No title

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

Ph erom on al Influences on Sociosexual Beh avior in Men Win n ifred B. Cutler ‚ Ph .D.‚1 ‚4 Erika Friedm an n ‚ Ph .D.‚2 Norm a L. McCoy‚ Ph.D.3

This study tested whether synthesized hu m an m ale pherom on es in crease the sociosexual beh avior of m en . Thirty-eigh t heterosexu al m en ‚ ages 26 ¯ 42 ‚ c o m p leted a 2 -w eek b aselin e perio d a n d 6-w ee k pla c ebo -c o n tro lled ‚ dou ble-blin d trial testing a pherom one “designed to im prove the rom an ce in their lives. ” Each subject kept daily beh avioral records for 6 sociosexu al behaviors: petting/affe ction/kissing ‚ formal date s‚ informal date s‚ slee ping ne xt to a romantic partne r ‚ se xual inte rcourse ‚ a n d se lf-stimulatio n to ejaculation (m asturbation ) an d FAXed them each week. Significantly m ore pherom one than placebo users increased above baseline in se xual inte rcourse and sle eping with a romantic partne r. There was a tendency for m ore pherom on e than placebo users to in crease abo ve baselin e in pe tting/affe ction/ kissing ‚ an d informal date s‚ but not in self-stimulation to e jaculation or in formal date s. A sign ificantly larger proportion of ph erom on e than placebo users increased in ³ 2 an d ³ 3 of the 5 sociosexual beh aviors involving a female partner. Thu s‚ there was a significan t in crease in m ale sociosexual behaviors in which a wom an ’s sexual in terest an d cooperation plays a role but not in m ale m astu rbation which involves on ly the m an . Th ese initial data need replication bu t suggest that hum an m ale ph erom on es affected the sexu al attractiveness of m en to wom en. KEY WORDS: human pheromone ; men; se xual attractivene ss; se xual be havior; social behavior.

Athena Institute for Women ’s We llness Research ‚ 1211 Braefield Road ‚ Cheste r Springs ‚ Pe nnsylvania 19425. 2 Departme nt of Health and Nutrition Sciences ‚ Brooklyn College ‚ Brooklyn ‚ New York 11210. 3 Departme nt of Psychology‚ San Francisco State University‚ San Francisco ‚ California 94132. 4 To whom correspondence should be addre ssed. 1

1 0004-0002/98/0200-0001$15.00/0

Ó

1998 Plenum Publishing Corporation

Cu tler ‚ Fr iedm an n ‚ an d McCoy

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INTRODUCTION The te rm “ phe romone ” was introduce d to the scie ntific lite rature in 1959 by Karlson and Luscher who de fine d it as: “ a substance se creted by an animal to the outside of that individual ‚ which is then re ceived by anothe r individual ‚ classically of the same spe cie s‚ which the n e licits some behavioral or developme ntal response in the latte r.” According to most biologic views‚ pe rception is not ne cessary. Rather‚ a change in behavior is sufficie nt e vide nce that phe romone s exist e ve n in the abse nce of aware ne ss of be havioral change . By 1986 ‚ phe romonal excretion from glands at the anus ‚ urinary outle t‚ bre asts ‚ mouth ‚ and axillae in a varie ty of spe cies was well e stablishe d (Cohn ‚ 1994; Filsinge r et al.‚ 1984; Gower‚ 1972; Gower et al.‚ 1985; Russell ‚ 1976) . Furthe rmore ‚ expe riments de monstrate d change s in spe cie s-specific reproductive or social be havior as well as the fe male reproductive cycle in response to both naturally occurring and artificially applie d phe romone s (Bartoshuk and Beaucham p ‚ 1994; Cowle y and Brooksbank ‚ 1991; Gustavson et al. ‚ 1987; Singe r‚ 1991) . The manufacture of chemical duplicate s le d to efficient methods of artificial inse mination in swine ‚ dive rsion of destructive pe sts from vege tation ‚ and most re cently‚ to se x attractants in cosmetics (Singe r‚ 1991; Gower and Rupare lia ‚ 1993; Knowlton ‚ 1994) . A discre te ‚ and highly specialize d anatomic locus for the reception of phe romonal stimuli is well establishe d in nonhuman mammals within the vome ronasal organ ( V NO ) ‚ a spe cialize d olfactory structure (Me redith ‚ 1991; Wysocki and Lepri‚ 1991) . The V NO is e sse ntial for the full and rich panoply of normal re productive function in some cases as e vide nce d by both stimulation and ablation expe riments (Wysocki and Le pri‚ 1991) . Recently the V NO was clearly identifie d as pre sent in normal human anatomy (Garcia-V e lasco and Mondragon ‚ 1991). Putative phe romone s puffe d into the nose were shown to cause a slow electrical pote ntial from the region of the V NO (Monti-Bloch and Grosser‚ 1991). Howe ver‚ no studie s have reporte d on behavior change in re sponse to stimulation of the human V NO receptors. In her landmark study‚ McClintock (1971) de monstrate d menstrual synchrony among women living toge ther and hypothe size d that such synchrony was due to phe romone s. She sugge sted that wome n in close contact with each othe r transmitte d a phe romone that affected menstrual onset timing. Be tween 1979 and 1989 ‚ a serie s of relate d publications by Cutler and her colle ague s demonstrate d that a woman ’s sexual e xposure to a man at le ast once per wee k— but not masturbation —was associate d with an increased freque ncy of regular 29.5 ± 3 day menstrual cycles (Cutle r et al. ‚

Ph erom onal In fluen ces in Men

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1979a ‚ 1983 ‚ 1985) ‚ an increased incide nce of fe rtile -type basal body temperature (BBT) graphs (Cutle r et al.‚ 1985) ‚ and double the estroge n leve l in the lute al phase (Cutle r et al. ‚ 1983; Cutle r‚ Garcia ‚ et al.‚ 1986; McCoy et al.‚ 1985) . Studie s that analyze d de tails of sporadic and celibate patte rns of behavior re ve aled that whe n sexual activity occurred sporadically ‚ increases in total freque ncy were associate d with an increase d incide nce of subfe rtile cycle s (Cutle r et al.‚ 1979b ‚ 1980) . The se studie s found a relationship be tween sexual activity and menstrual cycle parame te rs (length ‚ estroge n leve l‚ fertile-type BBT graph) but provide d no de finitive evide nce concerning the re ason for this association. In 1983 ‚ V e ith et al. showe d that wome n who “ sle pt with ” a man two or more times during a 40-day study period had a significantly highe r incide nce of ovulation than those who had slept with a man less often. In 1991 ‚ Burleson et al. defined se xual be havior according to the weekly‚ sporadic ‚ and celibate criteria describe d by Cutle r et al. (1979a) and replicate d the ir findings concerning menstrual cycle le ngth. They re porte d that wee kly active wome n had significantly le ss variable cycle le ngths than did women with either celibate or sporadic patte rns ‚ and that mean cycle le ngths were not diffe re nt among the thre e behavioral groups ‚ just the variation about the mean ‚ i.e .‚ their abe rrance . They also replicate d Cutler et al.’s findings of a lack of association be tween masturbation fre quency and cycle length. In a late r re port‚ Burle son et al. (1995) attempte d to te st se xual behavior fre quency patte rns using a 7-day moving ave rage without first dichotomizing behavior into weekly and < wee kly. They then reporte d that highe r ave rage coun ts of se xual be havior pe r we e k we re assoc iate d with le ss fe rtile -type cycle le ngths. Be cause wome n with highe r “ ave rage wee kly counts ” may be sporadically active ‚ Burleson et al. ’s failure e ithe r to cite the ir own 1991 re plication of Cutle r et al. or to include an analysis and explanation to account for the see mingly paradoxical effe ct of increased sexual be havior associating with increase d infertility‚ le aves the re ade r unable to interpre t the meaning of their 1995 pape r. The search for the source of both the menstrual synchrony effe cts as well as men ’s putative influe nce s on wome n ’s cycle le ngths led to the demonstration in double -blind place bo-controlle d trials that phe romone s appear to exist in humans (Cutle r et al.‚ 1986; Preti et al.‚ 1986 ‚ 1987) . Furthe r studie s of wome n sugge sted that application of fe male phe romone s to the skin unde r the nose ‚ 3 times pe r wee k‚ increase d the fre quency of their sexual be havior (Cutler‚ 1987; Cutle r and Stine ‚ 1988) . Although studie s of menstrual cycle length and incide nce of wee kly coitus sugge st that both men ’s and wome n ’s phe romone s may affect the reproductive functioning of women ‚ studie s examining the effe ct of male phe romone s on the sexual behavior of wome n have not bee n reporte d pre-

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viously. This double -blind place bo-controlle d study‚ be gun in Se pte mber 1994 ‚ te ste d the effe ct of human male phe romone s on the sociose xual behaviors of men and by implication ‚ the sexual response s of the wome n they encounte re d ‚ as well as the men ’s perception of the se e ffects.

MATERIALS AND METHODS Su bject Recru itm ent From local pre ss rele ase s and ne ws announce ments ‚ men responde d to an opportunity to participate in an e xpe riment that was de scribe d as testing whethe r a male phe romone adde d to the ir afte rshave lotion would “ increase the romance in the ir live s.” Participants were re quire d to be male ‚ hete rosexual ‚ be twee n the age s of 25 and 42 ‚ in se lf-re porte d good he alth ‚ ne ithe r unusually handsome nor unattractive ‚ have a cle an-shave n appe arance ‚ shave re gularly ‚ and have ade quate social skills vis- à -vis wome n. The men were scree ned for ade quate social skills base d upon the Eyese nck Pe rsonality Inve ntory (EPI-Q ). Any man whose score was more than 2 standard deviations above the Eyesenck’s Manual standardize d ne uroticism ‚ e xtrave rsion ‚ and psychoticism statistic was disqualifie d. Me n also signe d the following state ment that was include d in the application materials: “ I furthe r affirm that my basic social skills are already ade quate to allow me to e njoy the company of a romantic partne r and to treat he r in a manne rly way. ” The men comple ted an extensive history‚ an application form acknowle dging willingne ss to fulfill the te rms of the study‚ and a medical history form that detaile d sickne ss‚ dise ases‚ family history‚ and se xual history. Concurre nt use of recreational or pre scribed drugs or serious disease were furthe r crite ria for disqualific ation. Each man ’s signature atte sting to the accuracy of his data was accepte d ‚ and no furthe r atte mpt at verification was made. As an induce me nt to comple te the study‚ the me n we re inform e d that the ir tre atme nt condition would be re ve ale d at the e nd of the study‚ and at that time ‚ all place bo subje cts would re ceive a vial of the phe romone . A que stionnaire comple ted at the end of the study aske d whe the r the man had followe d the protocol ‚ prospe ctively recording data ‚ or had waited

Ph erom onal In fluen ces in Men

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to fill in the daily records whe n it was time to FAX. Any man indicating that he backfille d was disqualifie d. Sam ple O f 53 responde nts‚ 48 arrive d for an intake inte rview and 1 of the se was eliminate d base d on EPI-Q score . Thirty-e ight men comple te d the trial: 17 phe romone ; 21 place bo. O f the 9 subje cts lost‚ 3 did not comple te the base line pe riod ‚ 1 lost his job ‚ 1 move d away‚ 2 quit without e xplanation ‚ and 2 othe rs were disqualifie d for failing to follow the protocol. Although no restrictions were provide d for race ‚ all but one initial applicant and all 38 who comple te d the study were White . Average age of the men was 33.5 ye ars (SD = 5.0). The initial status of the ir re lationships was e ithe r not dating but wou ld like to be (ND) ‚ dating (D) ‚ keeping steady com pan y (KC) ‚ or m arried (M). Table I shows the number of men in each of these four cate gorie s as well as their mean age ‚ he ight ‚ and we ight by group assign m e nt ( phe romone ‚ plac e bo) . A 2 (Group) ´ 4 (Relationship Status) chi-square analysis reve ale d no significant diffe re nce be tween the two groups in relationship status‚ c 2(3 ‚ N = 38) = 4.82 ‚ p = 0.19. Analyse s also reveale d no significant diffe re nce s between the two groups for age ‚ t( 36) < 1 ‚ height ‚ t(36) = 1.4 ‚ p = 0.16 ‚ and weight ‚ t( 25.17) < 1. The de gre es of fre edom for the analysis of group differences in weight were adjuste d because of une qual variance s re ve aled by Le vene ’s Te st for Equality of V ariance s. Table I. Initial Age ‚ He ight‚ Weight ‚ and Re lationship Status for Subjects by Tre atment Group Pheromone (n = 17)

