Jill Norvilitis, Ph.D.
A few definitions to start us off…
Gender-maleness or femaleness
 Sex—biological distinction
 Gender roles—how males and females
are expected to behave
 Gender identity—personal experience of
being male or female
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Historical perspectives
 Art
from the Stone Age suggests
worship of women’s fertility
 Then, around 11,000 BC, ice age
retreated, more agrarian
 Phallic worship emerged around 9000
BC
 Incest
taboo—earliest of taboos;
universal, but varied
 Ancient Hebrews—polygamy
permitted, monogamy preferred
History continued

Ancient Greeks—viewed men and
women as bisexual
 Male-male sex was normal, but not
relationships
 Lots of prostitution
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Ancient Rome—sexual excess
 Julius Caesar
 Caligula—orgies with bestiality and sadism
 However, family was important social
structure
History continued
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Early Christianity
 Sexuality was associated with sin
 Marriage bed only
 Some ideas became more conservative over
time
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Eastern Religions
 Islam—marriage important and sexual
fulfillment in marriage
 Tao—sex as sacred duty
 Hinduism—sexual pleasure as a spiritual
ideal
 Kama Sutra—3rd to 5th century AD
Middle Ages
 Eve vs. Mary
 Roman Catholic church
○ Sex for procreation only
 Reformers
○ Sex strengthens marriage, which is a part of
worship
19th Century

Science of Sex began in the 19th
century—Victorian era
 Freud—next class
 Havelock Ellis—1859-1939—compiled
information on sex; believed that deviations
from the norm were not harmful
 Von Krafft-Ebing—200 cases of pathological
individuals
 Hirschfeld (1868-1935)—sex survey of
10,000 people on 130 items; much of his
work was destroyed by Nazis
 Kinsey—start of current sex research
Influences on sexual behavior
 Variety of behaviors
 Culture
 Peers and family
○ Larsson & Suedin, 2002—269 high school
students
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70%--knowledge from friends
62% knowledge from television
51%--knowledge from parents
15 %--(mostly boys) pornography
 Religion
○ Adolescents who are more religious are less likely
to have sex in high school
Evolutionary
psychology/sociobiology
Application of evolutionary biology to
understanding social behavior of
animals, including humans. Heralded by
EO Wilson
 Natural selection
 Parental investment

 Women—one child. Men—many children
 Related to sexual selection men
promiscuous, women monogamous
 Rape as an extreme casecauses genes to
be continued
Criticisms of evolutionary
psychology
 No personal choice
 Central function of sex is no longer
reproduction
 Wide variety of cultural behavior says
genetics can’t be cause
 Evolutionary psych looks at survival of
individual, but modern biology looks at
survival of species
Psychoanalytic theory

Freud
 Id—pleasure principle—seek pleasure/avoid pain
○ Need to get rid of anxieties/pain
○ Instincts—hunger/sex/thirst/elimination/aggression
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Ego—reality principle
Superego-idealism/conscience
Develop sequentially
Mind is both conscious/unconscious
Ego shields our more base urges through defenses
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Repression
Rationalization
Intellectualization
Projection
Reaction formation
Sublimation
Psychoanalytic theory continued
 We often banish sexual impulses to the
unconscious, but they creep in through dreams
 Erogenous zones—libido is focused in different
places—pt. of skin or mucus membrane
sensitive to stimulation—lips/mouth, etc.
 Stages of psychosexual development
○ Over vs. underindulged
○ Oral—birth to 1
○ Anal—1 to 2
○ Phallic—3 to 5 or 6
 Oedipal complex—castration anxiety
 Electra complex—penis envy
○ Latency
○ Genital stage—adolescence
Criticisms of psychoanalytic
theory
Lack of empirical testing
 Focus on disturbances in personality
 Overemphasis on biology
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Learning theory
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Classical conditioning helps explain fetishes.
 UCSUCR
 UCS+CSUCR
 CSCR
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Operant conditioning
 Behavior followed by reward or punishment changes likelihood
of behavior happening again
 Sex is a primary reinforcer
 Immediate vs. delayed reinforcement
 Punishments are less effective shapers
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Behavior modification
 Used to modify sexual dysfunction
 Deal with problemunconcerned with origins
 Aversion therapy
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Social learning
 Observational learning—peers, tv, parents, etc
 Imitation
 Identification
Social factors
Every society regulates sexuality in some way
Basic institutions of society (religion, family) affect the
rules governing sexuality
 Appropriateness/inappropriateness is culture bound
 Sexual scripts
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 Sexual behavior is scripted—much learning!
 People can predict what will happen next and there is
consensus about what the order should be
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Social levels of analysis
 Macro or societal—religion, economy, family, medicine,
laws
 Subcultural—social class, ethnic group
 Interpersonal
 Individual
Cross-cultural perspectives
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Ethnocentrism
Kissing is common, but not universal
Frequency of sex varies, US in the middle
Masturbation—universally practiced, universally disapproved
of
Eastern Polynesia
Incest—most common taboo; extramarital sex is second
Wide variety of beliefs about homosexuality
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4 rules emerge
It happens, regardless of social beliefs
More common in males
Never predominant
Never >5%
Attractiveness—what do we do to be attractive?
 Poor complexion always bad
Cross-species considerations
Analogues—something that is
comparable to something else. In this
case, animal beh. that is like human
beh.
 See masturbation in many mammals,
primarily primates
 Same gender beh in porpoises
 Polyandry in some sandpipers
 Sexual signaling—monkeys who parade
 Nonsexual uses of sexual behavior

