Psychology of Human Sexuality Final

beyond typical love, abnormal love, unusual sexual interest that does not require treatment
paraphilic disorder
unusual sexual interest that is personally distressing to the individual or involves victimization of others
a nonhuman object, body part, or bodily secretion, multisensory sexual outlet
dressing up as a member of the other sex or seeing oneself as a member of the other sex for sexual arousal
receiving pain
giving pain to others
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spying on unsuspecting others who are undressing or having sex
exposing one’s genitals to unsuspecting others
Telephone scatologia
placing obscene telephone calls
prepubescent children
corpses or human bones
nonhuman animals
orgasmic reconditioning
client is instructed to masturbate to a paraphilic fantasy until the brink of orgasm, then instructed to think about more socially appropriate fantasy
aversive conditioning
psychologically pair the paraphilic desire with something unpleasant or punishing
covert sensitization
paraphilic desires are paired with unpleasant thoughts
masturbatory satiation
instructed to masturbate to orgasm while thinking of socially appropriate stimulus, upon climaxing, client instructed to start thinking about paraphilic desire, continued masturbation is likely to be unpleasant
sexual assault
any event in which a person is touched in a sexual way against person’s will or made to perform a nonconsensual sex act by one or more people
statutory rape
used to describe sexual assault against a minor
roofies, sedative used for sexual abuse
child sexual abuse
describes any instance in which a child is sexually victimized by an adult
CSA by someone related to the child
if abuse stems from sexual attraction to children
child molestation
broader term used to describe any type of sexual abuse against child by nonrelative
sexual harassment
unwanted verbal or physical sexual advances that occur in the workplace or in an academic environment
Direct influences on attraction
experiencing positive leads us to evaluate others positively → we like people who make us feel good
pointing out something negative about another person as a way of catching that person’s attention → not usually a good way of trying to attract another person
indirect influences on attraction
we indirectly transfer our existing emotional state onto new people we meet
Propinquity effect
the closer 2 people are physically, the greater the odds that they will meet and an attraction will develop between them → people are more likely to start relationships with others who are geographically near
mere exposure effect
the more familiar we become with a given stimulus (that starts off as neutral), the more we tend to like it
– Repeated exposure might also cause us to believe that another person has similar interests and our comfort with that person may increase
assortative mating
the tendency for people to match with partners who are similar to them on a variety of dimensions
social comparison theory
we are driven to obtain accurate evaluations of the self, so we constantly compare our attitudes and beliefs to other people in order to see how we stack up, but we are biased to view ourselves positively, so we try to make comparisons that enhance our self-image, meaning that we actively seek to surround ourselves with people who hold similar beliefs and attitudes because it validates our own worldview and raises our self-esteem
a necessary prerequisite for relationship success
Demographic dissimilarity
The tendency to pair with demographically dissimilar partners seems to have increased in recent years
Interracial marriage has tripled to 9% since the 80s
When a person’s availability decreases, their attraction increases
Pennebaker (1979): at closing time nears, people’s attractiveness ratings increase
Jonason and Li (2013): playing hard to get increases one’s desirability
physiological arousal
Meeting a new person when one is already physiologically aroused increases the likelihood of developing an attraction toward that person
Makes sense that gyms are a popular place to meet a partner
Misattribution of physiological arousal
when the true source of arousal is ambiguous (and there is more than one possible source of arousal), leading the person to incorrectly label the source
Neurochemical factors
Neurotransmitters and hormones may also impact perceptions of attractiveness
Your brain chemicals affect your general level of interest in sex at any given moment, which affects whether you are actively looking for partners and how you evaluate new people you meet
contributes to initial attraction and may also help sustain attraction over time by promoting reciprocal positive interactions
physical attractiveness
the degree to which we perceive another person as beautiful/handsome
Influenced by multiple factors
People weigh different factors differently
The relative value individuals ascribe to physical attractiveness overall varies according to personality
unrestricted sociosexual orientation
physical attractiveness more important
Perceptions of attractiveness
are also subject to social influence (our perception of physical attractiveness is linked with peers’ perceptions) and are context-dependent (we evaluate a person’s beauty in reference to other nearby people)
contrast effect
perceptions of average can be thrown off by the presence of a few outliers
attractive people
are stereotyped very positively (more likeable, interesting, competent, and successful)
physical attractiveness
might be a potential indicator of a person’s health and fertility
usually most important early in a relationship and declines in importance over time
– more important to men than to women (attractiveness is still important to women, just not as important as other factors)
Men prefer
younger partners with less earning potential and a lower level of education, while women prefer older partners with higher earning potential and a higher level of education
similarities in sexual attraction in homosexuals
Lesbian and heterosexual women and gay and heterosexual men don’t differ in importance of physical attractiveness
Gay/heterosexual men prefer younger partners
Important differences among homosexual
Effect whereby heterosexuals are more attracted to those who are similar to them is not as strong in homosexuals → more interracial, interreligious, differences in education and earning levels
Why? Smaller pool of eligibles.
Propinquity plays a lesser role in attraction among homosexuals
Since a smaller pool and more social stigma, homosexuals are more likely to search online for partners
Evolutionary theory
we have tendencies to behave in very specific ways because those actions were adaptive for the survival of our ancestors → humans are thought to have evolved preferences for certain characteristics in our partners that are ultimately designed to enhance reproductive success
parental investment
women have a higher investment (effort, time, and resources) in a baby than men do, and so men seek out as many sexual partners/encounters as possible to maximize the possibility of reproductive success, while women try to find a man who will stick around
Men are attracted to
women who exhibit signs of sexual maturity and good health → youth, low waist-to-hip ratio, bodily symmetry, and long, shiny hair
Men have become attuned to focus on appearance more than anything else because it is the most useful cue for enhancing their reproductive success
Women are attracted to men
who are older and have had the opportunity to acquire more resources
Physical attractiveness is less important, since most men are almost always fertile
But, women show a preference for masculine men when they are near ovulation (sign of a stronger immune system)
sociocultural perspective
biological and evolved factors play some role; however, psychological sex differences are largely a response to the social structure → as the social structure changes, so should the magnitude and direction of sex differences
In societies with more gender equality, men and women have similar partner preferences, BUT even in the most equal countries, the traditionally observed sex differences still appear to some degree
traditional sex differences in attraction and sexual behavior
become much smaller or disappear entirely when social/cultural variables are manipulated
Bogus pipeline technique
half of participants connected to a lie detector and those who were exhibited no sex differences
limitations of socio structural perspectives
Argues that psychological characteristics are immune to evolutionary pressures → dualism of body and mind
There is lots of evidence that some sex differences have a biological basis
need to belong
a near-universal human desire to develop and maintain social ties, which drives intimate relationships
Family, friends, etc. are important to this driver of physical and psychological well being
But sexual/romantic relationships are as or more central to meeting our deep-seated needs and desires for social connection
having high quality romantic relationship
enhances personal health and longevity
The drive to pursue intimate relationships is ubiquitous
but the number and nature of relationships necessary to fulfill one’s belongingness needs varies across people
prejudice against singles, perpetuated by a generally negative view of singles and various stereotypes (ugly, immature, and lonely)
Generally an accepted prejudice (dissimilar to biases based on race, gender, etc.)
sexuality among singles
Singles run the gamut of sexual activity, from celibacy to frequent sexual contact with multiple partners
Singles do not necessarily have to be sexually active in order to be happy and they can potentially meet their belongingness needs through nonsexual relationships
one-time sexual encounters among people who do not know each other on a deep level
Tend to emerge after a night at the bar or a party
Strongly associated with alcohol use
No expectation (usually) that any kind of relationship will develop
The frequency with which people engage in hook-ups varies from one person to another
78% of college students have hooked up, with the average number of hookups at 10.8
Comprises a wide range of sexual activities
Men are more likely to enjoy them than women, while women are more likely to regret hookups
Friends with benefits
people who have a rather typical friendship, aside from the fact that they occasionally have sex
As many as 7 distinct types, ranging from true friends, to just sex, to network opportunism, to transition in (successful, unsuccessful, or unintentional), to transition out
Half of college students, but also amongst adults
Tends to occur with alcohol
Most common reason: regular access to sex (men) or emotional connection (women)
Men tend to want to remain FWB for as long as possible, whereas women hoped their relationship would ultimately revert back to friendship or evolve into romance
20% of college students currently in relationships were FWB first
They were less satisfied with their relationships, but no more likely to break up over time than romantic partners without prior FWB experience
Tend to be less satisfied and have lower levels of sexual communication than people involved in committed romantic relationships
serial monogamist
people who pursue a pattern of entering and exiting sexually exclusive relationships
sex lives of singles
are highly variable and may combine one or more of the activities
Singles tend to be less sexually satisfied than people who are married or involved in more committed relationships
Lower frequency of sexual activity
Lower levels of sexual satisfaction
Women are less likely to reach orgasm
Why? Sexual activities that increase the odds of female orgasm (ex: cunninlingus) are more likely to occur in committed relationships, and long-term partners learn how to please each other better
Some of singles’ sexual behaviors pose important health risks
Lower condom use
More sexual partners
Combo of alcohol isn’t great
a special set of emotions, cognitions, and behaviors observed in an intimate relationship → influences how we think, act, and feel toward another person
passionate love
an all-consuming psychological and physiological state characterized by an almost obsessive preoccupation with the other person, as well as an overly idealized view of one’s partner in which one fails to recognize and acknowledge that person’s flaws; an intense sexual attraction, as well as frequent feelings of excitement and ecstasy and excitement in the partner’s presence, but when separated possibly intense feelings of sadness; elevated heart rate, sweating, “butterflies” in the stomach, blushing, and other signs of heightened physical arousal
Usually develops before one knows their partner well
Intensity of the feeling decreases over time
Some amount of disillusionment inevitably sets in as passion begins to subside, which forces couples to shift the foundation of their relationship to something more stable
companionate love
much deeper and not as intense as passionate love, characterized by a strong emotional attachment and commitment to another person based on the full knowledge and appreciation of the other person’s character; desire to make the relationship work despite any difficulties that may arise, as well as a willingness to sacrifice self-interest for the betterment of the relationship
Not overlooking one’s partner’s faults, but acknowledging them, recognizing that they are imperfect, and learning to tolerate those shortcomings
Maybe not as much sex, but higher levels of trust and mutual concern for one another’s needs could improve sexual communication and satisfaction and allow partners to explore their sexual fantasies
Develops gradually (often from passionate love) and can be much more enduring
Robert Sternberg’s Triangular Theory:
love consists of 3 distinct components which exist to varying degrees in a given relationship (romantic or not), forming 8 different types of love
passion, intimacy, commitment
the motivational dimension, which encompasses physical attraction and sexual desire and is what distinguishes romantic love from platonic/familial love
Builds quickly, peaks, and then gradually declines, at which point intimacy and commitment come in in order for a relationship to survive
the emotional dimension, which refers to our sense of bondedness and emotional connection with another person (not physical connection, but emotional)