Placebo (n = 21)

x

SD

x

SD

Age (years)

33.1

4.9

33.8

5.2

He ight (inches)

69.6

2.5

71.7

2.7

189.7

32.4

187.0

19.7

n

%

n

%

7 2 2 6

41.2 11.8 11.8 35.3

9 8 1 3

42.8 38.1 4.8 14.3

Weight (pounds) Relationship status Not dating but would like to be (ND) Dating (D) Ke eping steady company (KC) Married (M)

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Proced ure The men attende d an initial intake inte rview to comple te scree ning ‚ sign informe d conse nt forms previously approve d by the Athena Institute ’s Human Studie s Committee ‚ adopt a code identity‚ and revie w the study protocol. Each man brought his afte rshave lotion with him ‚ and the technician examine d it to make sure it was a nonspray ‚ alcohol-base d product. The name of the afte rshave was re corde d‚ and each subje ct was instructe d to use it after e ach shave and at least three times pe r week. Subje cts were give n printe d be havioral calendars for FAXing. The six behaviors to be recorded daily and FAXed weekly to the senior author ’s office ‚ for the ne xt 8 wee ks ‚ were pettin g/affection /kissing‚ form al dates (prearrange d) ‚ inform al dates (not arrange d before that day) ‚ sleepin g next to a rom an tic partn er‚ sexual intercou rse‚ and self-stim ulation to ejacu lation (masturbation) . The men were also re que sted to re port wee kly whe ther they had notice d any change in their expe rience s with women. Data were gathere d from men only; this study did not gathe r data from the women who inte racted with our subje cts. At the e nd of the base line pe riod lasting 2 weeks‚ each man re turne d with his afte rshave lotion and sele cted a code d 5-ml vial containing either ethanol or phe romone with e thanol. The technician poure d the vial ’s conte nts into 2 ounce s of the subje ct’s aftershave . V ials were ide ntical in appe arance and ne ithe r the te chnician nor the subje ct kne w whe the r the sele cted vial containe d phe romone or place bo. The code from the sele cted vial was recorde d on the subje ct’s be havioral cale ndars for FAXing. Ph erom on es The phe romone formulation was a synthe tic ve rsion of a phe romone naturally se creted by men and describe d in earlie r work (Pre ti et al.‚ 1987) . The developme nt of the phe romone involve d re fining a proprie tary formula ‚ characte ristic of heterose xual men in their se xually most active ye ars. The identity of the se substance s will be disclose d whe n the pate nt proce ss is comple te d. Statis tical Evalu ation The occurrences of e ach of the six sociose xual behaviors and men ’s perception of a change in their e xpe rie nce with wome n was evaluate d. SPSS for Windows (SPSS ‚ 1993) was utilize d for all data analyse s‚ as detaile d below.

Ph erom onal In fluen ces in Men

7

Behavior For e ach man the total numbe r of days on which a measure d event occurre d was score d for each of the six behaviors for e ach wee k of the 2-we ek baseline and the 6-wee k trial period. A subje ct was characte rized as showing an incre ase ove r baseline whe n (i) his average wee kly score for the expe rimental period excee de d his ave rage weekly score for the base line wee ks and (ii) his highe st weekly base line score was excee ded at le ast once during the expe rimental pe riod ‚ if his base line score was not already at maximum. For each be havior ‚ as appropriate to the sample size ‚ a chisquare or Fisher exact probability te st was use d to te st for diffe re nce s between the two groups in the numbe r of subje cts showing an incre ase over base line . Perceptions Each wee k men were asked to report whethe r they had notice d any change in the ir “ e xpe riences with women.” The numbe r of individuals perceiving positive change s during any of the e xpe rime ntal weeks was counte d. A Z test was used to compare those using place bo with those using phe romone ; the te st e xamine d the proportions of men who pe rceive d positive change in sexual behavior as a function of which additive (phe romone or place bo) the y use d.

RESULTS Aftershave Usage During the 6 e xpe rime ntal weeks ‚ daily cale ndars showe d an ave rage use of the afte rshave of 5.82 ( ±0.98) time s pe r week for phe romone users and 5.29 ( ±1.24) times per week for place bo users. Usage did not differ significantly be tween the two groups ‚ t(36) = 1.49 ‚ p = 0.15. Socios exu al Beh avior The re porte d wee kly behaviors are presented in Table II. Data that fulfille d the de finition of increase above base line are unde rline d. Contingency table s (2 ´ 2) were use d to assess the significance of the difference betwee n the two groups in the numbe r of men who increased ove r base line for each of the six sociose xual behavior categorie s. With the exception of

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Table II. We ekly Number of Days of Occurrence of Each of Six Sociosexual Behaviors for Each Subject for the Two Baseline and Six Experimen tal Weeks a

Se xual intercourse

Slee ping ne xt to a romantic partner

Petting affection kissing

Informal dates

Formal dates

Selfstimulation to ejaculation

ND ND ND ND ND ND ND D D KC KC M M M M M M

00000001 00000010 00000000 01111231 00000000 00000001 00000001 00000000 00000000 42445445 00000000 22223232 00011000 32233202 31111122 21120221 00000000

00012001 00000010 00001000 30121221 00000000 00000001 00000000 00000000 10000000 66445445 00000000 71767777 77576774 57655243 75774777 76777774 67263476

23453345 10100111 01021010 00122221 00000001 00001011 00000000 00000000 10000000 66045445 33213312 75777777 00011000 64475223 11111101 76777774 12000000

22210221 00100010 00010110 43001001 00100111 00010001 00000000 00000000 00000000 00001002 10112011 33000000 00000000 11021000 00000000 00000000 00000000

01003001 10000101 01011000 00120010 00001001 00001011 00001000 00000000 10000000 66544443 23301322 00002000 00000000 00010031 00000000 00000000 00000000

21223232 00000000 77565473 25333303 00000000 00000000 11111110 77773777 10010000 10231221 00000000 11211116 01000031 00000000 12101111 00000000 34035434

ND ND ND ND ND ND ND ND ND D D D D D D D D KC M M M

00000000 00010110 00000000 01010000 00000000 00000000 00000000 01000000 00000000 22423434 00000000 00000000 11011000 22001102 04200000 10100100 20212210 00000000 24114410 12101011 01010101

00000000 01100112 00000000 00000000 00000000 00000000 00000000 00000000 00000000 25433535 00000000 00000000 00001000 34222343 04000000 10000000 20101110 00000000 77777777 77777777 77777575

00000111 04242522 00000000 01010010 00000000 00000000 00000000 01200000 00000000 06323534 00002300 20000000 23222241 54223303 04000000 21211300 41423221 41411140 77777777 13202202 11010101

00001101 11020110 00000000 01010000 00000000 00000000 00000000 00000100 00000000 12100001 00000000 01111110 20020121 22000000 00000000 00000000 20222221 00000000 00000000 00000000 00000000

00000010 12113323 00100000 00000010 11000110 00000000 00000001 01000010 00000000 10000503 11123301 32120222 33213120 32302030 00000000 32421310 21202110 00000000 00000000 00000000 00000000

45545444 21202100 22123222 00000000 00000000 00000000 76646357 00000000 00000000 00001100 00000000 32231222 76677474 00000000 11030111 10000000 00000000 21331221 10221222 77507777 00000000

Condition

Initial re lationship status

Pheromone Subject S10 S16 S21 S45 S46 S47 S34 S14 S36 S39 S08 S06 S09 S42 S02 S07 S51 Placebo Subject S33 S48 S03 S17 S24 S25 S29 S30 S35 S18 S41 S05 S13 S20 S23 S32 S38 S15 S11 S27 S40 a

Cells that are underlined show an increase over baseline.

Ph erom onal In fluen ces in Men

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Table III. Number of Subjects with an Incre ase Over Baseline for Each of Six Sociose xual Behaviors by Treatme nt Group Treatment Pheromone (n = 17) Sociosexual behavior

Place bo (n = 21)

n

%

n

%

Sexual intercourse

8

47.0

2

9.5

.01

Sleeping next to a romantic partne r

6

35.3

1

4.8

.02

Petting/affection/kissing

7

41.2

3

14.3

.07

Informal dates

6

35.3

2

9.5

.06

Formal dates

7

41.2

7

33.3

.62 a

Self-stimulation to ejaculation

4

23.5

2

9.5

.23

c (1‚ N = 38) = 0.25.

p

a 2

the analysis of form al dates ‚ all probability le vels are from Fishe r exact probability tests. For e ach be havior ‚ the numbe r of subje cts in the phe romone and place bo groups who incre ase d ove r base line and the Fishe r e xact probability leve ls are presented in Table III. A significantly highe r proportion of phe romone use rs than place bo users showe d an incre ase over base line for sexual in tercourse and sleeping next to a rom an tic partn er. The re was a tende ncy for a gre ater numbe r of phe romone users to incre ase above base line in petting/affection/kissin g and in form al dates. The proportions of phe romone and place bo users showing an increase over base line in self-stim ulation to ejacu lation and form al dates did not diffe r significantly. The numbe r of participants showing incre ases above base line in more than one of the five sociose xual be haviors involving a fe male partne r revealed that incre ase s above baseline in two behaviors or more were significantly more fre quent for those in the phe romone (n = 10/17 ‚ 58% ) than those in the place bo (n = 4/21 ‚ 19% ) group ‚ c 2(1 ‚ N = 38) = 6.4 ‚ p < 0.02. In addition ‚ significantly more me n in the phe romone (n = 7/17 ‚ 41% ) than in the place bo (n = 2/21 ‚ 9.5% ) group showe d an increase above base line in three or more be haviors (Fisher e xact te st‚ p = 0.03) .

Perception s A statistically significant and substantially highe r proportion of phe romone use rs perceived positive results during the expe rimental 6-wee k pe-

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riod than did the place bo use rs (phe romone use rs 47% vs. place bo users 24% ; Z = 5.05 ‚ p < 0.001) .