Issues in sex research

Sampling
 Identify the population to be studied and choose a subset
 Random sample—each member of the population has =
chance of being studied
 Refusal/non-response
 Volunteer bias—the Hite report was based on a 3 % return
rate
 Convenience sample
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Reliability
 Purposeful distortion
○ Enlargement
○ Concealment
 Memory
 Difficulty with estimates
Ethics in sex research
 Informed consent
 Protection from harm
 Confidentiality
 Deception
 Cost-benefit approach
Methods of research
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Case study
 Limitation—generalizability
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Survey
 Interview vs. questionnaire
 Interviews can branch, literacy is not an issue, rapport
harder on the phone
 Questionnaire—less costly, honesty?
○ People report riskier beh on questionnaires

Direct observation
 Observer effects--? Increased inhibition
 One study showed that men who volunteered for
observational research were less guilty, less sexually
fearful, more sexually experienced
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Participant observer
True experiments
Observational study example
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Study of flirting
 Cross-species studies find importance of female in
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choosing mate
Naturalistic observation as mode of data collection
Worked in bars with bar owners’ cooperation
No personal info
Microcassettes, proper dress to be unobtrusive
Random selection
Women indicated interest through…
Comparison of locations
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Women in bar: 70 flirting acts per hour
Student union: 19
Library: 10
Women’s center meetings: 5
 Women who signal most are most likely to be
approached by men
Major sex surveys
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Kinsey
 Born 1894, biologist
 Began to study sex after he became part of a faculty
committee for a class on marriage. Dearth of information
 He and colleagues studied 5300 males, 5940 females
between 1938 and 1949
 Sampling—not so great
○ 100% sampling—got permission from group, then interviewed all
members
 College, young, well-educated, city-living, white, Protestants, Indiana—all
over-represented
 Rapport well-established, non-judgmental, used
vernacular, assured confidentiality
○ Even had plans to destroy data if necessary
 Critique
○ Good results for his sample
○ Not representative
○ Overestimates of many behaviors
National Health and Social Life
Survey
 1990s
 Edward Laumann—National Opinion Research
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Center
Probability sampling of householdsexcluded
only 3 % of population 18-59
79 % participation rate
Originally targeted 20,000 individuals, reduced
to 3432 because of blocking of federal funds
One of the main findings—people will do sex
research if they are convinced it has a scientific
purpose
Other major surveys
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Playboy Foundation—Hunt Report
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Janus Report
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Selected people at random from 24 US cities
982 men, 1044 women
80% refusal rate
Asked over 1000 questions—both small group and questionnaire
2765 people 18 and up
Questionnaires and in-depth interviews with subset
Tried to construct a cross-sectional sample, but not randomly selected
61 % return rate
Magazine surveys
McCall’s—20,000 responses but many more married than general population,
more homemakers
 Redbook—mailed survey in magazine. 100,000 responded, but that was only
2 % of readership
 The Hite Report
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3019 responses from women
7000 men
100,000 distributed, essay-type questions
Claimed women were unhappy with loving relationships, that >70% had affairs
Masters and Johnson
Published 1966
 Began by interviewing prostitutes. Then set
up lab—EKG to measure heart,
electromyography to measure muscle
contractions, pH meter to measure acidity of
vagina
 694 people 18-89
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 276 couples
 106 women, 36 men unmarried
 Carefully screened out anxious people, let them
have practice session—collected data during
intercourse and masturbation
 Did follow up, no one reported harm
Female sexual anatomy—external
anatomy
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Vulva—collective term for external genitals
Mons pubis or mons veneris
 Fatty tissue that covers the joint of the pubic bones
 Covered with hair at puberty
 Captures chemical secretions from vagina during
sexual arousal—alluring to lovers
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Labia majora
 Large folds of skin that run downward from the mons
alongside of the vulva
 When close together, conceal labia minora, urethral,
and vaginal openings
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Labia minora
 Hairless, light-colored membranes that surround
urethral and vaginal openings
 At top, join the hood of the clitoris
Clitoris
 Knob of tissue situated externally in front of
vagina and urethral openings
 Two parts
○ Shaft and glans or tip
○ Glans is visible but shaft is hidden by clitoral hood
 Homologous to penissame embryonic tissue
 Varies in size
 Erectile