the cognitive dimension, which refers to our conscious decision to maintain a relationship over time, for better or for worse
consummate love
the ideal form of romantic love in which passion, intimacy, and commitment are present simultaneously
Difficult to achieve and maintain
Each person’s triangle for each relationship is the amount of each type of love they have in the relationship
the closer 2 triangles are matched, the more satisfied they are likely to be together
John Lee’s Styles of Loving (1977)
there are 6 love styles
hopeless romantic, great pleasure in partner’s physical appearance, often fall in love at first sight
selflessness and unconditional love
rational and practical style, looking for people who are compatible → less emphasis on passion, more on life partner
casual and uncommitted approach to love
begins in friendship and eventually transitions into peaceful, affectionate, and enduring love
intense, obsessive love relationships with many emotional highs and lows
sex differences in styles of loving
College-age men more likely to be game-playing or romantic
Women more likely to be pragmatic, possessive, or companionate
Could be evidence that men more interested in looks and casual relationships, while women more interested in finding long-term, reliable partner
an individual’s conscious decision to stick with a given partner over time; can be separate from love
strengthens a relationship by encouraging pro-relationship behavior
Rusbult’s Investment Model (1980):
commitment is measures as one’s intention to persist in a given relationship over time
Product of 3 factors:
1) overall ratio of good to bad thing compared to some comparison level
Downward social comparison makes us happier
Biggest predictor of commitment
2) quality of alternatives
3) investment size
Quality of alternatives
an individual’s perception of how desirable all the other people in their dating pool are
investment size
everything individuals put into their relationship over time that would be lost/decrease in value were their current relationship to end (can be tangible or intangible)
varieties of loving and committed relationships hetero vs homo
Acceptance of same-sex relationships varies widely across cultures
Same-sex couples typically do not adopt strict roles of husband and wife, instead establish equality and power-sharing
Heterosexual and same-sex relationships tend to be more similar than different
Equal levels of satisfaction and commitment
But, same-sex couples may break up more often, perhaps due to a lack of options for legal marriage
monogamous vs. nonmonogamous
In Western world, monogamous relationships are the norm, surrounded by a halo effect
4% of participants say they practice consensual nonmonogamy
Many forms of consensual nonmonagomy
open relationships
relational home-base, but can pursue other intimate relationships at the same time
married couples switch partners for an afternoon/night
multiple spouses
Permissible on 84% of cultures, but practiced by few
having multiple sexual/romantic partners simultaneously
Can be married or not
More emphasis on intimate relationships (not just sex) than open relationship or swinging
Type of relationship or relationship orientation?
often assumed to be safer, but due to cheating and other factors, it is not necessarily
married vs. cohabiting
Marriage exists in most societies and serves purposes ranging from practical to romantic
Worldwide rate of marriage has recently declined, and cohabiting/other forms of relationship definition has increased
Due to high divorce rate, marriage no longer viewed as permanent
Sometimes cohabiting as a trial period
Good or bad?
More equality in cohabiting relationships
Easier to end cohabiting relationship
Cohabiting offers fewer legal rights and protections
Couples who cohabit before marriage report lower marital equality
Enhanced health for both (over being single)
Greater effects for men than women: women tend to have many sources of social/emotional support outside their primary romantic relationship while men often do not
arranged marriage
common in some Eastern cultures, tend to be marriage for pragmatic reasons
appearing indifferent or showing no emotional response to one’s (usually female) partner’s concerns; bad for relationship
healthy sexuality
Sexual communication
Frequency that both partners are happy with (tends to reduce stress, but only for couples satisfied with the relationship)
Sexual communal strength – a willingness to satisfy one’s partner’s sexual needs, even when they do not necessarily align with one’s own personal desires
self-expansion theory
humans have a fundamental need to expand or grow the self over time
Accomplished by continually engaging in activities that are exciting and novel, as well as developing new relationships
Being in a relationship automatically makes this happen, because over time we start to incorporate certain characteristics of the partner
But to meet needs in long-run, couples need to regularly share self-expanding experiences
social disapproval
makes people less committed and more likely to break up, as well as worse health outcomes
attachment style
one’s pattern of approaching and developing relationships with others
Develop out of early relationships with caregivers
Relatively stable over time, but can change with new experiences
3 types:
securely attached
tend to have no trouble getting close to others, or fear of abandonment; trusting and confident that their partner will be there for them when it counts
anxiously attached
worry that partners don’t want to get as close as they do, fear partner leaving and get jealous
avoidant attachment
are not overly comfortable with intimacy and don’t wish to become dependent on others; recognize that partner will eventually leave, but don’t worry because they see love/relationships as temporary
jealousy in men and women
Men more jealous about physical infidelity (due to paternity uncertainty), while women more jealous about emotional (worry about father abandoning them and their kids)
Gay men and women tend to be more concerned about emotional infidelity
But unclear whether this is clearly true
one of most common causes of relationship turmoil and breakup
Most common reason for divorce
No universal definition
Definition depends on sex and attachment style
Anxiously attached more likely to label casual interactions as cheating
So prevalence estimates range from 1.2% to 85.5%
In college students, around 1 in every 2 or 3
In married couples, 1 in every 4 or 5
Significant cross-cultural variability
Men cheat more than women
Due to prevalence and how much it hurts people/relationships, question of whether monogamy is good/natural
coping with breakup
After a breakup, it is common to feel depressed, have lower self-esteem, have difficulty concentrating, and have a range of other negative emotions/cognitions
Active coping strategies, or attempts to confront the problem, tend to be better
Also good to see breakup as an opportunity for personal growth: learning about oneself, navigating relationships in the future, and a renewed focus on other aspects of life
sexual health
a state of physical, emotional, mentalk, and social well-being in relation to sexuality
Not merely the absence of disease, dysfunction, or infirmity
REquires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence
To be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled
sexual dysfunction
a case in which a specific sexual issue persistently emerges and creates distress at either the level of the individual, or the relationship
But its absence does not necessarily mean that someone is sexually healthy and satisfied
biological causes of sex difficulties
nature of aging
chronic illnesses
physical disabilities
natural aging process
our bodies and hormone levels change, and the more likely we are to develop chronic illnesses
chronic illnesses
especially diseases of the cardiovascular and nervous systems
Multiple sclerosis
Cancers or cancer treatment
physical disabilities
spinal cord injuries
Can still have sexual desire/a satisfying sex life by redefining what sex is and/or creating secondary erogenous zones
some, like Chlamydia and Gonorrhea, can lead to pelvic inflammatory disease, making intercourse uncomfortable and orgasm difficult for women
Antidepressants, especially SSRI’s delay orgasm because they keep serotonin in the brain longer
Psychiatric medicines like antipsychotics and tranquilizers can impair ability to reach orgasm
Blood pressure and allergy medications can have negative sexual effects as well
Alcohol, tobacco, and other drugs can create episodic sexual problems and long-term use can generate chronic sexual dysfunction
psychological causes of sexual difficulties
distraction, previous learning experience, beliefs about sexual difficulties, body image, and mental illness
over-thinking and over-analyzing one’s own sexual performance while having sex, creating anxiety that reduces arousal and the likelihood of orgasm
previous learning experiences
learning about sex growing up, traumatic sexual events
beliefs about sexual dysfunction
may lead to monitoring oneself for sexual problems, or produce anxiety
poor body image
and a lack of knowledge regarding one’s own body can cause distress/anxiety that ultimately leads to limited or no sex
Reduce sexual spontaneity and frequency
mental illness
egardless of whether one is receiving treatment, can be linked (in different ways) to sexual dysfunction
Affective disorders are associated with low libido or hypersexuality
Certain mental disabilities are linked to sexual difficulties, but not much is known, since sex for this population is typically ignored
social causes of sexual difficulties
Ineffective communication about sex both in and out of the bedroom is correlated with lower sexual satisfaction
Relationship problems, such as unresolved conflict and anger, often reduce desire for partnered sexual activity, which can lead to further issues
How the partners in a relationship view sex can affect performance and satisfaction
Cultural and religious factors may dictate certain prohibitions when it comes to seeking out/experiencing pleasure from sex
East Asian cultures have more conservative attitudes, as well as lower sexual desire and functioning than those in European cultures
dual control model
underlying sexual arousal and behavior there are 2 important brain mechanisms, both of which are influenced by biopsychosocial factors
excitatory system and inhibitory system
When one system becomes disproportionately active, sexual difficulties are likely
excitatory system
activation promotes sexual arousal and activity
Ensures reproduction
inhibitory system
activation suppresses sexual arousal and activity
Helps maintain harmonious interpersonal relationships by suppressing the impulse to have sex with our friends’ romantic partners
2 ways to classify problems
Primary vs. Secondary
situational vs. global
primary dysfunction
issues people have had their whole lives
secondary dysfunction
issues that appeared out of the blue one day after a period of healthy sexual functioning
occur only with one partner or during one type of sexual activity
occur with all partners and sexual acts
Female sexual interest/arousal disorder (SIAD) and male hypoactive sexual desire disorder (HSDD)
are characterized by absent/reduced sexual fantasies and thoughts, a lack of desire for sexual activity, and personal distress resulting from these symptoms
The most common difficulties relating to sexual desire
SIAD is broader and includes reduced/absent excitement during sexual activity, reduced genital sensations during sex, and a lack of responsive desire (sets in after sexual activity has begun
Low desire is the most common form of female sexual dysfunction
Occurs more often in women than in men
Not always pathological (asexuals) and it is normal for sexually active people to experience fluctuations in desire throughout their lives (decreased desire in times of stress)
Only considered a disorder if it is persistent and personally distressing
sexual desire discrepancy
cases when one partner has less sexual desire than the other, generating relationship difficulties
Couple-level, not individual, problem
sexual aversion disorder
an aversion to any type of partnered sexual activity
Can take many forms, ranging from fear to disgust
Very rare, dropped in DSM-5
hypersexuality.compulsive sexual behavior
when people have excessive sexual desire and engage in very high amounts of sexual behavior
Lack of research, so not clear how much is too much
2 categories of problems with arousal
Problems becoming/staying aroused
Problems with persistent/uncontrollable arousal
persistent genital arousal disorder
uncontrollable sexual arousal that occurs spontaneously, without being preceded by sexual desire/activity, in women
Relatively new and rare
Can last for days with orgasms presenting only temporary relief
Physically uncomfortable and singificantly impairs concentration
Erectile disorder
difficulty becoming aroused in men → persistent inability to develop/maintain an erection sufficient for sexual performance
One of most common sexual dysfunctions in men, especially as they get older
Can have physical or psychological causes
uncontrollable arousal in men → an erection that won’t go away on its own (longer than 4 hours)
Medical emergency b/c if left untreated can severely damage penile tissue and eventually cause ED
men more likely to
reach orgasm too soon, while women are more likely to have the problem of never reaching orgasm
premature orgasm
occurs when an individual consistently reaches orgasm before it is desired, rapidly and often prior to penetration
Can happen in women, but usually in men
Can have physical and psychological roots
Some researchers think it may reflect adaptive advantage in men
Alternatively, may be because some boys may condition themselves to ejaculate rapidly during adolescence to reduce the risk of being caught
orgasmic disorder
women who either have an inability to orgasm or a greatly delayed orgasm during sexual activity, or reduced orgasmic intensity
Can be lifelong pattern or situational
Can have physical or psychological roots
Heterosexual women who cannot reach orgasm as a result of vaginal intercourse alone but can reach orgasm in other ways are not considered to have a dysfunction