DISCUSSION In this prospe ctive double -blind ‚ place bo-controlle d study of six discrete sociose xual be haviors ‚ human male phe romone s cause d a statistically significant and distinct increase in the two most intimate behaviors: sexual inte rcourse and slee ping with a woman. These are sociose xual be haviors in which the willingne ss of a fe male partne r plays a major role. The re was a te nde ncy for phe romone s to increase the ne xt most intimate be haviors of petting/affe ction/kissing and informal date s. Human male phe romone s did not cause an incre ase in those be haviors in which a woman doe s not play a major role. Neithe r‚ masturbation ‚ which may re flect a simple increase of libido ‚ nor formal dating ‚ which re quire s advance d planning and assertion ‚ were incre ased by the phe romone . The perception of effe cts‚ while significantly highe r in phe romone users than in place bo users‚ was not as substantial as the actual increase over base line of the prospe ctive ly re corde d ‚ sociose xual be haviors. Me n ‚ it see ms‚ did not always accurate ly perceive the romance in their live s. It is particularly note worthy that the masturbation rate did not increase in men who use d the phe romone compare d with men who use d place bo ‚ while the numbe r of days of slee ping with a partne r and of se xual intercourse did. If replicate d in large r and more dive rse sample s‚ these re sults would sugge st that phe romone s in humans have e ffects that are not fundame ntally diffe re nt from those in othe r animals and insects; the unde rlying physiologic mechanisms are probably similar give n that phe romone s appe ar to have mediate d sexual attraction be tween our subje cts and the ir partne rs. A good candidate for the pote ntial site of neuronal reception would be the V NO (Gowe r and Rupare lia ‚ 1993; Takami et al.‚ 1993) . The the saurus define s “ attraction ” as the “ quality that elicits admiration or pleased responsive ne ss or a re lationship of pe ople . . . that are drawn toge the r and e xert influe nce on e ach othe r.” “ Sexual ” attraction would refer to this quality in the se xual sphe re. Although we have gathe red data only from he te rosexual me n ‚ we deduce that male se xual attractive ness must have incre ase d because the male phe romone users increased their rate of intimate be haviors with wome n while the rate of masturbation and formal dating did not differ significantly from that of place bo use rs. The more subtle issues that could influe nce the pote ntial response to phe romone s should be addre ssed in future studie s. For example ‚ the role of an establishe d re lationship in the re sponse to phe romone s is of consid-

Ph erom onal In fluen ces in Men

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erable inte re st. The presence of a partne r (dating or married) may make it e asie r to se e re sults due to the availability of a partne r. O n the othe r hand ‚ if the re lationship is a trouble d one ‚ an ongoing relationship may make it more difficult to see positive effe cts of phe romone s. Thus ‚ both the existence of an e stablishe d relationship and the le ngth and quality of that re lationship are important variable s for future re se arch studying the effe cts of men ’s phe romone s on sociose xual behavior. Initial re lationship status was not held constant in this study and varie d from “ not dating but would like to be ” to “ marrie d.” Howe ve r‚ we suspe ct that the status “ not dating but would like to be ” probably re pre se nts the group most unlike ly to be subje ct to compe ting relationship influe nce s that might obscure e vide nce of incre ase d sexual attraction due to phe romone s. Forty-one pe rcent (n = 7) of the men who use d phe romone and 43% (n = 9) of the men who used place bo had this status. All 7 of the “ not dating ” men ( 100% ) who use d the phe romone showe d increase s above base line for at least two of the five sociose xual be haviors involving a female partne r; 6 of the 7 (86% ) incre ased in thre e or more such categorie s. In comparison ‚ only 2 (22% ) of the 9 “ not dating ” subje cts in the place bo condition showed increases over base line in two or in thre e or more of these sociose xual behaviors. Thus ‚ the stronge st support for the effe cts of male phe romone s occurre d in men who‚ it can be argue d ‚ were pote ntially most like ly to reveal it. Although both phe romone and place bo users had reason to have the same e xpe ctations ‚ signifi cantly more phe rom one than place bo use rs showed an increase over base line in the two most intimate be haviors requiring the willingne ss and participation of a fe male partne r— but not those in which the partne r playe d a minor role . Thus ‚ it is sugge ste d that human male phe romone s‚ as applie d here ‚ incre ase d the se xual attractive ness of men to women in our study.

ACKNOWLEDGEMENT Ms. Brooke Wolle nberg is thanke d for he r valuable work in reference colle ction ‚ manuscript re view‚ and e valuation.

REFERENCES Bartoshuk ‚ L. M.‚ and Beauchamp ‚ G. K. (1994) . Chemical se nse s. Ann . Rev. Psychol. 45: 419-449. Burleson ‚ M.‚ Gre gory‚ W. L.‚ and Tre vathan ‚ W. (1991) . Heterose xual activity and cycle length variability: Effect of gynecological maturity. Physiol. Behav. 50: 863-866.

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Cu tler ‚ Fr iedm an n ‚ an d McCoy

Burle son ‚ M. H. ‚ Gre gory‚ W. L.‚ and Tre vathan ‚ W . R. ( 1995) . He te rosexual activity: Relationship with ovarian function. Psychoneuroend ocrinology 20: 405-421. Cohn‚ B. A. (1994) . In search of human skin pheromone s (a re view). Arch. Derm atol. 130: 1048-1051. Cowley‚ J. J. ‚ and Brooksbank‚ B. W. L. (1991) . Human exposure to putative pheromones and changes in aspects of social be havior. J. Steroid Biochem . 39( 4B) : 647-659. Cutler ‚ W. B. (1987) . Fe male e sse nce (phe romone s) incre ase s sexual behavior of young wom e n. Po ste r pre se nte d at the XV III me e ting of the Inte rnational Socie ty of Psychoneuroe ndocrinology‚ Chapel Hill ‚ NC. Cutler‚ W. B.‚ Garcia ‚ C. R.‚ Huggins ‚ G. R.‚ and Preti ‚ G. (1986) . Sexual behavior and steroid levels among gyne cologically mature premenopausal women. Fertil. Steril. 45: 496-502. Cutler‚ W. B.‚ Garcia ‚ C. R.‚ and Krie ger ‚ A. M. ( 1979a) . Sexual behavior freque ncy and me nstrual cycle length in mature preme nopausal wome n. Psychoneuroendoc rinology 4: 297-309. Cutler‚ W. B.‚ Garcia ‚ C. R.‚ and Krieger ‚ A. M. (1979b) . Luteal phase defects: A possible re lationship betwe en short hyperthermic phase and sporadic se xual behavior in women. Horm . Behav. 13: 214-218. Cutler ‚ W. B. ‚ Garcia ‚ C. R.‚ and Krie ge r ‚ A. M. (1980) . Sporadic se xual be havior and menstrual cycle length in women. Horm . Behav. 14: 163-172. Cutler‚ W. B.‚ McCoy‚ N.‚ and Davidson ‚ J. M. (1983) . Sexual behavior ‚ ste roids and hot flashe s are associated during the pe rimenopause . Neuroendo. L. 5: 185. Cutler ‚ W. B.‚ Preti ‚ G.‚ Huggins ‚ G. R.‚ Erickson ‚ B. ‚ and Garcia ‚ C. R. ( 1985) . Sexual behavior frequency and biphasic ovulatory-type me nstrual cycles. Physiol. Behav. 34: 805-810. Cutler‚ W. B.‚ Preti ‚ G.‚ Krieger ‚ A.‚ Huggins ‚ G. R.‚ Garcia ‚ C. R.‚ and Lawley‚ H. J. (1986) . Human axillary secretions influence women ’s menstrual cycles: The role of donor extract from men. Horm . Behav. 20: 463-473. Cutler‚ W. B.‚ and Stine ‚ R. (1988) . Female essence increases he terosexual activity of women. Poster presented at the annual meeting of the American Fertility Society‚ Atlanta‚ GA. Filsinger‚ E. E. ‚ Monte ‚ W. C.‚ Braun ‚ J. J.‚ and Linder ‚ D. E. (1984). Human (Hom o sapiens) re sponse s to the pig (Su s scro fa) se x phe rom one 5 alpha-androst-16-e n-3-one . J. Com parative Psychol. 98: 219-222. Garcia-V elasco ‚ J.‚ and Mondragon ‚ M. (1991). The incidence of the vome ronasal organ in 1000 human subjects and its possible clinical significance. J. Steroid Biochem . 39( 4B) : 561-563. Gowe r‚ D. B. ( 1972) . 16-Unsaturate d C19 steroids: A re view of their chemistry‚ biochemistry and possible physiological role. J. Steroid Biochem . 3: 45-103. Gowe r‚ D. B.‚ Bird‚ S.‚ Sharma ‚ P.‚ and House ‚ F. R. (1985) . Axillary 5a-androst-16-e n-3-one in me n and women: Re lationships with olfactory acuity to odorous 16-androste ne s. Experientia 41: 1134-1136. Gowe r‚ D. B. ‚ and Ruparelia‚ B. A. (1993) . Olfaction in humans with special reference to odorous 16-androstenes: Their occurrence ‚ pe rception and possible social ‚ psychological and sexual impact. J. Endocrinol. 137: 167-187. Gustavson ‚ A. R.‚ Dawson ‚ M. E.‚ and Bonett ‚ D. G. (1987). Androstenol‚ a putative human pheromone ‚ affe cts human (Hom o sapiens) male choice performance . J. Com p. Psychol. 101: 210-212. Karlson ‚ P.‚ and Lusche r‚ M. (1959). Pheromone s: a new term for a class of biologically active substances. Nature 183: 55-56. Knowlton‚ L. ( 1994) . Elixirs of love . Los Angeles Times‚ July 15 ‚ Section E ‚ p. 1. McClintock‚ M. K. (1971) . Menstrual synchrony and suppression. Nature 229: 244-245. McCoy‚ N. ‚ Cutler‚ W.‚ and Davidson ‚ J. M. ( 1985) . Relationships among sexual behavior ‚ hot flashes ‚ and hormone levels in perimenopausal women. Arch. Sex. Behav. 14: 385-394. Me re dith ‚ M. (1991) . Se nsory proce ssing in the main and acce ssory olfactory syste ms: Comparisons and contrasts. J. Steroid Biochem . 39( 4B) : 601-614.

Ph erom onal In fluen ces in Men

13

Monti-Bloch ‚ L.‚ and Grosser ‚ B. I. (1991) . Effect of putative pheromones on the electrical activity of the human vomeronasal organ and olfactory epithelium. J. Steroid Biochem . 39(4B): 573-582. Preti ‚ G.‚ Cutler‚ W. B.‚ Christensen‚ C. M.‚ Lawley‚ H.‚ Huggins ‚ G. R.‚ and Garcia ‚ C. R. (1987) . Human axillary extracts: Analysis of compounds from sample s which influence menstrual timing. J. Chem . Ecol. 13: 717-731. Preti ‚ G.‚ Cutler‚ W. B.‚ Garcia ‚ C. R.‚ Huggins ‚ G. R.‚ and Lawley‚ H. J. (1986). Human axillary secretions influence wome n’s me nstrual cycle s: The role of donor extract of females. Horm . Behav. 20: 474-482. Russell‚ M. J. ( 1976) . Human olfactory communication. Nature 260: 520-522. Singe r‚ A. G. (1991). A che mistry of mammalian pheromones. J. Steroid Biochem . 39( 4B) : 627-632. SPSS. Inc. (1993) . SPSS for Windows. SPSS Inc.‚ Chicago ‚ IL. Takami ‚ S.‚ Ge tchell‚ M. L.‚ Chen ‚ Y.‚ Monti-Bloch‚ L.‚ Berline r‚ D. L.‚ Stensaas ‚ L. J.‚ and Ge tche ll ‚ T. V . ( 1993) . V om e ronasal e pithe lial ce lls of the adult human e xpre ss neuron-specific mole cule s. Neuro. Rep. 4: 375-378. Ve ith ‚ J. L.‚ Buck‚ M.‚ Ge tzlaf‚ S.‚ Van Dalfsen ‚ P.‚ and Slade ‚ S. (1983) . Exposure to me n influences the occurrence of ovulation in women. Physiol. Behav. 31: 313-315. Wysocki ‚ C. J.‚ and Le pri‚ J. J. ( 1991) . Consequences of re moving the vomeronasal organ. J. Steroid Biochem . 39( 4B) : 661-669.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

Frequency an d Tim in g of Coital Orgasm in Wom en Desirous of Becom in g Pregn an t Deven dra Sin gh ‚ Ph .D.‚1 ‚4 Walter Meyer ‚ Ph.D.‚2 Robert J. Zam bar an o‚ Ph.D.‚2 an d David Far ley Hurlbert‚ L.M.S.W. 3

