on sexuality in 1986
since the popular press speaks of the sexual revolution as if it were over
and was possibly a mistake. Some people characterize society as too
sexually obsessed, and there is an undercurrent of desire for a return to
a supposedly simpler and happier time when sex was not openly dis
cussed, displayed, taught or even, presumedly, contemplated.
Indeed, we are experiencing something of a backlash against open
sexuality and sexual liberation. For example, during the '60s and '70s
tolerance of homosexual persons and homosexuality increased. Of late
there has been a conservative backlash against gay-rights laws. Sexual
intercourse before marriage, which had been considered healthy and
good, has been, of late, characterized as promiscuous. In fact, numer
ous articles have appeared about the growing popularity of sexual
abstinence. There is a renewed vigor in the fight against sex education in
the schools, and an 'anti-pornography' battle being waged by those on
the right and those on the left who organize under the guise of such
worthy goals as deterring child abuse and rape, but who are basically
uncomfortable with diverse expressions of sexuality.
One would hope that such trends, and the ignorance about sex and
sexuality that they reflect, would not touch medical professionals. That
Dr. Earl Shelp has spent years gathering these essays on sexuality and
medicine only goes to underscore the sad reality that medicine is not
immune to these regressive trends. Professor Shelp's interest in this
collection grew out of observations during clinical work that many
concepts of human sexuality were poorly understood by faculty and,
consequently, students were either kept in ignorance or misinformed.
Moreover, he found that historical and conceptual judgments concern
ing human sexuality tended to be myopic as clinicians perpetuated the
received tradition uncritically. Consequently, what are taught as medi
cal truths may actually be religious, philosophical, or cultural precepts,
not based on scientific reality.
ix
Earl E. Shelp (ed.), Sexuality and Medicine, Vol. II, ix-xi.
© 1987 by D. Reidel Publishing Company.
x FOREWORD
This comprehensive text calls to the attention of physicians the
relationship of conceptual understandings to normative judgments in
the area of sexuality. In spite of the sexual revolution, it appears that in
the main today's medical students and practicing physicians perpetuate
arbitrary judgments about normal and abnormal sexuality; they are
highly judgmental about practices that do not conform to their own; and
they are ignorant of the variety of possible human sexual expression.
The devastating results of these attitudes are obvious throughout our
culture. Moral judgments about sex should not be expressed as scientific
absolutes in a pluralistic society that values self determination and
individual freedom.
This fundamental American belief in individual freedom is one that
has concerned my father, Hugh Hefner, for thirty years. It is expressed
in Playboy magazine and in the work of the Playboy Foundation. In the
early 1960s, a series of editorials penned by him and termed the
'Playboy Philosophy' offered a historical overview of individual free
dom, particularly sexual freedom, and argued passionately for the right
of individuals to be free of governmental or religiously imposed moral
ity.
Through the Playboy Foundation, Hefner put his money where his
mouth was. It made the initial grant to establish an Office of Research
Services of the Sex Information and Education Council of the U.S.
(SEICUS) in the late '60s. And in 1971, Playboy awarded a grant to
establish a pilot program at the University of Minnesota to develop
curricula for changing the attitudes of men and women medical
students. The premise of the program, as stated in the grant proposal,
was:
While the physician is most frequently consulted in sexual matters, he is woefully
ill-prepared to handle them. The recent graduate of medical school is often in the difficult
position of an 'expert' who knows less about his subject than his patient. Medical students,
by nature of their social and economic background, personality types, and scientific
training, are traditionally among the most inhibited, threatened, naive and anxiety-ridden
of professional students. Unfortunately, even the physician who is factually knowledge
able about human sexuality is often unable to use the information he possesses due to his
emotional response to the subject. Our premise is that much of any attitude toward
sexuality is based on myths regarding sexual behavior, and that perpetration of these
myths leads, at best, to unsound therapy and counseling, and at worst, to failure of the
M.D. to even acknowledge sexual problems.
The rationale for these volumes suggests that the state of medical
practice today is not much better than it was in 1971. Perhaps this is due
FOREWORD Xl
to a still present uncomfortable titillation that permeates medical inter
est in sexuality. In the '60s, when the Playboy Foundation became the
major research sponsor of the Masters & Johnson Institute, we did so,
not only because of the importance of the work, but also because it was
virtually impossible for the Institute to attract more traditional support
due to this attitude toward sexuality. Tragically, the Institute's situation
remains substantially similar today.
This superstition and embarrassment, which continues to cloud our
understanding of human sexuality, makes it critically important that
medical professionals, as well as social scientists, philosophers, theo
logians, and the general public be exposed to the insights and informa
tion on human sexuality that Professor Shelp has developed in this
book.
I hope that this text is widely used, since its subject is so important to
each of us.
Playboy Enterprises, Inc., CHRISTIE HEFNER
Chicago, illinois, U.S.A.