○ Internal corpora cavernosa that fills with blood, like
penis
 Many nerve endings
 No reproductive value, except arousal
Clitoridectomy
 Surgical removal of clitoris
 Predominantly occurs in Islamic cultures, but not
required by Koran
 Generally done by women, no anesthesia,
unsanitary conditions
 Complications common—infections, bleeding,
scarring, painful menstruation, obstructed labor
 More radical version—infibulation
○ Also remove labia minora and inner layers of labia major.
○ Raw edges of labia majora are sewn together with only a
tiny opening to ensure chastity
○ After marriage, opening is enlarged, but it may take 3 mos
to allow penetration.
 85-114 million women in 30 countries in Africa,
Middle East, India-Pakistan subcontinent
 Illegal in US since 1996.
Urethral opening
 Below clitoral glans and above vaginal
opening
 Unrelated to reproduction,
 Proximity can be a problem
 Cystitis—bladder inflammation
○ Symptoms are burning and frequent urination
○ Also pain, blood, pus
○ Precautions to avoid this
 2 quarts water/day to flush system
 Orange and cranberry juice help maintain acidic
environment to prevent bacterial growth
 Alcohol and caffeine can both irritate bladder
 Wash before and after sex
 Prevent objects that touch anus from then coming into
contact with vulva
Perineum
 Skin from vaginal opening to anus
 Nerve endings here, too
 Area that is cut in episiotomy
Vaginal opening
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Hymen
 Thin membrane partially covering vaginal opening
 At time of first intercourse, hymen is torn or
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stretched
Can be bleeding or pain—may be unnoticed in
excitement
Generally remains intact until intercourse, though
rough sports like horseback riding may tear it
Taken through history as a sign of virginity
Defloration
○ Destruction of the hymen—significance as a cultural ritual
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Vaginal opening itself is called introitus (from
Latin for entrance)
Vagina
Extends back and upward from vaginal opening
Usually 3-5 in long at rest, expands in length and width
during arousal
 AKA birth canal—so it expands quite a bit
 Vaginal walls have 3 layers
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 Vaginal mucosa
○ Inner lining
○ Made visible by opening labia minora
○ Similar to skin in your mouth
 Middle layer—muscular
 Outer layer—fibrous covering that connects vagina to
other structures
Outer 1/3 of vaginal barrel has many nerves, inner 2/3
doesn’t
 Vaginal walls—secrete substances to maintain normal
acidity and contain pheromones
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Vaginitis
 Vaginal inflammation
 Many causes—infection, BCP, allergies
 To avoid
○ Wash with mild soap
○ Don’t wear tight pants
○ Make sure sex partners are clean
○ Cotton panties
○ Avoid diets high in refined carbs and sugar as
they alter vagina’s acidity
Cervix
Lower end of the uterus
 Opening in the middle is the os
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 About the width of a straw
 Expands to permit passage of baby
This is where sperm pass from vagina to
uterus
 500,000 cases of cervical CA/yr
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 95% are caused by HPV
 More common among women with many sex
partners, sex at a young age, low SES, smokers
 Pap test to ID
 5 yr survival is 67%, 90% if localized
 Can be prevented if precancerous cells are
removed
Uterus
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Where fertilized ovum implants and develops
90% women antroverted, 10 % retroverted
Suspended in pelvis by flexible ligaments
Shaped like an upside-down pear
In woman who hasn’t given birth, 3x3x1in thick at top
3 layers
 Endometrium—innermost layer
○ Supplied with blood vessels and glands
○ This tissue is discharged with menstruation
○ Endometriosis
 Myometrium—muscular
 Perimetrium—external cover
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Hysterectomy
 2nd most common surgery on women (c-section 1st)
 1/3 of women by age 60
Fallopian tubes
 AKA oviducts
or uterine tubes
 Lined with hairlike projections called
cilia
 Path of egg—where sperm and egg
meet
 Ectopic pregnancy
 Sx—missed period, abdominal pain,
irregular bleeding
 Can burst tubes and cause death
Ovaries
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Almond shaped, 1 ½ long
Produce ova (egg cells), estrogen, and progesterone
Each woman has about 2 million at birth
 About 400,000 survive into puberty
 Each is contained in a small capsule called a follicle
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Each year in US, 27,000 women are dx’d with ovarian
cancer
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Over ½ die from it
4th leading cancer killer
90% survive with early detection
Risk
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Family history
Never having given birth
Prolonged use of talcum powder between anus and vagina
Infertility
Breast CA
Diet rich in meat and animal fact
 Most recent research suggests acetaminophen may cut risk
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Most common symptom is enlarged abdomen
Breasts
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Almond shaped, 1 ½ long
Produce ova (egg cells), estrogen, and progesterone
Each woman has about 2 million at birth
 About 400,000 survive into puberty
 Each is contained in a small capsule called a follicle