G enerally‚ no fun ction al role ‚ except pleasu re‚ is assign ed to a wom en ’s coital orgasm . Recently‚ however‚ researchers have suggested that wom en can regulate the num ber of sperm accepted or rejected by m an ipu lation coital orgasm tim in g. Baker an d Bellis (1995) dem onstrated that wom en retain m ore sperm if coital orgasm occurs after‚ rather than before m ale ejacu lation . The present study investigated (i) factors associated with coital orgasm frequ ency an d (ii) whether wom en desirou s of becom ing pregnant report m ore coital orgasm s after than before their partn ers. Sixty-nine wom en rated their desire for pregnan cy and answered question s abou t their sexual behaviors ‚ coital orgasm frequen cy‚ and coital orgasm tim in g in relation to their partn ers. In regression analysis ‚ coital orgasm frequ ency was predicted by foreplay du ration ‚ m astu rbation frequency‚ and active sexual participation ; desire for pregnan cy did not predict coital orgasm frequ ency. Desire for pregnancy was predicted by age (negatively)‚ active sexual participation (positively)‚ and positively by orgasm after partn er ejacu lation . Con sistent with the Baker an d Bellis hypothesis ‚ frequ ency of orgasm after partn er’s orgasm remain ed a significant predictor for desire for pregn an cy after con trollin g for degree of m arital happiness ‚ sexual foreplay duration ‚ an d coital orgasm frequ ency. KEY WORDS: coital orgasm; evolutionary psychology theory; orgasmic timing; pre gnancy; spe rm competition.

of Psychology‚ University of Texas ‚ Austin‚ Te xas 78712-1189. Private Practice ‚ Austin‚ Texas. 3 Adult and Adolescent Counseling Cente r‚ Belton‚ Texas. 4 To whom correspondence should be addre ssed. 1 Departme nt 2

15 0004-0002/98/0200-0015$15.00/0

Ó

1998 Plenum Publishing Corporation

16

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

INTRODUCTION The que stion of whethe r fe male orgasm has any reproductive role has ge ne rated various vie ws‚ ranging from no reproductive role ‚ crucial for developing emotional intimacy ‚ to facilitating sperm retention (Margulis and Segan ‚ 1991; Thornhill et al.‚ 1995) . Many se xologists believe that coital orgasm fre quency and timing re lative to partne r’s ejaculation influe nces female ple asure and satisfaction and that such outcome can play an important role in stre ngthe ning pair bonding and e motional intimacy (Hurlbe rt‚ 1993) . Consiste nt with this belief is that women who e xpe rience orgasm afte r their partne r are not as sexually satisfie d as women having orgasms be fore or simultane ously (Darling et al.‚ 1991). However‚ some biologically oriented researchers have propose d that the ultimate function of fe male orgasm is to facilitate sperm re te ntion. Morris ( 1967) propose d that coital orgasm induce s fatigue and sle e pine ss‚ which promote s a supine position for a longe r pe riod of time ‚ thus allowing spe rm more time to re ach the cervix and ute rus. Fox et al. (1970) propose d orgasm functions to active ly suck up spe rm into the ute rus rathe r than provide gre ater time for spe rm to reach the uterus. Be cause conce ption can occur without orgasm ‚ it is argue d that fe male orgasm ‚ passive ly or active ly‚ helps spe rm reach the uterus ‚ the re by augme nting the probability of conce ption. Neithe r biological nor psychological e xplanations assign active control to women over the occurrence ‚ timing ‚ or outcome (conce ption) of he r orgasm. O nce a woman opts for inte rcourse ‚ it is assume d that the fre quency and timing of he r orgasm is primarily controlle d by her mate ’s se xual approach ‚ his se xual ade quacy‚ and his expe rtise as a love r (cf. Fishe r‚ 1973) . Thus‚ a woman is assumed to have little control over e ithe r orgasm or conception. A recent approach based on evolutionary theory‚ howe ve r‚ sugge sts the possibility that women have an influe nce on the ultimate outcome of sexual inte rcourse (conce ption) by regulating their coital and noncoital orgasm patte rns. It should be pointe d out that the re is no consensus among evolutionary and sociobiological the orists re garding the role of women ’s orgasm. Some theorists propose that orgasm has no adaptive role ‚ othe rs propose that orgasm e volve d to create confusion about pate rnity‚ while othe rs sugge st that orgasm cements the bond be twee n particular man and woman there by laying the foundation of human family (for re view of the se the orie s see Diamond ‚ 1992). Howe ver‚ e volutionary psychological the ory‚ unlike othe r evolutionary the orie s‚ propose s a psychological mechanism that can e xplain the functional significance of variability and timing of wome n ’s orgasms.

Orgasm Timin g an d Pregn ancy

17

An Evolu tion ary Perspective of Hu m an Fem ale Sexu ality Evolutionary psychological theory propose s that conditions existing in ance stral e nvironme nts shape d curre nt physical ‚ psychological ‚ and behavioral strategies for solving proble ms of survival and reproduction (Tooby and Cosmide s‚ 1992; Buss‚ 1994; Symons ‚ 1979) . In the arena of reproduction ‚ men and wome n must coope rate ‚ but the time and e nergy require d to produce childre n is vastly greate r for wome n. Given a narrowe r window of opportunity to reproduce (from pube rty to menopause ) and highe r costs of re production (pregnancy‚ lactation ‚ and child care ) ‚ wome n e volve d various strate gies to maximize the ir re productive success. Wome n ‚ relative to men ‚ are more discriminating and choosy of the ir mates‚ le ss overt over sexual matte rs‚ pre fe r a longe r courtship prior to e ngaging in se x‚ and assign great importance to love and fee ling for se xual intimacy (Crooks and Baue r‚ 1996; Symons ‚ 1979). The se be haviors are strate gies to evaluate pote ntial mate s for re source fulne ss‚ depe ndability ‚ and commitment to dire ct resources to her and her childre n (Buss ‚ 1994; Buss and Schmitt ‚ 1993) .5 Recent evide nce sugge sts that wome n have evolve d strate gies to influence eve nts occurring in their reproductive tracts after spe rm e jaculation to ensure that the e gg is fertilize d by the be st possible spe rm (Bake r and Be llis ‚ 1995) . This strate gy could have bee n be ne ficial in ancestral environments if fe male s were obtaining re sources and physical prote ction from a permane nt mate ‚ yet promoting fertilization by anothe r male of highe r genetic quality. The succe ss of such strate gy would be gre atly enhance d if occurrence of orgasm become s cryptic. Neither men nor wome n should be able to predict accurate ly the occurre nce of the orgasm that induce s maximal re te ntion or reje ction of inseminate d spe rm. (Women ’s unaware ne ss of orgasm occurrence would make this strategy practically unnotice able to men.) Indee d ‚ women ’s orgasm appe ars to vary conside rably across situation and time (Crooks and Baue r‚ 1996) . Currently‚ wome n sometimes e ngage in extrapair copulation resulting in childbirth. This can be infe rre d from pate rnity discrepancy rate s ranging from 1 to 30% reporte d for the U.S. ‚ England ‚ and Europe ‚ as well as among African bushme n and the Yanomamo (Bake r and Be llis ‚ 1995) . Female orgasms may have e volve d to have control over offspring pate rnity‚ The term “ strategy” refers to algorithms or a program designed to solve a problem without implying conscious intent. For example ‚ release of insulin is a strategy for regulating the amount of blood sugar after a meal ‚ but this strategy is activated with no conscious planning or awarene ss. Thus ‚ mating and reproductive strategies refer to subconscious physiological and psychological activation of a programmed solution (Tooby and Cosmides ‚ 1992). Many time s these subconscious strategies concur with conscious strategies ‚ but many times they may not.

5

18

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

by sele ctively re taining sperm of a pre fe rre d mate and hinde ring spe rm of a nonpre fe rre d mate (Smith ‚ 1984) . In a se ries of inge nious studie s‚ Bake r and Bellis (revie wed in 1995) have demonstrate d that wome n can affect the numbe r of sperm re taine d (from total re jection to maximal retention) by the timing of self-induce d (masturbation) ‚ spontane ous (nocturnal) ‚ and coital orgasms. The se inve stigators found that wome n retain more sperm ( 50 ¯90% ) if the y have their orgasm close to the time of e jaculation and up to 45 min after‚ or so-calle d high-re te ntion orgasm. If orgasm pre cede s ejaculation sperm re te ntion is not facilitate d; as a matter of fact ‚ the numbe r of sperm re taine d ( 0¯50% ) when a woman has no orgasm or orgasm be fore male ejaculation do not differ significantly. 6 The mechanism that e nable s the woman to regulate the numbe r of spe rm retaine d or re jected is propose d to be the cervical mucus which acts as a spe rm filte r (Bake r‚ 1996; Bake r and Be llis ‚ 1995) . A woman can enhance the filter e fficie ncy during any phase of her menstrual cycle by blocking the narrow mucus channe ls; the more cervical mucus channe l blocke d ‚ the gre ater the efficiency of the filte r. Bake r and Bellis (1995) also found that spe rm inse minate d in a copulation increase the e fficiency of the filte r or produce a block which depresses the numbe r of spe rm re taine d from the ne xt copulation. The block de cline s in efficiency ove r the next 8 days. Women can ree stablish this block at roughly the same point of natural de cline ove r days with the help of masturbatory or nocturnal orgasm or having an orgasm during foreplay. A woman ‚ howe ve r‚ can override the block produce d from previous sperm insemination by having a high-re te ntion orgasm at subse que nt copulation. Bake r and Bellis (1995) sugge sted that “ by altering the occurrence ‚ seque nce and timing of the different type s of orgasm ‚ the female can influe nce both the probability Some reade rs may not be familiar with the techniques use d by Baker and Be llis (1993 ‚ 1995) to measure sperm retention by women. Therefore ‚ we provide a summary of what happens to sperm after e jaculation and the technique s used to calculate the numbe r of sperm retained by wome n. The spermatic fluid in a typical e jaculation has a volume of 3 to 6 ml. After a coital ejaculation ‚ women can eject (so-calle d flowback) up to 3 ml fluid consisting of spe rm ‚ seminal fluid‚ and female secretion from the vagina. The average (median) time of eme rgence of flowback is 30 min after male ejaculation. Flowback either occurs while the woman is still in a horizontal position after copulation‚ when she next begins to walk‚ or most often (and most fre quently) when she next urinates. Broadly speaking‚ Bake r and Bellis first count the number of sperm inseminated into the woman at copulation (count of sperm in whole e jaculate collected by condom during copulation) and then the number of sperm found in the flowback. The estimate d number of sperm retained is obtained by subtracting the number of spe rm obtained in the flowback from the numbe r of sperm inseminated. (For de tailed procedures and me thodological issues ‚ see Baker and Bellis‚ 1995.) It is important to note that when a woman experience s a high-retention orgasm (1 min prior to male ejaculation to 45 min after ejaculation) ‚ flowback volume is not decre ase d and sperm retention is achie ved without any gross retention of seminal fluid.

6

Orgasm Timin g an d Pregn ancy

19

of conception in monandrous [paire d to single man] situations and the outcome of sperm compe tition in polyandrous situations ” (p. 231) . Ration ale of th e Present Stu dy O ur main obje ctive was to e xplore the relationship betwee n a woman ’s desire of to be come pregnant and the timing of he r coital orgasm. If the Bake r and Be llis ( 1995) hypothe sis is correct‚ the women who are desirous of becoming pre gnant should report having more coital orgasm after‚ rathe r than before ‚ the ir partne r’s orgasm. In contrast ‚ it may be that de sire for pre gnancy simply incre ase s a woman ’s ove rall orgasm fre quency‚ both before and afte r her partne r. The occurrence of coital orgasm can be affe cted by increase in pe lvic vascularity resulting from pre vious pre gnancy (She rfey‚ 1966) ‚ de gre e of happine ss or satisfaction in the romantic re lationship (Trude l et al.‚ 1993) ‚ history of women ’s masturbatory orgasm (Be ntle r and Pee le r‚ 1979; Hurlbe rt and Whittake r‚ 1991) ‚ duration and nature of sexual foreplay (Hurlbe rt‚ Apt ‚ and Rabehl‚ 1993) ‚ and se xual technique s used by the wome n and the partne r (Crooks and Baue r‚ 1996; Maste rs et al.‚ 1994) . Many of the se and othe r variable s associate d with freque ncy of coital orgasm could be re lated to desire for pre gnancy. It may be that any relationship be tween a woman ’ s de sire for pre gnancy and he r fre quency of orgasm afte r her partne r is simply to due to a ge ne ral increase in orgasmic pote ntial during this period. To rule this out ‚ we first asse sse d the relationship between de sire for pre gnancy and overall coital orgasm freque ncy in a regression analysis including othe r docume nted pre dictors of coital orgasm. Then ‚ in a similar regre ssion analysis ‚ we inve stigate d whethe r self-reporte d occurrence of orgasm after their partne r’s e jaculation is greate r in those who de sire to ge t pre gnant.