delayed ejaculation
orgasmic disorder in men
Usually involves a man whose ability to ejaculate is either significantly delayed or frequently absent during intercourse, but functions normally during masturbation and other activities
Often psychological explanation where men prefer one type of sexual activity over others
orgasmic difficulties
faced by post-operative transsexuals (more for MTF than FTM)
2 main forms of pain in men
phimosis and peyronie’s disease
a condition in which an uncircumcised man’s foreskin is too tight and makes erections painful
Peyronie’s disease
a condition in which a build-up of scar tissue around the cavernous bodies results in severe curvature of the penis and makes intercourse difficult and painful
STI’s, smegma, and urinary infections
can also lead men to experience physical pain during sex
painful sex more common for
women and has many possible causes
Genito-pelvic pain/penetration disorder (GPD)
when women experience pain in anticipation of or during vaginal intercourse, or when vaginal penetration is difficult
any type of pelvic or genital pain that occurred during sexual arousal/activity
Can be due to STI’s, infections of the Bartholin’s glands, yeast infections, smegma accumulation under the clitoral hood, and vaginal scars and tears
OR inadequate lubrication, irritation from spermicides, and allergies to latex condoms
Psychological factors can also play a role in developing and maintaining painful sex
a situation in which the lower third of the vagina exhibits sudden and severe contractions during any attempt at vaginal penetration, making intercourse difficult and painful
May coincide with first attempt at vaginal penetration, or occur later in life
Involuntary and not only inhibit intercourse, but also gynecological exams and tampon insertion
Usually conditioned response, often stemming from a chronic history of painful sex, chronic relationship problems, or past experiences with sexual coercion/assault
behavioral therapy
sexual dysfunction can often be explained by basic principles of psychological learning theory (punishment and reinforcement)
Master and Johnson (1970)
Goal was to change the way people approach sex and recondition the client to feel pleasure rather than stress in sexual situations → relax
Start by temporarily stopping having sex and slowly working back up to it through a series of sensate focus techniques, a gradual reconditioning process in which individuals ultimately come to associate sexual arousal/activity with relaxation and pleasure instead of anxiety
Based on the notion that both touch and communication are vital aspects of healthy sexuality
PLISSIT model of sex therapy
combines sensate focus techniques with sex education
Jack Annon (1976)
Stands for permission, limited information, specific suggestions, and intensive therapy
Idea is that most people experiencing sexual dysfunction do not need major therapy, instead just a little reassurance (permission), an anatomy lesson (limited info), or some new sexual strategies or advice, such as sensate focus (specific suggestions)
Final step is usually not required
cognitive-behavioral sex therapy
combines behavioral approach with cognitive component → looks at thoughts and feelings underlying behaviors
Goal is to reshape thought patterns to make them more positive
sex surrogacy
cases where a therapist provides clients with substitute/practice partners in order to reach desired therapeutic outcomes
Highly controversial
treatment of sexual difficulties with medicinal drugs
Only psychiatrists can practice the full range
The number of medications with a demonstrated therapeutic effect on sexual dysfunction is rapidly growing
Hormonal therapy, viagra, SSRI’s, and botox
Growing use in treating sexual difficulties
Does it ignore biopsychosocial nature of sexual difficulties?
Should they be the 1st line of defense (because more convenient)?
We may be fundamentally altering the nature of sex therapy away from an emphasis on the couple and toward the individuals
Success rates of each vary depending on definition of success, etc.
Growing use of pharmacotherapy to treat sexual difficulties
How to define a sexual disorder/dysfunction
treating desire problems
tends to be difficult and has low success rate
Multiple treatment options and may take more than one attempt
Behavioral therapy and CBST if linked to relationship problems
Psychopharmacology → testosterone therapy
treating arousal problems in women
CBST if due to psychological/relationship problems
Hormone therapy if physical
Estrogen in postmenopausal women can increase lubrication
Artificial lubricants
EROS clitroal therapy device – draws blood into the clitoris with vacuum power, increasing genital sensation and sensitivity
EROS clitroal therapy device
draws blood into the clitoris with vacuum power, increasing genital sensation and sensitivity
treating arousal problems in men
Priapism treated by drawing blood out of penile tissues
ED treated with drugs, pumps, or surgery
First, need to determine is psychological or physical → erections in sleep?
Viagra dilates blood vessels, allowing more blood to flow into penis
Most effective when combined with couple’s sex therapy focused on improving communication and intimacy
Potential side effect is priapism
Penile implant is most extreme and last option
Destroys cavernous bodies → natural erection no longer possible
Men tend to be satisfied
treating orgasm problems
Resolution of inhibited/delayed orgasm requires determination of if physical or psychological
Psychological → behavioral therapy or CBST
Kegel exercises enhance genital sensitivity and may enhance likelihood of orgasm
treating premature ejaculation
stop-start technique
squeeze technique
stop-start technique
involves continuing sexual activity to the point where orgasm is about to happen, then stopping everything until the feeling goes away
squeeze technique
involves continuing sex until the point of impending orgasm, but then squeezing the head/base of the penis to prevent ejaculation
Also numbing cream/condoms, kegel exercises, or small dose of SSRI
treating phimosis
with circumcision or superincision/dorsal slit, or application of topical steroids
treating Peyronie’s disease
with anti-inflammatory medication and physical therapy, and in severe cases, surgery
GPD treatment
depending on cause
vaginismus treatment
with dilators (cylinders of various sizes inserted into vagina) → gradually desensitize the vaginal muscles to different degrees of penetration
Also botox to paralyze vaginal muscles
tips for avoiding sexual difficulties
Communicate verbally and novverbally during sex
Tell what you like
Be specific
Using slang is positively correlated with satisfaction in women
Don’t look at sex as an activity in which you should achieve something
Failure to launch will happen to everyone at least once → best thing is not to dwell on it
Take care of yourself physically and psychologically
casual sex
• Sex outside of a committed, romantic relationship
• Can take many forms
• Media narrative is that casual sex is increasingly common among college students and its effects are largely negative
• Study by Monto and Carey
– compared college students from 1988-1996 to students from 2002-2010, found that students today
committed relationship
: more likelihood of oral sex for women
casual relationships
can fulfill people’s needs and they’re not always one time things, but the sex isn’t quite as good as it is in a romance
how quickly do we form impressions
I. In a fraction of a second!
II. Willis and Todorov (2006) – viewed male and female faces for varying amounts of time
III. Looked at brief exposures versus unlimited exposure
b. Strong correlation between brief exposures and unlimited exposure condition (.7) and above
c. Speed-dating might be relevant
I. Those judgments are very highly correlated in the unlimited exposure condition. Looking at a photo longer did not change anything.
II. Confidence in judgments increased with longer exposures, but the nature of those judgments did not change. These impressions can be created in as little as 1/10th of a second. We can infer a wide variety of characteristics from a person.
affective moods
increase attraction
I. If we already feel good and we meet someone new, we have a tendency to like someone more because you already feel good.
2. If you prime people with positive associations, they usually start feeling better about strangers too.
propinquity effect
I. Greater physical proximity increases chances of attraction
II. Works through repeated exposure (mere exposure effect)
1. More frequent contact with a stimulus will have more positive attraction – the more familiar with someone, the more you are to have a positive association with it.
2. The more you see the same person, the more comfortable you feel with them. The more you see them in shared environments, you think that you have more in common with them → similar interests.
III. If your initial reaction to someone is negative, very little will change. Your initial reaction to the person needs to be neutral or positive. Your idea of someone will not easily change.
1. Same sex couples (44%) meet online
we tend to like people who are similar to us – age, appearance, etc
I. By and large, opposites do not attract as much as people who are similar
II. Same-sex relationships are more likely to be interracial and interreligious maybe because they have a smaller pool of people to choose from
III. Similarity may facilitate attraction, but it doesn’t guarantee relationship success.
level of physiological arousal
I. Greater arousal leads to greater attraction
Shaky Bridge study
attractive female researcher approached men who were walking across a shaky suspension bridge – anxiety inducing bridge versus a lower, stable bridge.
III. Dependent variable – did the men call the woman? Shaky bridge men were more likely to call the female research assistant. Physiologically aroused were more likely to report arousal.
1. Why does this work?
a. Misattribution of arousal – misattribute this to the individual rather than other characteristics that are there.
b. You should do something that is physiologically arousing for a date.
neurochemical influences: pheromones
linked to increased sexual activity
1. Men who lack a sense of smell – lacking a sense of smell leads to fewer sexual partners
levels of dopamine and serotonin
these plan a role in sexual arousal happening
physical attractiveness
I. Determined by multiple factors – height, weight, etc
II. There is research on beer goggles – when people are inebriated they rate individuals as more attractive. Judgments of attractiveness are not just about who is around you – based on substances around you etc.
III. We tend to like attractive people because we stereotype them as more likeable and more socially skilled, etc.
1. People tend to seek out attractive people as friends, lovers, etc.
2. This is also seen as an indicator as health and fertility status (evolutionary theory).
3. The longer a relationship goes on, attractiveness is less important. Men tend to value physical attractiveness more than women.
evolutionary explanation for gender difference in long-term mating
Women make a larger parental investment than men do → hence they have developed greater mating strategies. Men are thus promiscuous in order to spread their seed. Women should generally avoid being promiscuous and should choose men who will provide shelter, food, etc.
sex differences in partner selection
a. Men sex healthy and fertile women – they pay attention to signs of health:
i. Age (younger)
ii. Waist-to-hip ratio (smaller waist than hip)
iii. Hair (long and shiny)
b. Women seek reliable men
i. Focus on men who are older, have more resources
ii. Less focus on youth/beauty because sperm are still usable later on
evidence of different sexual strategies
a. Clark and Hatfield 1989
i. Had male and female RAs – would ask three questions: date tonight, apartment tonight, sex with me tonight?
ii. These encounters occurred on week days
b. Buss&Schmitt – probability of consenting to sex for women depends on how long they know them as opposed to men who will consent to sex.
friends with benefits are
less sexually satisfied & communicate less about sex than romantic partners
heterosexual women
have fewer orgasms in
hookups than in romances
why the orgasm gap?
different sexual activities
sexual scripts
quality of casual sex
Perhaps not surprisingly, heterosexual men (84%) report enjoying their hookups more than heterosexual women (54%)
nature of casual relationships
Differ based upon frequency of contact, type of contact, personal disclosure, discussion of relationship, & friendship
• One-night stands (“hit it and quit it”), booty calls, ****
buddies, friends with benefits
nature of FWB relationships
N=246 individuals with current FWBs
• 181 women, 65 men; Average age: 29
(range 18-65); 71% White; 88% Heterosexual
60% were sexually exclusive, 23% had other FWBs, 14% had romantic partners
• However, only about half (48%) were friends first
• 21% were romantic partners, 25% were sex partners, 7% were something else
7 different types of FWB
True friends
• Just sex
• Network opportunism
• Successful transition in
• Unintentional transition in
• Failed transition in
• Transition out
why do people begin FWBs?
desire for sex 56% women, 72% men
desire for emotional connection 37% women, 25% men
desire for change more women than men
desire to stay the same more men than women
do FWBs ever become lovers?
N=764 college students in exclusive dating relationships
§ 601 women, 163 men; Average age: 19 (range 17-25); 71%
§ 1/5 of student participants said current romantic partner was a
FWB first!
§ FWB-first group had lower relationship satisfaction, but were no
more likely to break up
is romance the most likely outcome in FWBs?
1-year study of about 150 FWBs
• After 1 year, 29% were still FWBs, 29% were “just friends,”
15% were romantic partners, & 27% had no relationship of
any kind
• Those who maintained some type of relationship set up rules
& boundaries and did more than just talk about safe sex
• Of those who were hoping for roman
Pros of FWBs
no commitment
access to sex
staying single
becoming closer
develop feelings
hurt friendship
negative emotions
lack of commitment
negative sex outcomes
investment model of commitment
1) satisfaction
2) alternatives
3) investments
• Your subjective evaluation of the relationship