Each year in US, 27,000 women are dx’d with ovarian
cancer
 4th leading cancer killer
 90% survive with early detection
 Risk
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Family history
Never having given birth
Prolonged use of talcum powder between anus and vagina
Infertility
Breast CA
Diet rich in meat and animal fact
 Most recent research suggests acetaminophen may cut risk
Menstrual cycle
4 phases—each has changes in hormones, ovaries,
and uterus
Hormones and ovaries
 1) Follicular, proliferative, preovulatory phase
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 Pituitary (master gland) secretes relatively high levels of
FSH, thus stimulating the follicles in the ovaries
 Although several follicles may be stimulated, usually only
one matures.
 Follicle secretes estrogen and moves toward the surface
of the ovary
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2) Ovulation
 Follicle containing egg is released from ovary, follicle
ruptures open
 High level of estrogen inhibits FSH production
 High level of estrogen stimulates hypothalamus to
produce GnRH-gonadotropin-releasing hormone-which
cases pituitary to produce LH (leutinizing hormone)
Stages 3 and 4
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3) Luteal or postovulatory phase
 Follicle (having released egg) doesn’t just disappear. It turns
into a mass of cells called the corpus luteum with the stimulation
of LH
 Corpus luteum produces progesterone which inhibits production
of LH. As LH decreases, corpus luteum degenerates
 Because CL declines, progesterone and estrogen production
decline
 Falling levels of estrogen stimulate pituitary to begin production
of FSH so the whole cycle can begin again
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4) Menstruation
 Inner lining of uterus is shed, then passed out through cervix and
vagina
 Estrogen and progesterone are now low and FSH is increasing
 Menstruation is triggered by low estrogen and progesterone
Meanwhile, back in the uterus
1 & 2) High levels of estrogen stimulate the
endometrium to grown, thicken, and form glands that
will eventually secrete substances to nourish the
embryo.
 3) Progesterone secreted by corpus luteum stimulates
glands of the endometrium to start secreting nourishing
substances
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 If egg is fertilized, about 6 days after ovulation, the
fertilized egg arrives in a uterus well-equipped to nourish
and cradle it
 If no egg, CL continues to produce estrogen and
progesterone for 10-12 days
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4) If no pregnancy, hormone output of CL declines
sharply at the end of the luteal phase. The uterine
lining can’t be maintained and is shed. Immediately
after, a new lining starts to form.
Length and timing
20 to 36/40 normal; 28 avg
 Menstruation begins day 1 of cycle
 Ovulation is about day 14. Luteal phase
is pretty constant at about 14 days, so it
is phase 1 of a cycle that varies
 Anovulatory cycles—common if only 1
or 2x year
 Slight dip in temperature on day of
ovulation, sharp rise day after
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Cultural views
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Orthodox Judaism
 Old Testament (Leviticus 15:19-24)
○ Menstruating women were separated for 7 days
○ Anything that touches her is unclean
○ Intercourse is forbidden
○ At the end of 7 days, bathe in mikvah
 As recently as 1972, chief rabbi of Israel called for punishment for
married couples that violate Torah by having intercourse at this time
Jamaica
 Traditional rural Jamaicans believe that menstrual blood has + power
 Menstruation is a sign of health to get rid of toxins, esp toxins from
semen
 Post-menopausal women don’t need to menstruate because wombs are
closed up and not susceptible to dangerous effects of semen
Mescalero Apache
 Pubertal rites that accompany menarche are a celebration of power and
fertility
 Each year, 4 day celebration for all young women who began
menstruating that year
Menstrual problems