METHOD Su bjects The sample consiste d of 69 volunte er active duty military or civilian nurse s employe d at a military medical center locate d in the Southwe stern region of the Unite d State s. Me an age was 31.7 years (SD = 6.38; range 23¯ 50) ‚ with a mean 14.3 years of e ducation (SD = 1.25; range 13 ¯18) . The majority of participants were Caucasian (Caucasian 62% ‚ Hispanic 19% ‚ Black 15% ‚ and othe r 4% ) ‚ ide ntifie d the ir socioe conomic status (SES) as middle class (middle class 81% ; uppe r middle class 12% ‚ and

20

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

lower class 7% ) and profe sse d being Catholic (29% ‚ Baptist 17% ‚ Mormon 9% ‚ Luthe ran 6% ‚ othe r 7% ) ‚ or not practicing any religion (32% ). The majority of the participants atte nde d church service fewer than six times per ye ar (64% ). Most were marrie d (83% ‚ live -in 10% ‚ divorce d/se parate d 7% ). Proced ure Me dical staff and nurse s reque ste d volunte e rs for a study on fe male sexual be havior and practice s during an initial orientation program. Data for the prese nt study were colle cted as part of an ongoing proje ct on body morphology and female reproductive function. Afte r reading and signing a consent form ‚ participants comple ted seve ral que stionnaire s. First ‚ each participant fille d out a brie f medical history and provide d de mographic information. Then ‚ body weight ‚ he ight ‚ waist and hips circumference were obtaine d by thre e graduate nursing stude nts. Participants were also give n various que stionnaire s de aling with sexual behavior ‚ sexual de sire and fantasy‚ numbe r of sons and daughte rs‚ and lifetime numbe r of sexual partne rs. Findings from the se inve stigations will be reporte d else where. Q uestionnaire s rele vant to the pre se nt study were as follow: Person al and Sexual History Participants provide d information about their age ‚ e thnicity ‚ marital status and SES ‚ education ‚ church affiliation ‚ and church atte ndance . The n ‚ each participant fille d out a brief medical history (major illne ss‚ prese nt use of any medication) and information about age of menarche ‚ age at first masturbation ‚ duration of marital re lationship ‚ age at first se xual intercourse ‚ age at first orgasm ‚ masturbation freque ncy‚ active ve rsus passive role during sexual intercourse ‚ importance of having simultane ous orgasm with mate ‚ and incide nce of extramarital relationships ‚ abortions ‚ and miscarriage s. Coital Orgasm an d Desire for Pregnancy Each participant rated six questions de aling with coital orgasm and relate d issue s (see Appe ndix) . These que stions were identical to those used by Thornhill et al. (1995) for studying timing of women ’s coital orgasm. For assessing active ve rsus passive role during sexual intercourse and ease of having multiple orgasm ‚ each participant rated the following state-

Orgasm Timin g an d Pregn ancy

21

ments on a 5-point (1 = strongly disagre e; 2 = mode rate ly disagre e ; 3 = neither agre e nor disagre e; 4 = mode rate ly agre e; 5 = strongly agre e) scale : (i) In a se xual encounte r‚ I practically take charge of the situation. (ii) In a sexual e ncounte r‚ I wait for my partne r to de cide all sexual move s and te chnique s. (iii) I rare ly have proble ms having multiple orgasms. Finally‚ all participants were asked to rate their current de sire for ge tting pregnant on a five point scale (1 = not important at all; 2 = somewhat important; 3 = neithe r important nor unimportant; 4 = some what important; 5 = e xtre mely important). Spe cifically‚ participants rate d the following que stion: How important is it to you eventually conce ive and give birth to a child? Hurlbert Index of Sexual Com patibility (Hurlbert‚ White ‚ et al.‚ 1993) This scale measure s the emotional ‚ behavioral ‚ and cognitive components of se xual compatibility. It has good re liability ‚ high inte rnal consiste ncy an d good face ‚ constru ct ‚ pre dictive ‚ and discriminate validity (Hurlbe rt‚ White ‚ et al.‚ 1993; Hurlbe rt et al.‚ 1996) .

RESULTS All data were analyze d using SPSS-6 software program (Noursis/SPSS ‚ 1993) . Descriptive statistics for pe rtinent variable s are shown in Table I. None of the participants were suffering from ovarian disorde rs‚ gallbladde r disease ‚ diabe tes‚ or lung ‚ or cardiovascular disorde rs. The majority of participants did not take birth control pills (76% ) ‚ and none reporte d regular use of any pre scription medications. A majority of the participants reporte d being happily marrie d (91% ). Most participants reporte d that having orgasm with their mate was important ‚ although having orgasm simultane ously was not. Coital Orgasm Frequency Participants reporte d that the y e xpe rie nced orgasm during 40% of the sexual intercourse e pisode s (SD = 2.88; range 0 ¯100% ) in their curre nt relationship. Inte rcorrelations among various social and be havioral indice s and fre quency of coital orgasm and desire for pregnancy are presented in Table II. Keep in mind that the probability value s associate d with the se corre lations are not adjuste d for inflation of Type I e rror due to multiple comparisons ‚ and they should be interpre te d cautiously. Using this se t of

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

22

Table I. Reproductive and Sexual Characteristics of Participants V ariable Age at menarche (years) Age at first orgasm (ye ars) Age at first masturbation (years) Age at first sexual intercourse (years) Duration of current marital re lationship (ye ars) Sexual compatibility score Age at birth of first child (years) Number of live children born Duration of nongenital foreplay (min) Duration of genital foreplay (min) Importance of having orgasm (1= not important; 5= very important) Importance of simultaneous orgasm (1= not important; 5= very important) Active participation in sexual act (1= not active; 5= ve ry active) Masturbation frequency (% ) Percentage of time spontane ous (nocturnal) orgasm experience d in past ye ar Status of married life (% ) Had extramarital affair (% ) Had miscarriage (% ) Had abortion (% )

x

SD

13.8 21.9 20.1 17.6 8.0 77.4 23.3 1.8 8.8 6.0

1.5 4.7 6.4 2.3 6.0 11.1 2.6 0.70 5.3 5.0

Range

3.2

1.5

1¯ 5

1.4

0.93

1¯ 5

11 ¯ 19 Never ¯32 Never ¯31 14 ¯ 22 0.58 ¯ 28 49 ¯ 99 17 ¯ 32 1¯ 3 0¯ 30 0¯ 23

2.4 1.1 1¯ 5 Neve r= 13; 2 ¯3/we ek= 51;quite freque ntly= 36 0% = 77; 10 ¯ 20% = 23 V ery happy= 61; happy= 30; unhappy= 9 Yes= 41; no= 21; no re sponse= 38 Yes= 34.8; no= 65.2 Yes= 23.2; no= 76.8

variable s‚ multiple line ar re gression was conducte d to pre dict fre quency of coital orgasm. A backwards e limination technique was used by ente ring the se variable s into a starting model‚ removing the least significant pre dictor ‚ recalculating the mode l coe fficients‚ removing the le ast significant predictor from the re stricte d mode l ‚ and re pe ating this proce ss until all remaining pre dictors obtaine d probability value of 0.1 or less. It should be note d that the ratio of subje cts to variable s is some what low for the application of this technique ‚ and again ‚ re sults should be inte rpre te d cautiously. The distribution of the residual value s was examine d for deviation from normality and the presence of outlie rs. Neither condition was appare nt. Partial plots of e ach predictor with the depe nde nt variable were e xamine d to asse ss line arity and homosce dasticity; we found no compe lling evide nce of proble ms. Table III pre sents the final regre ssion mode l of be st fit selected afte r e limination of all pre dictors not meeting the criteria ‚ F(4‚ 56) = 18.32 ‚ p < 0.0001. The column labe le d D R2 represents the unique proportion of variance in the depe nde nt variable accounte d for by each variable within this mode l. Probability value s from the t tests re pre se nt the

b

a

¯.07 .06 ¯.06b .63 ¯.07 .02 ¯.18 ¯.03b .57 ¯.09b ¯.48 .12

—

1

— .06 .07 ¯ .13 .21 .22 .06 .04 ¯ .09 .14 .01 .11

2

— .37 b .11 .50 b .18 .43 b .18 .10 .19 .28 a .47 b

3

— .11 .40b .06 .28a .11 ¯.11 ¯.12 .02 .37b

4

—

¯.12 ¯.23 ¯.14 ¯.09b .37 ¯.07b ¯.47 ¯.01

5

— .36 b .22 .01 ¯.14 .23 .21 .40 b

6

— .16 .06 ¯ .12b .35 .24 .36 b

7

— .27a .14 ¯ ¯ .10 ¯ .05 b .57

8

— .02 .07 ¯ .01b .48

9

—

¯ .19b ¯ .41 .10

10

Table II. Corre lations Among V ariable s in Re gression Model Predicting Coital Orgasm Frequency

Age Church atte ndance Marital happine ss Sexual compatibility Re lationship duration Masturbation fre quency Active sexual participation Duration of ge nital foreplay Duration of nongenital foreplay Numbe r of children Nocturnal orgasm frequency Desire for pregnancy Coital orgasm

p < 0.05. p < 0.01.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

V ariable

— .25a .04

11

— .04

12

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

24

Table III. Multiple Linear Regression Pre dicting Coital Orgasm Freque ncy with Curre nt Partner Depende nt variable

Indepe ndent variable

b

a

t

p

D R2

Coital orgasm fre quency Ge nital foreplay

.40

4.22

.0001

.14

Nonge nital foreplay

.33

3.52

.001

.10

Frequency of masturbation

.27

2.92

.005

.07

Active sexual participation

.20

2.17

.034

.03

2

Mode l R = .57 2

Adjusted mode l R = .54

b value s represent standardized regression coe fficients.