You compare your good/bad ratio to some comparison level

Favorable comparisons = greater commitment

The perceived desirability of the rest of your dating pool

Based on comparison level for alternatives

Worse alternatives = greater commitment

Anything you have “put into” your relationship; would be lost if relationship ended

Combination of factors determines commitment

Strong commitment increases likelihood of accommodation

Accommodation reduces likelihood of breakup

Commitment can be based on different factors in different relationships
• Rusbult & Martz (1995)

This model has been validated experimentally (Agnew, Hoffman, Lehmiller, & Duncan, 2007) & applies in same-sex and heterosexual relationships

living together in a sexual relationship, but unmarried
Increasingly common & accepted
• Copen et al. (2012)

Compared to married couples, cohabiting couples tend to have more relationship equality

Advantages: informal, easier and cheaper break-ups

Disadvantages: more infidelity, fewer legal protections

Found in virtually every society; however, “universal” nature of marriage is often overstated

Marriage serves both social and personal functions

Marriage is typically linked to better health (especially among men); however, it is not necessarily better than cohabitation
• Musick and Bumpass (2012)

variations on marriage
• In Western society, marriage is most commonly a heterosexual, monogamous union; usually carries both religious & legal connotations

• However, marriage assumes different forms cross-culturally

collectivist cultures
arranged marriages may occur
same-sex marriage
• Increasing prevalence, but controversial
consensual nonmonogamy
• Estimated at 4% of population
exchange of partners
• Bergstrand & Blevins Williams (2000): Swingers report being happier & say lives are more “exciting”
open relationship
“home base,” but sex with other partners permitted
man has multiple wives
woman has multiple husbands
• Multiple romantic/sexual partners at once, regardless of whether marriage is involved

• Seen as a relationship orientation

what makes for a good marriage?
• Videotaped married couples discussing a relationship problem
• Factors that predicted divorce:
• Ratio of positive to negative comments

• Negative facial expressions, elevated heart rate, & defensive behaviors

maintaining a good relationship
• We are constantly seeking personal growth and progress, and one of the ways we accomplish this is through close relationships (Aron & Aron, 1996)

• We “expand” the self to include our partner

positive sexual communication is vital
• Babin (2013): couples who communicate more about sex are more satisfied
1. Have mutual trust and respect

2. Know how to start a conversation about sex

3. Know how to express yourself during a sexual conversation

make sure to listen
– use active listening
– paraphrase
– express unconditional positive regard
Think of a serious romantic relationship that you have had in the past, that you currently have, or that you would like to have. Imagine discovering that the person with whom you’ve been seriously involved became interested in someone else.
What would upset you more?
A: Imagining your partner falling in love with and/or forming a deep emotional attachment to that person

B: Imagining your partner enjoying passionate sexual intercourse with that other person
From the evolutionary perspective, male concern w/ sexual infidelity due to paternity uncertainty

Female concern w/ emotional infidelity due to they need male investment in offspring

cheating 2
Sexual interaction with someone other than one’s primary partner
Reasons vary
Nonconsensual non-monogamy (“affairs”) à partner does not know

Prevalence is difficult to determine because people define “cheating” differently
• Luo, Cartun, & Snider (2010) meta-analysis: rates ranged from 1.2-85.5%!