Dysmennorhea
 Pain or discomfort during menstruation
 Cramping, headaches, backaches, nausea,
pressure, bloating
 Prostaglandins—likely culprit—cause uterine
muscles to contract
 Tx—aspirin, orgasm, naprosyn
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Endometriosis
 When endometrium grows elsewhere
 Sx—painful periods that last a long time
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Amenorrhea
 Primary if no menstruation by age 18
 Secondary if it stops
 Related to cysts or tumors, hormonal imbalance,
disease, stress, strenuous exercise, anorexia
PMS—Is it real?
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¾ women experience some premenstrual problems
4-6 days prior to menstruation
Over 150 sx id’d as part of PMS—anxiety, irritability,
depression, fatigue, headaches
Could also be a + moods around ovulation
 Some studies have found increased sex at ovulation
 BDI
○ 6.84 Ovulation
○ 9.30 PMS
○ 16.03 Depressed
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One study of PMS—10% of women had sx of PMS, but ½ of
90% and ½ of the 10% said they had PMS
Evidence suggests
 Some fluctuation in mood
 No changes in intellectual or athletic performance
○ 31 % of athletes say they experience decline (Quadagno et al , 1991)
 Big range among women
Why the link?
 Some relationship between sex hormones and depression
○ Increase depression premenstrually, postpartum, menopause,
with BCP
○ No one knows quite why
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Absolute amount of estrogen
Estrogen/progesterone ratio
Absolute amount of progesterone
Hypersensitivity to estrogen
Changes in estrogen or progesterone
Most data are correlational
 Cultural—ultra-orthodox religions experience more PMS
 Women led to believe they were premenstrual made
premenstrual complaints
 McFarlane et al 1988—longitudinal study of men and
women on and off pill—no diff in fluctuation of mood, but
when retrospectively asked about sx, women reported
changes at PMS time
Menopause

Climacteric lasts 15-20 years
 Roughly age 45-60
 Transition to not being able to reproduce marked by
decline in function of ovaries
Menopause refers to cessation of menstruation only—
takes 2 years approximately, about age 50
 As women age, pituitary continues to produce FSH and
LH, but ovaries become less able to respond, therefore
no eggs and low estrogen and progesterone
 Sx—hot flashes, headaches, dizziness, heart
palpitations, joint pain
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 Increased risk for osteoporosis due to estrogen deficiency
 Hot flashes-sudden waves of heat from the waist up
 Sexuality
○ Vagina less well lubricated, less acidic
Culture and controversy
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Cultural stereotype of empty nest syndrome and depression
 May be brief increase in depression at menopause due to
hormones—then relief
 Matthews et al 1990—not connect to depression, anx, stress,
anger or job sat
 Jackson et al 1991—also no relation
 Jones, 1994—reaction is related to what menopause means to
woman
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HRT
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Reduces sx, decreases osteoporosis
May help lower risk for colon cancer and dementia
Replaces estrogen, progesterone and sometimes testosterone
Related to increase in breast cancer and heart disease
Number of women taking HRT dropped dramatically
Now women with normal menopause (not surgical) are
recommended to take the lowest dose for the shortest time
Male anatomy
Penis
 Arrived on evolutionary scene 100 million years ago in
reptiles
 Much more efficient than cloaca that preceded it