a

statistical significance of the se variance proportions ‚ as well as the significance of the be ta value s presented. Results indicate that duration of ge nital and nonge nital foreplay are powe rful predictors of fre quency of coital orgasm. Additionally ‚ participants reporting a greate r tende ncy to active ly “ take charge ” of se xual encounte rs also reporte d a highe r freque ncy of coital orgasm. Also ‚ participants who masturbate d more freque ntly had a highe r freque ncy of coital orgasm. Most important to the pre sent study‚ de sire for pregnancy was not relate d to ove rall fre quency of coital orgasm. Desire for Pregn an cy Desire for pregnancy was measure d on a scale from 1 to 5 ‚ with 1 (least desirous) and 5 (m ost desirou s). Participants sele cted value s all along this range ‚ with a mean of 3.73 (SD = 1.52). Intercorre lations among various social and behavioral indice s and fre quency of coital orgasm and de sire for pregnancy are pre se nte d in Table IV . These correlations are presented to supple ment the results of the following re gression analysis. The same caution should be used in interpreting these re sults as for the last re gression. Using this se t of variable s‚ a second multiple line ar regre ssion was performed ‚ using the same te chnique as for the last. Table V pre se nts the regre ssion mode l afte r e limination of nonsignificant pre dictors and recalculation of the coefficients‚ F(3 ‚ 61) = 11.57 ‚ p < 0.0001. Consiste nt with the findings of Baker and Be llis ( 1995) ‚ de sire to become pre gnant was pre dicte d by fre quency of orgasm after partne r; frequency of orgasm before partne r was not a significant predictor for de sire

b

a

Age Birth control Marital happine ss Sexual compatibility Re lationship duration Miscarriage Active sexual participation Multiple orgasms Orgasm before the partne r Orgasm after the partner Pregnancy de sire No. of childre n Coital orgasm fre quency

p < 0.05. p < 0.01.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Variable

— .25a .06 ¯ .06b .63 ¯ .08 .02 ¯ .03 ¯ .11 ¯ .17b ¯ .48 b .57 .12

1

— .06 ¯.04 .13 ¯.10 .13 .18 .07 .02 .02 ¯.05 ¯.01

2

— .37 b .11 .03 .18 .50 b .17 .28 a .28 a .10 .47 b

3

— .11 .30a .06 .31b .21 .11 .02 ¯.11 b .37

4

— .07 ¯ .23 ¯ .06 ¯ .07 ¯ .12b ¯ .47 b .37 ¯ .01

5

— .05 .17 ¯.01 .01 ¯.02 ¯.16 .08

6

— .44 b .29 a .00 .24 ¯ .12 b .36

7

— .42b .25a .14 a ¯.27 b .47

8

—

a

¯ .24 .15 ¯ .14 b .41

9

Table IV. Correlations Among Variables Mode l Predicting Desire for Pregnancy

— .27a ¯ .17 .18

10

—

¯.41 .04

11

b

— .10

12

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

26

Table V. Multiple Linear Regression Pre dicting De sire for Pregnancy Depende nt variable

t

p

D R2

¯ .44

¯4.27

.0001

.19

Active sexual participation

.27

2.69

.009

.07

Orgasm afte r partner

.25

2.42

.018

.06

Indepe ndent variable

Desire for pregnancy Age

b

a

2

Mode l R = .36 2

Adjusted mode l R = .33

b value s represent standardized regression coe fficients.

a

for pregnancy. A scatterplot showing the de sire for pre gnancy ve rsus orgasm after partne r ejaculation after controlling for all othe r variable s‚ (partial residual plot) is shown in Fig. 1. Desire to ge t pregnant was positive ly pre dicted by active sexual participation or “ taking charge of the situation ‚” inde pende nt of othe r predictors. Active sexual participation could e nable the woman to manipulate the timing of her orgasm in re lation to he r partner’s e jaculation.

Fig. 1. Re lationship betwe en perce ntage of orgasms afte r partner ejaculation with desire for pregnancy afte r controlling for all other variables. Orgasm after is partial re sidual (adjusted) from the regression model prese nted in Table V . The be ta shown in the figure is a standardize d regression coefficie nt.

Orgasm Timin g an d Pregn ancy

27

DISCUSSION To summarize the main findings ‚ the fre quency of fe male coital orgasm was relate d to marital happine ss‚ sexual compatibility ‚ masturbatory frequency‚ active sexual participation ‚ and duration of nonge nital and ge nital foreplay‚ but not to the de sire for pregnancy. The de sire for pregnancy was relate d ne ither to overall fre quency of coital orgasm nor the fre quency of orgasm be fore partne r e jaculation . Howe ve r‚ orgasm afte r the partne r ejaculation was a significant predictor of pre gnancy de sire. If having orgasm afte r the partne r is associate d with less inte nse se xual satisfaction as reporte d by Darling et al. (1991) ‚ it appe ars that intense se xual satisfaction is not e sse ntial for de siring to ge t pre gnant. It is note worthy that various sexual behaviors ‚ including nature and duration of foreplay‚ are not significant pre dictors of pregnancy de sire . Active se xual participation ‚ howe ve r‚ was an inde pende nt pre dictor for de sire for pre gnancy. Actively participating and regulating the nature and/or duration of se xual inte rcourse would enable a woman to manipulate he r orgasm timing in re lation to he r partner’s e jaculation. O rgasm after partne r ejaculation ‚ or so-calle d high-re tention orgasm can ove rride the spe rm-blockin g filte r produce d by spe rm inseminate d from prior copulation and maintaine d by masturbation ‚ nocturnal orgasm ‚ or fore play orgasm. Thus ‚ a woman can choose ‚ without any conscious aware ne ss or planning ‚ to acce pt or reje ct sperm inse minate d by a man. O ur data support the conte ntion of Bake r and Be llis that fe male orgasm patte rning has a significant functional role above and be yond a ple asurable e xpe rie nce . If wome n inde e d utilize orgasm occurre nce and its patte rn to re gulate the amount of sperm retaine d‚ the succe ss of such strategy would be greatly e nhance d if occurrence of orgasm re maine d cryptic. This assumption permits a functional explanation for high variability associate d with female orgasm. Some women have orgasm during copulation ‚ while othe rs only during masturbation; some expe rience orgasm both by copulation and masturbation but some e xpe rience it more unde r one condition than anothe r. Such conside rable variability across situation and time in female orgasm would be expe cted by evolutionary psychology theorists be cause such variability would e nsure that wome n can active ly regulate spe rm re te ntion without counte rre gulation initiate d by men predicting the occurrence of wome n ’s orgasm. Howe ver‚ men have also evolve d strategies that enable them to incre ase the probability that the ir spe rm would successfully inseminate (Bake r and Bellis ‚ 1995). The outcome is that neither men nor women have de ve lope d omnipote nt strategies. Strate gies used by each se x partne r must have be en freque ntly succe ssful in the past‚ howe ve r‚

28

Sin gh ‚ Meyer ‚ Zam baran o‚ and Hurlber t

and he nce are maintaine d presently. Me n and wome n may utilize a mixture of conflict and coope ration to e nsure the ir reproductive success. Some potential limitations of the present study should be pointe d out. First‚ our population sample was conve nience-based rather than random; all participants were professional nurses employe d at a military medical center. Second ‚ our data pertains to de sire for pregnancy rathe r than actual pregnancy. While our data are consiste nt with the Baker and Bellis hypothe sis (1995) re garding orgasm timing ‚ no infere nce can be drawn that having orgasm after mate ejaculation is inde ed effective in producing pregnancy. Third ‚ this pape r concentrate s more on e volutionary explanations than psychological factors ‚ but one should not assume that we conside r the latte r unimportant. Psychosocial factors regulate motivation ‚ inte raction ‚ and the emotional outcome associate d with se xual be havior. In many socie tie s‚ men and women engage in and e njoy sexual interactions without any conscious desire for re production. This study reinforce s the role of fe male orgasm as multidime nsional ‚ subsuming affe ctive ‚ cognitive ‚ be havioral ‚ and e volutionary factors. At this point ‚ however‚ the e xtent to which these re search domains contribute to the study of human sexuality has not be en e xamine d in a multidime nsional conte xt. Future examinations of the referents combining both the psychosocial and evolutionary aspe cts of fe male se xuality could assist in a gre ater empirical unde rstanding and clarity in human sexuality in ge ne ral and the role of fe male orgasm in particular.

APPENDIX Question s Dealin g with Coital Orgas m an d Related Issues 1. What percentage of the time do you expe rience orgasm during se xual inte rcourse within your curre nt re lationship? 0% ¯100% 2. What percentage of the time do you e xpe rience orgasm more than a couple of minute s before your partne r? 0% ¯100% 3. What percentage of the time do you e xpe rience orgasm more than a couple of minute s after your partne r? 0% ¯100% 4. In the past year ‚ what percentage of the time did you have a dream or dre ams in which you expe rience d orgasm? 0% ¯100% 5. Within your curre nt relationship ‚ how long (on ave rage ) doe s foreplay without dire ct ge nital stim ulation ( but including kissing ‚ care ssing ‚ hugging ‚ etc.) occur prior to se xual intercourse ? ______ minute s. 6. Within your curre nt relationship ‚ how long (on ave rage ) doe s foreplay involving dire ct ge nital stimulation occur? _____minute s.

Orgasm Timin g an d Pregn ancy

29

REFERENCES Baker ‚ R. R. (1996) . Sperm Wars: In fidelity‚ Sexual Conflicts and Other Bedroom Battles‚ Fourth Estate ‚ London. Baker ‚ R. R.‚ and Bellis‚ M. A. (1993) . Human sperm competition: Ejaculate manipulation by females and a function for the female orgasm. Anim . Behav. 6: 887-909. Baker ‚ R. R.‚ and Be llis‚ M. A. (1995) . Hum an Sperm ‚ Com petition ‚ Copulation ‚ Masturbation ‚ and Infidelity‚ Chapman & Hall ‚ London. Bentle r ‚ P. M.‚ and Peele r‚ W. H ( 1979) . Models of female orgasm. Arch. Sex. Behav. 8: 405-423. Buss ‚ D. M. ( 1994) . The Evolution of Desire. Strategies of Hum an Mating‚ Basic Books ‚ New York. Buss ‚ D. M.‚ and Schmitt‚ D. P. (1993) . Se xual strategies theory: An e volutionary perspective on human mating. Psychol. Rev. 100: 204-232. Crooks‚ R.‚ and Bauer ‚ K. (1996) . Our Sexuality‚ Brooks/Cole ‚ CA. Darling‚ C. A.‚ Davidson ‚ J. K.‚ Sr.‚ and Cox‚ R. P. ( 1991) . Female sexual response and the timing of partne r orgasm. J. Sex Marital Ther. 17: 3-21. Diamond ‚ J. (1992). The Third Chimpanzee. The Evolution and Future of the Hum an Animals ‚ Harper Perennial ‚ New York. Fisher ‚ S. (1973) . The Fem ale Orgasm . Psychology‚ Physiology ‚ Fantasy‚ Basic Books ‚ Ne w York. Fox‚ C. A. ‚ W olff‚ H . S. ‚ and B ake r ‚ J. A. ( 1970) . Me asure me nt of intra-vaginal and intra-uterine pre ssures during human coitus by ratio-teleme try. J. Reprod. Fertil. 22: 243-251. Hurlbert‚ D. F. (1993). A comparative study using orgasm consistency training in the treatment of wome n reporting hypoactive sexual de sire. J. Sex Marital Ther. 19: 41-55. Hurlbert‚ D. F.‚ Apt‚ C.‚ and Rabe hl‚ S. M. ( 1993) . Ke y variables to unde rstanding female sexual satisfaction: An e xamination of women in nondistressed marriages. J. Sex Marital Ther. 19: 154-165. Hurlbert‚ D. F.‚ Apt‚ C.‚ and Rombough ‚ S. ( 1996) . The female e xperience of sexual desire as a function of sexual compatibility in an intimate re lationship. Can. J. Hum . Sex. 5: 7-14. Hurlbert‚ D. F.‚ White ‚ C. L.‚ Powell‚ R. D.‚ and Apt‚ C. (1993) . Orgasm consistency training in the tre atment of women reporting hypoactive sexual desire: An outcome comparison of wome n-only groups and couple-only groups. J. Behav. Ther. Exp. Psychiat. 24: 3-13. Hurlbert‚ D. F.‚ and Whittaker ‚ K. E. (1991). The role of masturbation in marital and sexual satisfaction. J. Sex Educ. Ther. 17: 272-282. Margulis‚ L. and Segan ‚ D. (1991) . Mystery Dan ce: On the Evolu tion of Hum an Sexuality‚ Summit Books ‚ New York. Masters ‚ W.‚ Johnson ‚ U.‚ and Kolodny‚ R. ( 1994) . Heterosexuality‚ Harper Collins‚ New York. Morris‚ D. (1967) . The Naked Ape‚ Cape ‚ London. Norusis‚ M. J. (1993). Base syste m user guide ‚ ve rsion 6 ‚ SPSS Inc.‚ Chicago. She rfe y‚ M. J . ( 1966 ) . Th e e vo lution an d nature of fe mal e se xual ity in re lation to psychoanalytic theory. J. Am. Psychoanal. Assoc. 14: 28-128. Smith‚ R. L. (1984). Human sperm competition. In Smith‚ R. L. (ed.) ‚ Sperm Com petition and the Evolu tion of Animal Mating System s ‚ Acade mic Pre ss ‚ London‚ pp. 601-660. Symons ‚ D. ( 1979) . The Evolution of Hum an Sexuality‚ Oxford University Press ‚ New York. Thornhill‚ R.‚ Gangestad ‚ S. W.‚ and Comer ‚ R. (1995) . Human female orgasm and mate fluctuating asymmetry. Anim. Behav. 50: 1601-1615. Tooby‚ J. and Cosmides ‚ L. (1992) . Psychological foundations of culture ‚ In Barkow‚ J. ‚ Cosmides ‚ L.‚ and Tooby‚ J. (eds.) ‚ The Adapted Mind: Evolutionary Psychology and the G eneration of Culture‚ Oxford University Press ‚ New York ‚ pp. 19-136. Trudel ‚ G.‚ Boulos‚ L.‚ and Matte ‚ B. ( 1993) . Dyadic adjustment in couple s with hypoactive sexual desire. J. Sex Edu c. Ther. 19: 31-36.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