So Is Monogamy A Realistic Expectation?
• Some scholars argue that humans are “meant” to be monogamous, others say we are “meant” to be non-monogamous

recurrent and persistent genital pain before, during, or after intercourse
female: genito-pelvic pain/penetration disorder
involuntary spasm of muscles in outer third of vagina, usually a conditioned, involuntary response
foreskin is too tight, may require circumcision
Peyronie’s disease
extreme curvature of penis, make sex difficult, may require surgery
Benign coital Cephalgia
severe headaches just before or after orgasm
Sex therapy
• Historically viewed through heterosexist lens, most therapies originally designed to improve pv intercourse
• Most suggestions and techniques have shown comparable success rates in gay and lesbians couples
• Continuing controversy are we medicalizing sexual disorders?
• Are we creating biological cures for psychological problems?
behavioral therapy
– learning theory can help us understand basis of sex difficulties
– reconditioning approach: goal is to get client to feel pleasure instead of anxiety
sensate focus
recommended as part of most therapy: touch partner’s body for exploration, not arousal or pleasure, enhances communication and intimacy
– 20% failure rate, Masters and Johnson
combines behavioral therapy with sexual education
– 1st level: permission
– client given permission to follow desires
– 2nd level: Limited information
– information about specific concerns provided
– 3rd: specific suggestions: suggestions offered, homework given
– 4th: intensive therapy (if 3 stages unsuccessful)
– psychosexual therapy: consider role of childhood influences
• Systems therapy: consider dysfunction in context of relationship
• Sex surrogate Therapy: a substitute sex partner known as surrogate, intentionally engages in sexual activities with client to teach techniques, originally recommended by Masters and Johnson
– surrogate is not the therapist
– very controversial: should it be legal? Is it a form of prostitution?
– most psychologists consider in unethical
– treating sex difficulties with medicines/drugs. Eg. Testosterone, Viagra, SSRIs
– rapidly increasing in popularity, displacing traditional focus of therapy, focusing on the individual instead of the couple
Eros Clitoral Therapy device
equivalent of penis pump for women, goes over clitoris and creates suction to pull more blood into the clitoris to make it more sensitive it seems to work, but this device is available only by subscription and costs a lot
– effective treatment requires figuring out the cause
• Eg. Anxiety, relationship conflict, medication side effect, kegel exercises recommended, genital sensitivity and likelihood of orgasm
for vaginismus
begin with relaxation and exploration exercises
– use of dilators may be recommended, dilators vary in size, get vaginal walls accustomed to relazation, eventually partner participates and work up to penetration
– newest treatment: botox paralyzes muscles makes involuntary contraction impossible
for delayed ejaculation
– begin with sensate focus
– then self stimulation with partner present, goal is to psycholoigally connect partner with pleasure, conditioning
– partner provides oral or manual stimulation, work to penetration
for premature ejaculation
– ejaculate more freuqnetly or come again with partner
– change positions, having partner with PE be on bottom
– consider sexual alternatives
– communicate
• Professional treatment: cognitive behavioral therapy
– reduce fear and anxiety and learn helpful techniques
squeezing technique
man stimulated to point of impending orgasm, then partner squeezes glans or base of penis → repeat
• High success rate, other interventions include medications, desensitizing agents, SSRIs may be administered to delay orgasm
for erectile disorder
– cognitive behavioral approach: for psychologically induced erectile dysfunction, begin with sensate focus and work up to genital stimulation, a modified stop=start technique is recommended. When erection appears, stop stimulation and wait until it subsides, then restart
• Medical treatments: Viagra, Cialis, and Levitra
– in about 80% of men, these drugs create capacity for erection, but stimulation is required for erection to occur
– effects amplified if combined with couple’s therapy
• Other treatments
– korena red ginseng
– vasoactive penile injenctions: self administered injection to create erection, relaxes penile tissues and increases blood flows
– medicated urethral system for erections: similar mechanism to injections
penile implants
– only used in extreme cases when nothing else works
– destroys penile tissue , makes natural erection impossible
a. semiridgid rods
b. inflatable device
– cold glans syndrome, implants can create mechanism for erection
– do not restore lost sensation or ejaculation
learning theory
can help us understand basis of sex difficulties
Reconditioning approach
goal is to get client to feel pleasure instead of anxiety
female sexual arousal disorder treatment
• “Talk therapy” for psychological causes

• Testosterone replacement

• Eros Clitoral Therapy Device

anorgasmia treatment
• Effective treatment requires figuring out the cause

• Kegal exercises sometimes recommended

genito-pelvic pain/penetration disorder treatment
• For vaginismus, begin with relaxation & exploration exercises

• Use of dilators may be recommended

• Eventually, partner participates—work up to penetration

• Newest treatment: Botox

delayed ejaculation treatment
• Begin with sensate focus

• Then, self-stimulation with partner present

• Partner provides oral or manual stimulation; work up to intercourse

premature ejaculation treatment
a.) Self-help strategies for men
• Ejaculate more frequently alone or “come again” with partner

• Change positions

• Communicate

• Consider sexual alternatives to intercourse

treating low sexual desire
• Difficult to treat; requires intense therapy

• Cognitive-behavioral approach aimed at modifying erotic impulses

• May or may not involve partner

• Medical treatments often used to enhance desire

avoiding sexual difficulties
A. Maintain good sexual communication

B. Avoid spectatoring

C. Recognize and understand that “failure” will sometimes occur & that you are not “supposed” to achieve something during sex

D. Maintain good physical and psychological health

facts about sex
(1) Most teenagers have sex
– and some are doig it at very young ages

(2) The U.S. has one of the highest teen pregnancy rates in the world
– 750,000 15-19 year olds become pregnant each year
(3) Young adults have the highest rates of STIs

why are teen pregnancy and STI rates so high?
• Misuse/underuse of contraceptives and barriers
• Many other contributing factors
– lack of knowledge and myths
– fear, guilt, embarrassment about sex
– less stable relationships
how do we address these problems?
(1) We could provide free or low-cost teen contraceptive services
• But is this an endorsement of teenage sex?
– research suggests not

(2) We could improve sex education
• But how far should it go?

sex education
A majority of Americans support sex education in schools (NPR, 2004)

Support for the “abstinence only” approach is relatively low
– surveys put it around 15%
– but 30% of schools are teaching it

Most adults support comprehensive or “abstinence plus” education
– abstinence is best, but just in case…
– advocates of those programs have been very good at directing money towards those programs even though those programs contain a lot of inaccuracies
– 97% of respondents think that school based sexual education should want students to ask their parents about it, how babies are made, some think students should be a little older, how to get tested

does abstinence only education work?
Kohler, Manhart, & Lafferty (2008)
• Abstinence only education did not reduce sex, teen pregnancy, or STD rates compared to comprehensive sex education
– teens with comprehensive education had lowest rates of pregnancy
Stanger-Hall & Hall (2011)
• States with abstinence only education have higher teen pregnancy rates

Problems with abstinence only approach
• Ignores certain groups
– what about sexually active teens and GLBT youth?

• Teaches misconceptions and falsehoods

Any actions, devices, or medications used in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth
– some, but not all forms also provide STI protection
history of contraception
• Illegal throughout many parts of the United States until recently
• Landmark case: Griswold vs. Connecticut (1965)
• Estelle Griswold, challenged law
• Supreme Court ruling changed everything
– ruling: there is a constitutional right to privacy that extends to contraception

• Since Griswold, contraception has become more widespread; attitudes more favorable
– but still controversial, eg Plan B

behavioral methods
By doing or not doing a particular behavior, a heterosexual couple tries to reduce risk of pregnancy

Advantages for a couple’s wallet & health
– free in terms of financial cost and side effects

Disadvantage: difficult to implement perfectly
– require lots of self-control

• Strict definition: no genital contact

• Effectiveness: 100%

• Everything except penetrative intercourse
– include oral sex, mutual masturbation, etc

• Nearly 100% effective

natural family planning and fertility awareness method
• Couple abstains from sex during perceived fertile times (NFP) or uses barrier (FAM)
• Variety of methods to chart menstrual cycle
– certvical mucus consistency
– basal body temperature

• Effectiveness:
• Typical use: 76%
• Perfect use: 95% – 99%

• Goal: withdraw penis from partner’s body before ejaculation

• Effectiveness:
• Typical use: 78%
• Perfect use: 96%

barrier methods
Creates a physical or chemical barrier so sperm doesn’t reach woman’s uterus
Good for people who have infrequent sex
• Chemicals inserted into vagina to kill or inactivate sperm
– must be applied every time

• Effectiveness:
• Typical use: 72%
• Perfect use: 82%

male condoms
• Sheath that covers penis

• Effectiveness:
• Typical use: 82%
• Perfect use: 98%

condom concerns
• People make a lot of condom use errors
• Dubois, Emerson, & Mustanski (2012) study of MSM condom use
– 95% made condom use errors

• Sanders et al. (2012) review of 50 condom use studies
– people don’t put condoms on soon enough and often do it incorrectly

female condom
• Polyurethane pouch that lines vagina and catches ejaculate

• Effectiveness:
• Typical use: 79%
• Perfect use: 95%

• Shallow latex cup placed over the cervix, usually covered with spermicide
– must be comfortable with body

• Effectiveness:
• 88% – 94% diaphragm

hormonal methods
Hormones introduced into woman’s body that reduce fertility for given amount of time
3 potential methods of action
– prevent ovulation
– thicken cervical mucus
– alter uterine lining to make implantation less likely

Major advantages: Nothing to do before/during sex, menstrual regulation, high effectiveness
– protection begins quickly can be less than a week

Major disadvantages: Hormonal side effects, medication interactions

major disadvantages
Pills, patches, and vaginal rings
– different methods of hormone delivery
– pill offered in dozens of formulations

Required “maintenance” varies
• Typical use: 91%
• Perfect use: 99.7%

progestin-only hormone methods (estrogen and progestin)
For women who can’t use estrogen or smoke heavily
1. Progestin-only pill

2. Hormone injection (Depo Provera)
• Very long-lasting
– but once stopped, fertility takes a long time to resume

• Effectiveness:
• Typical use: 94%
• Perfect use: 99.8%

Hormonal Intrauterine Device
• Small plastic “T” inserted into uterus that secretes progestin
– good for up to 5 years
The Implant)
• Small plastic rod inserted into arm that secretes progestin
– good for up to 3 years
• IUD & Implant Effectiveness:
• Typical & perfect use: > 99%
psychological effects of hormonal contraceptives
Hormonal contraceptives may alter they type of men heterosexual women are attracted to
During ovulation, women’s grooming habits & clothing changes
• Haselton et al. (2007)
– ovulating women wear nicer and more fashionable outfits

• Durante et al. (2011)
– ovulating women pick out sexier clothes when shopping

• Ovulating women are attracted to more masculine men (Gangestad et al., 2005)

• Hormonal contraceptives wipe out these ovulatory shifts
• Women on the pill may pick more reliable men
• Roberts et al. (2012)
• Compared women on the pill to “naturally cycling” women
– women on the pill had longer lasting relationships, but slightly less satisfying sex
– no difference in likelihood of orgasm