Does not contain bones in humans—but other mammals
have bones
 No muscles except at base

Instead, 3 cylinders of spongy material
 Larger 2 are side by side—corpora cavernosa
○ Fill up with blood and stiffen during sexual arousal
 Corpus spongiosum
○ Runs along bottom side
○ Contains penile urethra
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Glans of penis—extremely sensitive
Corona/coronal ridge—separates glans from shaft
Base of penis—called the root
 Attached to pelvic bones by crura
Foreskin
 Covers the penile glans
 Loose skin, but smegma can accumulate and
not allow foreskin to retract
 Circumcision—surgical removal of foreskin
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Discuss—list on board—arguments for and against
Masters and Johnson—no difference in excitability
UTI more common in uncircumcised
Uncircumcised slightly more likely to contract HIV when
exposed
○ NHSLS—lower rates of sex dysfunction in circumcised
○ Hygiene—big argument for, but opponents say regular
cleaning is enough
○ 1971—American Academy of Pediatrics said did not
recommend for health reasons
 Currently about 75% in US
 About 30% worldwide
Scrotum
Pouch of loose skin that holds the testes
(male sex glands--produce sperm cells and
sex hormones)
 Each testicle is held in place by a spermatic
cord
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 Cord contains the vas deferens (tube carrying
sperm to ejaculatory duct of penis), blood
vessels, nerves, and the cremaster muscle
(raises and lowers testicle in response to room
temp and sexual arousal—closer to body during
arousal)

Scrotum develops from same embryonic
tissue that becomes labia majora in female
Testes
Produce androgens and germ cells/sperm cells
Most important androgentestosterone which is
secreted by interstitial cells known as Leydig’s
cellsrelease testosterone directly into bloodstream
 Testosterone—masculinizing hormone
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Stimulates secondary sex characteristics
Maintains genitals and sperm production
Stimulates growth of bone and muscle
Level is kept constant by a feedback loop between testes
and hypothalamus
Pituitary also secretes FSH in males. Here it
stimulates sperm production.
 This is controlled by Inhibin—secreted by testes. This
serves as a different feedback loop.
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Testes usually range between 1 and 1 3/4 “ in length
Sperm
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Each testicle is divided into many lobes that are filled with
seminferous tubules.
Takes 72 days for testes to manufacture a mature sperm cell
Mature sperm cells are called spermatozoa (1/5000 in long)
Sperm cells actually have the same kind of receptors that
nose uses to sense odors
Men produce about 1000/second
Sperm go from seminferous tubules through maze of ducts
to a single tube called epididymus.
Mature sperm move into vas deferens
Seminal vesicles are small glands that lie behind bladder
that produce a high fructose fluid to nourish sperm
At base of bladder, each vas joins a seminal vesicle to form
ejaculatory duct that goes through prostate gland where it
then opens through urethra where it can be carried out
through penis
Other structures
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Prostate gland
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Secretes prostatic fluid
Gives semen its odor and texture—milky alkaline fluid
Combines with seminal fluid and sperm
The alkalinity neutralizes the acidity of the vagina to
prolong life of the sperm
Cowper’s gland
 Below the prostate gland
 Clear slippery secretion precedes ejaculate
 But may contain sperm
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Semen
 70% fluid from seminal vesicles
 29 % Cowper’s gland and prostate gland fluids
 1% sperm
Illnesses
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Testicular Cancer
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7000 new cases/year
Most common CA in men 20-34
Accounts for 10% of all cancer deaths in that age
Usual 1st sx is a painless lump, generally on side or front
Early detection 90% survival, 25 % when wait three months
Should not affect sexual performance, enough testosterone will
be produced by other testicle
Enlarged prostate
 Prostate is tiny at birth, grows at puberty, may shrink in
adulthood
 Usually becomes enlarged past age 50
 About 1/8 men will dev prostate CA
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3rd most common CA in men
About 37,000 men die from it annually
Spreads/grows slowly
More than 80% of cases are in men over 65; 25 % of men over 90 have it
Sx—frequent urination, especially at night, difficulty in urination, difficulty
emptying bladder