Th e Em ergen ce of Lesbian Sexuality an d Identity Cross-Culturally: Brazil ‚ Peru ‚ the Ph ilip pin es ‚ an d the United States Frederick L. Whitam ‚ Ph.D.‚1 ‚2 Ch ristop h er Daskalos ‚ Ph .D.‚1 Curt G. Sobolewski ‚ M. A.‚1 an d Peter Pad illa ‚ Ph .D.1

Question naire data were collected from 205 lesbian s an d 224 heterosexual wom en in Brazil ‚ Peru ‚ the Philippines ‚ and the United States between 1981 and 1988. Items inclu de direction of childh ood sexual interests‚ age of first awareness of sexual attraction ‚ cross-attractions ‚ age of first sexual contact‚ sex of partn er in first sexual contact‚ age of awareness that sexual attractions were seriou s ‚ an d age of realiza tio n of ad u lt sexu al orien tatio n . In gen eral ‚ sim ilarities in the developm ent of lesbian sexuality and differences between lesbian s and heterosexual wom en were fou nd ‚ regardless of culture. Fin dings include: Lesbian s were m ore sexually active as children an d displayed m ore sexual interest in girls than heterosexuals did in boys; lesbian s tended to becom e aware of their attraction s to wom en later than heterosexuals realized attraction s to m en; lesbian s reported con siderably m ore early attraction to m en than heterosexuals did to wom en; lesbians reported earlier sexual con tact than did heterosexual wom en; the sex of the partn er of first sexual contact for lesbian s was split roughly equ ally between m ales an d females whereas heterosexuals reported con tact with m ales alm ost exclu sively; child hood awaren ess that sexual attraction s were seriou s were sim ilar in lesbian s an d heterosexuals; lesbian s defined them selves as hom osexual later than heterosexuals defined themselves as heterosexual. We conclud e that norm s for heterosexual behavior im pact the developm ent of lesbian sexuality and iden tity‚ im peding‚ bu t not obliteratin g‚ their developm ent. Lesbian sexuality and iden tity eventually em erge regardless of cultu re. KEY WORDS: homosexuality; lesbians; cross-cultural; sexual identity. Departme nt of Sociology‚ Arizona State University‚ Te mpe ‚ Arizona 85287-2101. To whom correspondence should be addre ssed.

1 2

31 0004-0002/98/0200-0031$15.00/0

Ó

1998 Plenum Publishing Corporation

32

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

INTRODUCTION Although some obse rve rs (Wee ks ‚ 1977; Gree nberg‚ 1988; Trumbach ‚ 1994) view the emergence of gay men and lesbians as the re sult of unique social structural patte rns‚ it is like ly that lesbians ‚ like gay men ‚ appe ar in all societie s. G aia ’s G uide Internation al (1988) ‚ the main international guide for lesbian trave le rs‚ lists lesbian bars ‚ coffee shops ‚ and book store s and othe r facilitie s and organizations in many countrie s throughout the world including such disparate locale s as Austria ‚ Dominican Republic ‚ India ‚ Israe l‚ Japan ‚ and Yugoslavia. While this guide is not as compre hensive as the Spartacus International G ay G uide (1989) for men ‚ G aia ’s G uide Internation al sugge sts that le sbians are not a unique creation of Western Europ e a n s oc ie t ie s ‚ but pr obably a u nive r sal as pe c t of h um an s e xu a l orie ntational arrange ments. Although we do not know the e xact pe rcentage of lesbians in various societies‚ the y probably comprise a relative ly small percentage of the population of all societies. Gebhard (1972) ‚ in re examining the original Kinse y data ‚ conclude d that lesbians comprise 1 ¯2% of the fe male populations in the United State s and Weste rn Europe an socie tie s. This estimate is consiste nt with the more recent e stimate of 1.4% reporte d by Laumann et al. (1994) . It should be said at the outse t that while no comple tely accurate measure of the incide nce of le sbians is possible ‚ the four countrie s studie d — Brazil ‚ Pe ru ‚ the Philipp ine s ‚ and the Unite d State s— have small but significant populations of lesbians. None se ems to have more le sbians relative ly speaking than the othe rs and the pe rcentage see ms consiste nt with the se e stimate s. Although it is probable that lesbians exist in all socie ties‚ there are many gaps and limitations in our knowle dge of lesbian behavior cross-culturally. For example ‚ we do not know whether le sbian se xuality is similar in all societies or whe ther it is subje ct to significant cultural variability. We cannot answe r all pe rtinent questions about le sbian sexuality cross-culturally‚ give n the limitations of our sample s and the fact that we have data for only four socie tie s. We do propose ‚ however‚ to explore more spe cifically the developme nt of le sbian sexuality and identity from a cross-cultural perspe ctive. Most of the rese arch on lesbian se xuality and ide ntity has be en conducte d with Anglo-Saxon sample s (e .g. ‚ Cass ‚ 1979; Troide n ‚ 1988; Kitzinge r and Wilkinson ‚ 1995) . As a conseque nce ‚ there is a tende ncy on the part of researchers to accept the Anglo-Saxon model of the de ve lopme nt of le sbian se xuality and ide ntity as valid for lesbians in ge neral. We have refraine d from regarding American lesbians in our sample s as the base line or norm for lesbians gene rally. Our two main guiding que stions — as we explore the relevant data — are (i) Are lesbians in the four socie ties similar with re gard to the developme nt of the ir sexuality and ide ntity? (ii) Are

Lesbian Sexu ality Cross -Culturally

33

le sbians in the four societies similar to the heterose xual wome n in those societies with re gard to the de ve lopme nt of their se xuality and identity?

DATA COLLECTION This re port is base d upon que stionnaire data obtaine d from groups of le sbians and comparative groups of heterose xual wome n in four societie s— Brazil ‚ Pe ru‚ the Philippine s‚ and the United State s— from 1981 through 1988. The re search reporte d was originally inte nde d to be an analysis of le sbians paralle l to a study of male homose xuality in Brazil ‚ Guatemala ‚ the Philippi ne s ‚ and the Unite d State s re porte d upon by Whitam and Mathy in 1986. For le gal re asons ‚ it was not possible to return to Guate mala to colle ct le sbian mate rial; hence Peru ‚ the Latin American country most like Guate mala in social background characte ristics ‚ was substitute d for Guate mala. Furthe rmore ‚ it was decided to expand the rese arch to include Indone sia and Thailand. Atte mpts were made by the senior re searche r to inte rvie w le sbians in Indone sia in 1990 and Thai lesbians in 1994. This prove d more difficult than anticipate d for a varie ty of re asons —the unwillingne ss of lesbians to talk about their live s‚ language barrie rs and ‚ in the case of Indone sia‚ the gove rnment prohibition that Indone sian citizens not talk with foreign journalists and social scie ntists. Effort was made to obtain the wide st possible spectrum of le sbians with regard to age ‚ social class ‚ ethnicity ‚ and othe r social background characte ristics. Four background characte ristics— age ‚ social class of pare nts ‚ social class of responde nts‚ and ethnic identification — are presented at the end of the discussion for e ach country. The re is ge neral comparability for heterose xual and homose xual wome n in each socie ty. The composition of the total sample of 429 re sponde nts is: Brazil: 61 he te rosexual wome n and 61 le sbians; Pe ru: 49 heterose xual women and 42 le sbians; the Philippine s: 49 he te rosexual women and 55 lesbians; the Unite d State s: 65 he te rosexual wome n and 49 lesbians. Brazil Be ginning in 1984 ‚ Brazilian le sbians were locate d in Salvador ‚ Bahia ‚ the colonial capital of Brazil ‚ a city of more than 2 million pe rsons. Using a Portugue se version of a que stionnaire ‚ re sponse s to a varie ty of questions dealing with the developme nt of se xuality and identity were elicite d. The le sbian community was e nte re d initially through contact with a group calle d Grupo Libertá rio Homossexual ‚ which primarily consiste d of

34

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

middle -class le sbians and their friends. In addition to the comple te d que stionnaire s‚ this group provide d valuable advice and descriptions regarding the le sbian community in Salvador. With this knowle dge ‚ effort was made to obtain re sponde nts through various social networks ‚ extending in as many directions as feasible . The Grupo Gay da Bahia ‚ a men’s group ‚ was also he lpful in providing contact with lesbians and heterosexual wome n known to the m. In addition to women known to these organize d groups ‚ contact was made with lesbians who fre que nte d a mixed gay and lesbian lowe r class bar. Some lesbians from this bar formed the basis of anothe r core network‚ distributing questionnaire s into anothe r lower class exte nsion. A male rese arch assistant was paid to distribute que stionnaire s to known lesbians and he terose xual wome n in a lowe r class neighborhood. An anthropology stude nt at the Federal Unive rsity of Bahia was paid to distribute questionnaire s to he terose xual wome n‚ primarily middle -class unive rsity stude nts. In 1986 ‚ more que stionnaire s were obtaine d from lesbians in Salvador. By this time ‚ the Grupo Libe rtá rio Homossexual was no longe r in e xiste nce ‚ and ne w contacts were develope d. Two lesbian re se arch assistants (unive rsity stude nts) used the que stionnaire s as an interview schedule to obtain both lesbian and hete rosexual responde nts. Responde nts were obtaine d from dive rse networks: a lower class lesbian bar ‚ a lower class gay and lesbian bar ‚ a middle -class gay and lesbian bar ‚ a gove rnme nt office ‚ a middle-class ne ighborhood ‚ and unive rsity classe s. These inte rviewers were also valuable informants regarding lesbian life in Salvador. A male graduate stude nt in sociology at the Fe deral Unive rsity of Bahia also distribute d que stionnaire s to lesbians and heterose xual wome n in a lowe r class neighborhood in which he live d ‚ in a neighborhood bar owne d by his brothe r‚ in unive rsity classe s‚ and in friendship ne tworks. Brazilian lesbians se em well tole rated in Brazilian socie ty and e njoy a high degre e of personal free dom. Yet some responde nts reporte d that under the pre vious military gove rnme nt‚ le sbians ‚ along with male homose xuals‚ Blacks ‚ poor pe ople ‚ and othe rs‚ were subje ct to arbitrary arre st and othe r forms of harassme nt in a “ show of power.” More recently‚ because of the AIDS e pide mic ‚ which is particularly virule nt in Brazil (Whitam ‚ 1988) ‚ homophobia has increase d significantly. The Grupo Gay da Bahia reports that 320 homose xual men and women were murdere d in antithomose xual viole nce the first 8 ye ars of the AIDS e pide mic (Paz y Libe ració n ‚ 1989) . Ye t an important aspe ct of Brazilian attitude s is the wide spre ad public support for civil rights of homose xuals. B razilian public opinion gene rally doe s not condone the repression of homose xuals and the new Brazilian constitution prohibits discrimination on the basis of sexual orientation. Two subgroups of lesbians ‚ masculine and fe minine ‚ are re cognize d by le sbians in Brazil as well as in the othe r three socie tie s. Terminology re-