Leading form of birth control in U.S. and world
A. Tubal ligation
• Blocks tubes to prevent sperm from reaching egg

B. Vasectomy
• Blocks tubes that carry sperm outside body

• Both > 99.5% effective

infections transmitted via sexual contact
– broader, more inclusive
infection with or without symptoms
infection with symptoms
how common are STIs and who gets them?
• 1 in 4 treated for STD by age 21
• 19 million new cases/year (U.S.)
• About half contracted by 15-24 year-olds
• Most prevalent bacterial STI
• 1.4 million cases/year (U.S.)
– teenagers and women have highest infection rates

• Transmission via sexual contact, touching

• Effects on women:
• Urethritis or cervicitis
– few or no symptoms

• If untreated, pelvic inflammatory disease (PID) can develop
– symptoms can be mild or severe

• Effects on men:
• Epididymitis or nongonococcal urethritis (NGU)
– men are more likely to experience symptoms than women, about half experience symptoms (urethral discharge, some pain)

• Serious consequences if left untreated
– infertility, sterility, trachoma, premature birth

• Treatment: antibiotics (usually treated for gonorrhea as well)

• Not as common as Chlamydia
• 320,000 cases/year
– young adults have highest rates

• Transmission via sexual contact
– may get infection in genitals, rectum or throat
• Effects on women include cervicitis and PID
– most women asymptomatic, have a higher risk of complications

• Effects on men include urethritis
– most men show symptoms, which prompts treatment

• Symptoms appear earlier in men

• Serious consequences if untreated
– infertility, sterility, infant blindness, others

• Treatment: antibiotics. However, antibiotic-resistant strains of the disease have developed recently

• Less common
• 14,000 cases/year (US)
– but more common and increasing among MSM

• Transmission via sexual contact

• Advances through 4 stages in both men & women
• Primary Syphilis
– chancre (painless sore) develops on genital region

• Secondary Syphilis
– rash (palms of hands or soles of feet)

• Latent Syphilis
– no symptoms

• Tertiary syphilis
– most severe symptoms, blindness, heart failure, etc, the longer syphilis goes untreated, the worse the health outcomes are

• Treatment: penicillin

Herpes (viral)
• Type 1 (oral)
• Type 2 (genital)
– both can cause sores in either area

• VERY prevalent
• Some estimates put it at 100 million oral, 50 million genital
• Millions of new cases/year

• Transmission: sexual contact

• Virus never goes away
– can be spread with or without sores present

• Men—no major complications

• Women—uncommon, but serious potential complications
– cervical cancer, newborn infection

• No cure

• Treatment: Retroviral drugs (e.g., Valtrex)
– can suppress outbreaks, lessen symptoms

Human papillomavirus HPV
• Also extremely common
• 40 million cases (U.S.)
• 6 million new cases/year

• Transmission: any skin to skin contact
– can be transmitted even when using condoms

• Most don’t develop symptoms

• Genital warts may occur in some

• Complications: increased cancer risk, newborn respiratory infections
– linked to cervical, anal and throat cancers

• No cure

• Treatments: wart removal; cancer treatments

• Gardasil is an FDA approved vaccine for both women & men
– may protect against developing cancers
– recommended for adolescents, politically controversial

Human immunodeficiency virus HIV
is a retrovirus that targets & destroys helper T-4 cells (CD4 lymphocytes)
• HIV becomes AIDS when 2 conditions are met
1) HIV is present and
2) T-4 count is less than 200 cells per microliter of blood

• Incidence
• U.S.: 1.1 million currently infected with HIV
– mostly men in US but sex ratio is even worldwide

• Approximately 50,000 new cases/year in U.S.
• Infection depends on Two Factors

• Viral load highest in new and advanced infections
– more virus present in bloodstream

• Body secretions vary in amount of virus
– blood, semen, maternal milk,are highest for transmission risk

• After a few weeks flu-like symptoms may develop

• After 3-6 months, antibodies appear
– HIV is typitcally diagnosed based on presence of antibodies

• Later symptoms vary

• After 10 years on average, immune system becomes seriously compromised
– opportunistic infections, cancers

HIV treatments
• No cure currently exists
• Highly active antiretroviral therapies
• “Cocktail” of reverse transcriptase inhibitors & a protease inhibitor
– can reduce viral load to undetectable level

• Very expensive

• Problems with nonadherence, toxicity, & treatment failure

• MTCT reduced by 2/3rds in recent years
– risk is lowest when mother takes Zidovudine AZT and does not breastfeed

• Scientists have been working on a “vaccine”
• Grant et al. (2010) study of Truvada
– infection risk reduced by 70+% in MSM

• 2014: Thousands in the U.S. now using Truvada for HIV prevention (PreP)

factors that increase spread of STIs
– biopsychosocial
biological factors
• Lack of disease symptoms

• Having one STD increases chances of contracting & spreading others
eg. Herpes, syphilis (open sores allow easier transmission)

• Some animal research suggests that certain STIs may alter host’s sexual behavior to increase spread of infection!

psychological factors
• Use of oral contraceptives (Williams et al., 1992)
– may create false sense of security
– alone, provide no STI protection

• Testing stigma
• Stall et al. (1996)
– 59% of men never tested for HIV say it’s because they feared social consequences

• Personality
– erotophilia and sensation seeking linked to unprotected sex

• Perceived invincibility (“it can’t/won’t happen to me”)
– health psychology: unrealistic optimism

• Being committed to a sexual partner reduces sense that partner is a health risk (Gerrard, Gibbons, & Bushman, 1996)
– commitment may undermine condom use

• When partner is very physically attractive, safe-sex intentions are lower (Agocha & Cooper, 1999)

social factors
• Alcohol and drug use
– often linked to low likelihood of taking precautions, but effects are complicated

• Social norms: Is it “taboo” to ask about sexual history?

• Doctor-patient relationships
• Tao et al. (2000): only 28% reported being asked about STDs during routine checkups

• Many people have limited access to health care
– less likely to be tested and treated

psychological impact of STIs
Infection is often accompanied by negative changes in self-image and self-esteem
– feelings of victimization
– fear of being alone

Effects even more severe for HIV infection
– increased mortality salience, fear of becoming dependent upon others

These effects are compounded by the social stigma (Sayles et al., 2007)
• Pervasive lack of knowledge & widespread fear about many infections
eg. Myths about trasnmission

• Infected persons are often seen as being personally responsible

Impact of HIV
• Intense stress may lead to substance use as a coping mechanism
– exacerbates mental health issues

• Anger and denial are common reactions to HIV infection and may lead some to intentionally infect others
– intentional or reckless infection is a crime

• There are rare cases where some individuals want to be infected with HIV (“Bug Chasers”; Mokowitz & Roloff, 2010)
– subculture of gay men who voluntarily seek infection

effects on relationships and sexuality of HIV
• Benefits of seeking a seroconcordant partner
• Frost et al. (2008)
– reduced risk of transmission, greater sexual intimacy

• But the drawback of seroconcordance is a much smaller dating pool

• Dating someone of unknown or serodiscordant HIV status is complicated
• How and when do you discuss disease status?
• How do you manage infection risk?
• How do you cope with stigma?

STIs and relationships
Many people assume an STI is the end of dating and relationships, but it doesn’t have to be
– some online dating websites cater exclusively to “positives”

Can relationships between infection discordant couples work?
• Yes, but only if the couple:
• Uses consistent protection
– condoms and dental dams

• Has excellent communication
– partner with herpes may limit intimacy when they feel an outbreak coming on

the evolution of sex laws
o The rise of the sex-for-procreation view laid the foundation for modern regulation of sexual activity

o Many sexual activities we take for granted today were illegal in the Western world until recently
– contraception, same sex activity, cohabitation

many restrictions on sex have been loosened
• Griswold vs. Connecticut (1965)
– legalized contraception

• Lawrence vs. Texas (2004)
– legalized same-sex activity

most cultures regulate
sexual victimization, prostitution, and pornography, but nature of laws varies dramatically
– porn is illegal to sell in most of Australia
sexual assault
Any event in which a person is touched in a sexual way against their will or made to perform a non-consensual sex act
– applies to persons of all genders and sexualities as well as all sex acts

• Laws vary across countries & U.S. states
– eg spousal rape only exists in certain parts of the world

prevalence of sexual assault
o U.S.: 668 sexual assaults per day (Truman & Planty, 2012)
– most go unreported

o Most assaults involve male perpetrator and female victim
– most assailants known to victim

types of sexual assault
o Stranger (unknown assaliant)

o Acquaintance/Date
– rohypnol (roofies) and alcohol often used to facilitate

o Statutory
– age of consent varies across states and countries

o “Corrective” rape
– goal is tu cure woman of homosexuality

motivations for sexual assault
o Is it all about power and control?

o Research suggests that sexual motives contribute in some cases (e.g., Mann & Hollin, 2007)

o Probably best to think of a typology of rapists that vary based upon motive (Beech, Ward, & Fisher, 2006)
– anger resentment, hostility toward women, women as objects, feeling entitled, uncontrollable sex drive

psychological effects of sexual assault
o Negative emotions and cognitions
– depression, shame, guilt

o Post-traumatic stress disorder (PTSD; Cloitre et al., 1997): prolonged emotional reaction, reliving experience

o Sexual effects
– vaginismus, erectile dysfunction

child sexual abuse (CSA)
• Any instance in which a child is sexually victimized by an adult

• Two categories:
1. CSA perpetrated by a relative
– incest

2. CSA perpetrated by non-relative
– pedophilia (if stemming from attraction to children)
– child molestation ( any child abuse, regardless of motive)

characteristics and prevalence of CSA
o Most acts perpetrated by men against female victims (Murray, 2000)
– most assailants known to victims

o Most perpetrators were victims of CSA themselves

• Blanchard et al. (2007)
– however research suggests biological or biosocial basis for pedophilia

o Meta-analysis puts prevalence of CSA at 7.9% among men, 19.7% among women (Pereda et al., 2009)

psychological effects of CSA
o Similar emotional disturbances to adult sexual assault

o CSA victimization linked to risky sexual & other behaviors, as well as relationship difficulties
– potential intimacy and sexual performance problems

sexual harassment
• Unwanted verbal and/or physical sexual advances in workplace or academic environment

• Like other forms of sexual victimization, most cases involve male perpetrators & female victims
– however reasons for harassment vary

EEOC guidelines of sexual harassment
o Unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature when:
Submission to such conduct was made either explicitly or implicitly a term or condition of an individual’s employment,
• Submission to or rejection of such conduct by an individual was used as the basis for employment decisions affecting such individual, or
• Such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment.
quid pro quo
• Sexual favors requested in return for (1) securing job/academic benefit, or (2) for desirable treatment
– this for that

• Power differential necessarily exists

hostile environment
• Persistent, inappropriate behavior that makes environment hostile, abusive, or unbearable

• No power differential necessary
– harasser can be equal or lower status to victim

• Less clear cut; may be ambiguous to outside perceivers
– legal standard what would a “reasonable person” find hostile?
• Key is whether victim feels offended/uncomfortable

prevalence and effects of harassment
o Estimates vary depending upon how “harassment” defined
• e.g., “Have you ever been harassed?” vs. select from a checklist of potentially harassing behaviors
• Ilies et al. (2003)
– 24% of women say they’ve been harassed, but 58% pick behaviors off checklist

o Men less likely to be victims & less likely to report it

o Can lead to emotional disturbances & PTSD
– also, potential to quit job or school or have worse performance

o Most common definition: Exchange of money for sexual service
• But this concept gets tricky…
– more precisely defined as explicit agreement to trade money for sex, usually offered indiscriminately

o Largely legal in US through early 1900s
– one reason for change was maintaining a functional military

types of prostitues
o Persons of any sexual and gender identity can be prostitutes, but most are female-identified

o Two classes of prostitutes
• Those who literally walk the streets: most visibility & danger, lowest $ rates
– streetwalkers (female) and hustlers (male)
– peer delinquent prostitutes (male) prostitution for robbery

• Those who work as “escorts”: regular clients, more safety, higher $ rates
– call girls (female) and gigolos (male)

o Other variety: the brothel worker
– where legal, safeguards in effect (eg. STI testing, condom requirements)

o Would legalized brothels provide more safety for sex workers and clients?

motivations and effects of prostitution
o Some find it exciting, but most women enter the profession because they feel little other choice (Kramer, 2004)
– but also drug habits, coercion, etc

o Most female streetwalkers & escorts report work as emotionally unpleasant (Kramer, 2004)
• Farley (2004)
– many meet criteria for PTSD

o Drug use/abuse common, but is it a cause or consequence?

o Heightened risk of STIs
– compounded by $ incentive to not use condoms

clients of prostitutes
o Most customers are men; not social deviants (Monto, 2002)
– educated, employed, half are married

o Motivations vary
– uncomplicated sex, excitement, no partner

• Another legally regulated area—we will consider in detail separately later

• Laws address both production and distribution of porn
– production: condom and age requirements
– distribution: type available for sale and where sold

uncommon forms of sexual expression
– beyond usual or typical love

• The traditional DSM definition
• “Recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other nonconsenting persons that occur over a period of at least 6 months.”

characteristics of paraphilias
A. Distinction between “having a paraphilia” and “having a paraphilic disorder”
– you can have an unusual interest without having a disorder

B. Occur to varying degrees across persons
– these behaviors occur to varying degrees among people, these are not done on a daily basis, potentially once a day,
– for it to be paraphilia it has to be repeated

C. Typically occur in clusters
– many people have multiple paraphilias” sexual fetish for underwear might be into BDSM

D. Sex difference: Men > Women
• May be due to women’s greater erotic plasticity
– women are turned on by wider range of stimuli, may have an easier time changing socially undesirable interests

E. May or many not involve others (coercive vs. non-coercive)

biopsychosocial roots of paraphilia
associated with hormones and neurotransmitters, past learning, and social skills

• How do we determine what is “normal” and “deviant” sexual behavior?
• Cultural and societal standards
– pedaresty in ancient Greece was once an accepted practice

• Receiving sexual arousal from body part or inanimate object
– must be focused on object to exclusion of everything else

• May substitute fetish for relationship

• Development: Classical conditioning
• (Rachman, 1966)
– conditioned boot fetish in male participants

• Rarely harmful to others
– except potential burglery

• Cross-dressing for the purpose of sexual arousal

• NOT transsexualism!
– no desire to change one’s sex

• Is it always a fetish?

• Range of behaviors

• Who is a typical transvestite?
• Docter & Prince (1997)
– most are heterosexual, married men, exceedingly rare among women
– some wives are accepting

• Conditioning is a frequent cause

sadism and masochism
• Association between sexual pleasure and pain
• Sadism
– sexual arousal from giving physical or psychological pain

• Masochism
– sexual arousal from receiving pain

• Amount of pain required varies
– symbolic to intense

• Mild S&M is somewhat common
• Richters et al. (2008): 1.8% had engaged in BDSM
• Defined in this study as “bondage and discipline, sadomasochism, or dominance and submission”

• Gross (2006)
– when you ask about specific behaviors such as spankings, love bites, mild S&M is common

• Masochism more common than sadism
– masochism only paraphilia common among women

• May arise from conditioning or other factors
– sensation seeking personality
– Baumeister: escape from self-awareness

autoerotic asphyxia
pressure-induced oxygen deprivation
– one of the most dangerous paraphilias
giving or receiving enemas
– flushing out anus with liquid
contact with feces
– watching someone defecate, defecating on someone, having someone defecate on you
contact with urine
– watersports, golden showers
coercive paraphilias
• Involves an unwilling participant
– potentially harmful and illegal, victim may be traumatized
non-coercive paraphilias
• May be a solo activity or include participation by a consenting adult
– generally considered harmless behaviors
– fetishism
– transvetism
– s and m
• Exposing genitals to UNWILLING others, usually in easily escapable setting
– arousal derived from shocked reaction

• Typical “flasher”: young, shy man

• Several reasons for exhibitionism
– fear of rejection
– affirmation of manhood
– social skills deficit

• Men with history of exhibitionism sometimes progress to sexual assault

• Suggested response: calmly ignore it and leave immediately

obscene phone calls
• Viewed as a subtype of exhibitionism
– arousal from shocked response

• Profile: Usually shy, insecure male

• Suggested response: hang up and screen calls

• Observing others undressing or engaging in sex without their consent

• Some degree of voyeurism appears natural
• Rye & Meaney (2007)

• True voyeurism requires an ongoing pattern of behavior

• Offenders are typically young men with poor social skills

• New technologies have given voyeurs more opportunities

• Videovoyeurism: filming/photographing without consent

pedophilia 2
• Sexual attraction to prepubescent children; diagnosed when individual “acts upon” urge or is distressed by urges

• Most are heterosexual, married men (de Silva, 1999)
– 4% of population

• Increasingly thought to have a biosocial basis (Blanchard et al., 2007)
– from past sexual experiences of child victimization,
– genetic predisposition brought out by environment, more likely to be left handed or ambidextrous, below average IQs
– many report past child abuse/sexual abuse

rubbing against an unsuspecting person in a crowd
– behavior appears inadvertent, may not be noticed
sexual arousal from viewing or violating a corpse
• Rosman & Resnick (1989)
– most common reason: desire for partner who won’t resist

• Zoophilia (beastiality): desire for sex with animals
– zoophiles care about animals’ pleasure, bestialists care only about own pleasure

treatment of paraphilias
• Treatment appropriate & important when it meets “disorder” criteria
– but offenders usually aren’t interested
– psychotherapy
– behavior therapy
– orgasmic reconditioning
– satiation therapy
= arousal inhibiting drugs
– social skills training
psychotherapy for paraphilias
– Generally not effective by itself
behavior therapy for paraphilias
– aversive conditioning
– orgasmic reconditioning
– satiation therapy
aversive conditioning based on learning theory
paraphilia paired with unpleasant stimulus
Orgasmic reconditioning
associate orgasm with acceptable behavior/imagery
Satiation therapy
imagine paraphilia after orgasm, pair with low arousal, discomfort
Arousal-inhibiting drugs
– Depo-Provera
– lowers testosterone, chemical castration

– Prozac
– increases serotonin

Social skills training
teach skills to develop socially acceptable relationships
treatment outcomes for paraphilias
• Success rates vary; reoffending is common
• Schmucker & Losel (2008) meta-analysis
• Programs reduced recidivism by 37%
– cognitive-behavioral and hormone therapy most effective
– works better for volunteers

• Best outcomes for those treated early & who are motivated to change

Sexually explicit material that has the intent of producing arousal in those who consume it
Differs from erotica
Sexual depictions that evoke themes of mutual attraction and typically have an emotional component
history of pornography
As old as civilization
But modern concept of pornography stems from Victorian era
Arose from discovery of Roman ‘obscenities’ during Pompeii excavations
Obscene Publications Act of 1857 – first law criminalizing pornography
Beginnings of Mass Circulation
16th Century: Erotic literature
“The Ways” (1524)—book of sexual positions
17th & 18th Centuries: Erotic fiction
John Cleland’s “Fanny Hill” (1748) – first erotic fiction, depicted woman free with her sexuality
19th Century: Nude photography
Technological advances allowed faster & cheaper photo production
Nude photography prohibited unless it had “artistic” or “scientific” purposes
Most nude photos at the time consisted of solitary woman exposing breasts
19th & 20th Centuries: Magazines
Mostly nude and semi-nude photos of women
Focus of camera changed over time: 1940s featured legs, 1950s featured breasts
First issue of Playboy Magazine in 1953
Magazines have become more explicit over time → eventual shift to genitals
20th Century: Pornographic Films
Earliest films date back to 1908
Secretly produced and distributed
Reached peak in US in 1970s with mainstream success
“Deep Throat” (1972)
Launched modern porn industry
Today: The Internet
Caters to all sexual proclivities; frequently utilized as a sexual aide
A source of social and legal controversy
profile of a porn star
Money is the most common incentive (Griffith et al., 2012)
Similar to prostituion in this way, but very few people coerced into porn
Public perception is that porn stars are “damaged goods”
However, research suggests that porn actresses show comparable psychological well-being to a matched sample in many ways (Griffith et al., 2012)
No difference in past history of CSA; porn actresses had slightly higher self-esteem
But, porn actresses have higher levels of substance abuse
who uses porn?
Major sex differences in porn use
Carroll et al. (2008) study of college students at 6 universities
9 in 10 men and 1 in 3 women
48.4% of men report daily use vs. 3.2% of women
Men’s relationship status makes no difference in porn use, but women in relationships use it more than single women
Why Do Men Use More Porn Than Women?
“Research has shown that men are more visually stimulated, while women are more literary; they’re turned on by words or erotic stories.” – Dr. Michael Krychman on Fifty Shades of Grey – but is Krychman right?
Men do report more subjective arousal to porn than women (Koukounas & McCabe, 1997)
But genital arousal tells a different story (Chivers et al., 2004) – perhaps women underreport arousal due to social pressure
do men and women look at porn the same way?
Rupp & Wallen (2007)
Heterosexual men & women viewed explicit sexual images while attached to eye-tracking device
Female faces were statistically the most likely feature to capture men’s attention
Perhaps men see the face as the biggest indicator of female arousal
Results for women depended upon contraceptive use
Naturally cycling women: genitals and female body most likely to capture attention
Women on the pill: contextual features of situation most likely ot capture attention
porn and the law
Laws may regulate production, distribution, and possession of porn—huge cultural variability
U.S. federal law: Child Protection and Obscenity Enforcement Act (1988) – no one under 18 allowed to perform
U.K. law against “extreme pornography” – “grossly offensive, disgusting, or otherwise of an obscene character”
obscenity criteria
established by U.S. Supreme Court
Miller vs. California (1973)
The dominant theme of work must appeal to “prurient interest in sex”
Must be patently offensive for contemporary community standards
Must fail the SLAP test: lacking serious scientific, literary, artistic, or political value
Commission on Obscenity and Pornography
Appointed by Lyndon B. Johnson to study effects of legalization of pornography in Denmark
What happened in Denmark?
Sales of porn decreased
No increase in sex offenses
Research on college students found no long-lasting behavioral changes after exposure to porn
Meese Commission
Appointed by Ronald Reagan
Utilized unscientific research methods
Came to a very different set of conclusions
Violent and degrading porn causally associated with sexual violence
The Commission also reported that non-violent, non-degrading erotica is destructive to the moral environment of society
i.e. promotes sex outside of marriage
Recommended vigorous law enforcement and prosecution of porn
effects of pornography on rape and sex crimes
Ferguson & Hartley (2009) meta-analysis
No evidence that porn causes rape or sexual assault
In fact, as porn consumtpion has increase, sex crimes have decreased
Stand in stark contrast to Meese Commission findings
But does this mean that porn is completely harmless?
Hald, Malamuth, & Yuen (2010) meta-analysis
Is there a link between porn use & acceptance of violence against women?
Positive correlation, particularly for violent pornography and for aggressive men
effects of porn on relationships
Men who viewed Playboy centerfolds reported less attraction to and love for their spouses than men who viewed abstract art (Kenrick, Gutierres, & Goldberg, 1989)
But no baseline measure of attraction/love was taken and effects were assessed immediately after exposure
Causal evidence of harm is lacking—but it is possible that frequent porn consumption could hurt by creating a contrast effect
i.e., partner looks at partner in comparison to porn actors
Compulsive porn use is linked to reports of relationship problems (Bridges et al., 2003)
When porn use becomes a problem in a relationship, it’s usually men’s (not women’s) porn use that’s the issue
Not surprising because men use it much more!
When porn use is compulsory for one partner, it can inhibit both partners’ sexual satisfaction
Effects on body image and perception of what is “normal”
Porn penises are far from average
Lever et al. (2006): estimated that only 2.5% of men have penises longer than 6.9 inches
Porn may also contribute to distorted perceptions of what the vulva and breasts are “supposed” to look like
As a result, some people may feel that they never “measure up” and/or develop unrealistic expectations for their partners
May prompt genital modification surgeries or use of enhancement devices
Porn sometimes depicts unsafe activities
e.g. “barebacking” (having sex without condoms), ATMs (ass to mouth: taking the penis directly from the anus to the mouth, spreading intestinal diseases)
Should there be any regulations?
effects of porn in brain
Some research suggests brain atrophy associated with excessive porn consumption (Hilton & Watts, 2011)
But, it’s correlational and virtually all compulsive porn watchers sampled had other problematic behaviors (e.g. alcohol use)
Some in the media have claimed that porn exposure can cause “memory loss” based upon research (Laier et al., 2013)
Participants shown sexual or non-sexual images & asked to recall the image that appeared 4 slides ago
`Participants were right 77-80% of the time for non-sexual images, and 67% correct for porn
However, the effects were only for memory of other porn and memory was still good overall
Abstinence only approach
focus is teaching kids to abstain from sex. There is no information provided on obtaining and using contraception/condoms.
Abstinence plus approach
kids are taught that abstinence is the best policy but they are also given information on how to obtain and use contraceptives for those who are sexually active.
Comprehensive sex education
abstinence is not the primary goal. Students are given a wide range of information and the focus is on responsible decision making skills when it comes to sexual activity.
Problems with abstinence only approach
• Ignores certain groups
• What about sexually active teens and GLBT youth?
• Ignores gender identity and orientation – many of these programs also discuss saving yourself for marriage.
• Teaches misconceptions and falsehoods
• A study by the US Department of Health and Human Services found that more than 80% of abstinence only programs contained scientific errors and taught false information
• These programs may also teach incorrect information such that safe sex and pleasurable sex are at odds with each other.
• Some sex education organizations have tried combatting this misconception by re-conceptualizing safe sex in pleasurable terms. School based education should include parents and must go beyond just discussing abstinence.
History of Contraception
• 1500s condoms made their debut and were made of animal skin, they were not made of vulcanized rubber until around 1800s. In the 1900s, the latex condom became a thing.
• Illegal throughout many parts of the United States until recently – medicine, etc
• Landmark case: Griswold vs. Connecticut (1965) – case was argued in front of SCOTUS in which contraception than became legal in the US
• Estelle Griswold, challenged law – Director of Planned Parenthood in Connecticut – she was convicted and tried in court – constitutional right to marital privacy – this started off as a narrow ruling for contraceptives. This right to privacy was then expended later on.
• Supreme Court ruling changed everything – since Griswold, contraception has become more widespread; attitudes more favorable
• But still very controversial – ex: Plan B – legalized for sale without a prescription in 2006, but we still are debating how it should be available and also at what age. Should pharmacists not sell this medication?
• Variety of methods to chart menstrual cycle
• Standard days method – plotting the menstrual cycle on a calendar to determine which days are safer to have sex
• Symptothermal method – checking for biological indicators of ovulation
• Uses cervical mucus consistency and basal body temperature as biological indicators
• Basal body temperature – ovulation = .5/1 degree higher than when not ovulation
• Cervical mucus – get up in there – mucus more like an egg white – riskier days
• Leaves open conception to happen – ok’d by the Catholic Church except for barriers
• This uses different techniques to determine days that are more or less risky
• Basic way: calendar method – least reliable since women have unpredictable cycles
• Reasons for abortion
not being able to afford a child, not being ready for children, not wanting additional children, and being in an unstable relationship
o most women who chose to have an abortion were okay with their decision 2 years later, but 20% reported experiencing at least one episode of clinical depression after the procedure
o expressing depression prior to the pregnancy was also a strong predictor of experiencing depression after the abortion
Dental dams
latex barriers that look like a fruit roll up and are put over the vulva or anus for oral sex
Indirect partners
when you have sex with someone, you are indirectly being exposed to every other sex partner that person has had as well
• Unrealistic optimism
people think that they are unlikely to encounter health problems and are healthier than they actually are
Psychological factors that spread STIs
• Use of oral contraceptives (Williams et al., 1992)
• By removing the fear of unwanted pregnancy from the equation, some couples feel protected and therefore stop using condoms
• Testing stigma
• Stall et al. (1996)
• Getting tested can make it awkward between you and your partner – others feel like they will be judged
• Among men who had never been tested for HIV, 59% felt like they did not get screened because they feared the potential social consequences.
• Personality
• People with more erotophilic personalities (strong, positive emotion towards sex) and those who perceive a condom as a barrier to sexual pleasure are more likely to report having unprotected sex
• Sensation-seeking personality is also linked to reporting sex without condoms in risky situations, cheating, and contracting more STIs
• Also unrestricted socio-sexual orientation – more risky sexual behaviors
• Perceived invincibility (“it can’t/won’t happen to me”)
• Being committed to a sexual partner reduces sense that partner is a health risk (Gerrard, Gibbons, & Bushman, 1996)
• People in monogamous relationships often cheat and when they do, they infrequently use protection AND do not disclose those encounters to their partners
• When partner is very physically attractive, safe-sex intentions are lower (Agocha & Cooper, 1999)
• This is stupid because they probably have more sex because they are attractive
• Expectancy effects
the idea that our beliefs about how something will affect us can ultimately shape our experiences