Lesbian Sexu ality Cross -Culturally

35

flecting this dichotomy has e merge d and is in common usage . In Brazil ‚ the most wide ly unde rstood term for le sbian is lésbica; however‚ Brazilian le sbians prefer the term entendida ‚ a fe minization of entendido ‚ a widely use d term for male homose xuals ‚ gene rally e quivale nt to the American term “ gay.” The English word “ lady” is sometimes use d to re fe r to feminine le sbians while radical and the plural radicais re fe r to masculine le sbians who dre ss in me n ’s clothing ‚ have short haircuts ‚ and othe rwise imitate me n. Also in common usage are the te rms ativas and passivas ‚ the former be ing the more masculine and the latte r the more fe minine lesbians. Brazilian lesbians are much more ope n and live a much more public existence than those in most othe r Latin American societies. In Salvador the radicais can be see n publicly in side walk cafe s‚ dressed in men ’s clothing and sporting men ’s short haircuts. The re is also a growing group of m odernas‚ unive rsity-e ducate d lesbians who do not participate in role -playing and value egalitarian relationships. With re gard to social background characte ristics ‚ four ite ms are prese nte d here: age ‚ social class of parents‚ social class of responde nts ‚ and ethnic ide ntification. The age s of heterosexual re sponde nts range d from 16 _ to 66 years (x =_ 27.20) ‚ the age s of homose xual responde nts range d from 18 to 35 years (x = 23.96) . With regard to social class of pare nts of responde nts ‚ 42.9% of heterosexual re sponde nts’ pare nts were working class‚ 31.4% were middle class‚ and 25.7% were uppe r middle or uppe r class ‚ whereas 50.0% of pare nts of homose xuals were working class‚ 25.0% were middle class and 25.0% were uppe r middle or uppe r class ‚ c 2(2) = 0.43 ‚ ns. With re gard to the social class of the hete rosexual responde nts 45.7% were working class‚ 31.4% were middle class ‚ and 22.9% were uppe r middle or uppe r class. O f homose xual re sponde nts‚ 45.5% were working class ‚ 51.5% were middle class ‚ and 3.0% were uppe r middle or uppe r class ‚ c 2(2) = 6.71 ‚ p < 0.05. The majority of the responde nts conside red the mselves Hispanic-Latin with respe ct to ethnicity. O f the hete rosexual re sponde nts ‚ 15.7% were Eastern or Northern Europe an‚ 25.5% were Black‚ 45.1% were Hispanic-Latin ‚ and 13.7% were O the r. O f the homose xual responde nts 6.7% were Eastern or Northe rn Europe an‚ 20.0% were Black‚ 62.2% Hispanic-Latin ‚ and 11.1% were Other‚ c 2 (3) = 3.79 ‚ ns. The Other category include s persons of mixed White and Black ancestry‚ quite common in Brazil ‚ and for which there are numerous terms refe rring to various mixed type s. Peru Early in 1986 ‚ a paid rese arch assistant (a unive rsity-e ducate d journalist) began distributing a Spanish version of the questionnaire to primarily edu-

36

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

cate d‚ profe ssional ‚ middle - and uppe r middle -class lesbians and hete rosexual women in Lima ‚ Peru ’s capital and principal urban area with a population of about 5 million. In the Summer of 1986 ‚ when the senior researcher arrive d in Lima ‚ contact was made with lowe r class le sbians and he te rosexual women through a public school teacher who obtaine d both type s of responde nts from his lower class ne ighborhood. Some lower class re sponde nts are there fore include d in the predominantly middle -class sample . Rese arch in Peru was conducte d at a particularly difficult time in that country’s history. Te rrorism by the Maost Sendero Lum inoso was at its height ‚ gove rnme nt tanks were in the stree ts of Lima‚ terrorist bombs e xplode d daily in various parts of the city‚ including a re staurant whe re some inte rviews were conducte d ‚ and a toque de qu eda or 1 AM curfe w was in place for the e ntire population. Attitude s toward le sbians in Pe ru are somewhat ambivale nt. Le sbian activity is not criminalize d nor do public attitude s appe ar to be particularly negative . During inte rviews in 1986 lesbian responde nts in Lima consiste ntly re porte d widespread tolerance for lesbian activity. One complaint ‚ howe ve r‚ was the e xploitation of homose xuals — both male and fe male —by the pre ss for the creation of ne ws scandals to increase circulation. Indee d ‚ in 1987 ‚ a year after inte rviews were conducte d ‚ a police raid on Lima ’s only lesbian bar was conducte d and 72 lesbians were arreste d and tele vised nationally. Several responde nts in this re port were involve d in this incide nt. Pe ruvian lesbians ofte n re fe r to themselve s as activa ‚ the more masculine lesbian ‚ and pasiva ‚ the more feminine partne r. A couple is pareja ‚ which term may also be used to refer to one ’s love r as in m i pareja. The most commonly use d te rms in Lima to re fe r to the feminine /masculine dichotomy are femm e re fe rring to the more feminine partne r and chito refe rring to the more masculine partne r. Chito is derive d from m achito ‚ the diminutive of m acho. While the term lesbiana is known ‚ it is not regarde d as polite . The term m odern a is used by some Peruvian lesbians to re fe r to middle -class ‚ educate d‚ profe ssional lesbians who have re jected the traditional masculine /feminine dichotomy. Lima’s lesbians complaine d a good de al about the lack of organize d networks ‚ re staurants ‚ or coffee shops whe re le sbians could mee t. Lima ’s only e xclusive ly le sbian bar is a middle -class establishme nt‚ where men are exclude d. Its custome rs are dre sse d according to strict role-playing norms and conduct the mselve s accordingly. The chitos typically dre ss in men ’s clothing ‚ including men ’s pants ‚ shoe s‚ windbre ake rs‚ and very short hair. The femm es are dressed in conve ntional women ’s clothing such as pantsuits ‚ jeans‚ skirts ‚ blouse s‚ and sweate rs. Among Pe ruvian lesbians rathe r strict norms prevail with re gard to the public acting out of the chito and femm e role s. For e xample ‚ a femm e may not ask a chito to dance . In one instance

Lesbian Sexu ality Cross -Culturally

37

a femm e asked a chito to dance and the chito responde d angrily ‚ “ You are a femm e you can ’t ask a chito to dance ; go back to your table .” Some lesbians take masculine nickname s. For example ‚ the lesbian bounce r in a mixe d male-fe male homose xual bar in Lima pre fe rs to be calle d “ Chato ‚” a common masculine nickname . _ The age s of heterose xual responde nts range d from 15 to 42 (x _ = 28.9) while the age s of homose xual responde nts range d from 21 to 43 (x = 29.0) . With re gard to social class ‚ 47.9% of he te rosexual re sponde nts ’ pare nts were working class ‚ 12.5% were middle class ‚ and 39.6% we re uppe r middle or uppe r class ‚ whereas 28.6% pare nts of homose xuals were working class ‚ 21.4% were middle class‚ and 50.0% were uppe r middle or uppe r class ‚ c 2(2) = 3.77 ‚ ns. O f the heterose xual re sponde nts ‚ 22.4% were working class‚ 32.7% were middle class ‚ and 44.9% were uppe r middle or uppe r class whereas 21.4% of homose xual responde nts were working class ‚ 50.0% were middle class ‚ and 28.6% were uppe r middle class or uppe r class ‚ c 2 (2) = 3.30 ‚ ns. O f the he te rosexual re sponde nts 4.1% were Black ‚ 81.6% were Hispanic-Latin ‚ and 14.3% were Indigen a (Indian) . O f the homose xual responde nts ‚ 11.9% were Southe rn or Northe rn Europe an ‚ 4.8% were Black ‚ 71.4% Hispanic-Latin ‚ 4.8% were Asian ‚ and 7.1% were Indigena ‚ c 2 (5) = 9.565 ‚ ns. Philip pin es Inte rvie wing of Philippine re sponde nts began in 1981 in Cebu ‚ a city of 2 million ‚ the se cond large st city in the Philippine s and the “ capital ” of the V isayas ‚ a group of islands in south-ce ntral Philippine s. Two fe male unde rgraduate sociology majors at San Carlos Unive rsity worked as paid research assistants. The y had become frie nds with some le sbians the previous year while conducting unre lated social research in both lowe r class and middle -class neighborhoods in Cebu. The se contacts se rve d as the beginning point for contact with le sbian ne tworks in these neighborhoods. Colle ction of data in the Philippine s was delaye d by the tumultus political eve nts of the mid-1980s in which Ninoy Aquino was assassinate d ‚ Ferdinand and Imelda Marcos were turne d out of power‚ and Corazon Aquino was ele cted president. In 1988 the senior re se arche r returne d to the Cebu to colle ct new sample s of both he te rosexual and homose xual re sponde nts from the lowe r and middle classes. He was aide d by a profe ssor of English at the Unive rsity of San Jose-Recole tos in Ce bu. This assistant had contacts with le sbians and worke d as a paid re searche r in the summer of 1988 helping to interview both homose xual and heterose xual wome n from the same neighborhoods.

38

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

In Ce bu City where fie ld work with Philippine lesbians was conducte d ‚ the term lakin -on refers to lesbians in the Ce buano language but is not wide ly use d. Unive rsally use d and unde rstood is the English word “ tomboy.” Like numerous othe r foreign words ‚ tomboy has be come part of the Ce buano language and is not pe rceive d by Ce buano le sbians as a fore ign word. If a tomboy has a love r who live s with her she is referred to as a “ live -in.” The Philippine s is often se en by We sterners as an e xte nsion of Spanish or American socie ty. Although influe nce s from colonization by Spain and the United State s remain ‚ the se xual culture of Philippine s is very much Southe ast Asian. Le sbian life in the Philippine s is quite diffe rent from that in American society and Latin American socie ties. An important difference from the othe r thre e socie tie s is that Philippine lesbians see k he te rosexual wome n for relationships. In Brazil ‚ Peru ‚ and the Unite d State s‚ le sbians ge ne rally pair with othe r le sbians ‚ but lesbian ¯le sbian relationships are alie n to the norms of Philippine lesbians. The ide al partne r for Philippine le sbians is a he te rosexual woman ‚ who may be courted during her tee n ye ars or one who has recently unde rgone an abusive or unhappy marriage . A well-educate d Philippine le sbian re sponde nt when asked if she fe ared that her he te rosexual live -in would some day le ave her for a male husband ‚ replie d ‚ “ Of course at time s I fear this ‚ but what can I do? This is the nature of our live s.” The Philippine s is re markable for its tole rance of male and fe male homose xuals ‚ transve stite s ‚ and transse xuals. The Philippin e s doe s not criminalize any of the se forms of variant sexuality‚ regarding the m as a normal part of the eve ryday life of Philippine socie ty. Hostility toward lesbians is rare but some time s provoke d when a young he te rosexual woman decides to pair with a le sbian. Then the family may e nte r the situation to ke ep the ir daughte r away from the le sbian in hope s of preserving he r for a prope r he te rosexual marriage . _ The age s of heterose xual responde nts range d from 18 to 40 (x = 27.8) _ whereas the age s of homose xual responde nts range d from 14 to 48 (x = 26.7) . O f he te rose xual re sponde nts ’ pare nts ‚ 34.7% were working class ‚ 24.5% were middle class‚ and 40.8% were uppe r middle or uppe r class ‚ whereas 29.4% of the pare nts of homose xuals were working class‚ 45.1% were middle class ‚ and 25.5% were uppe r middle or uppe r class ‚ c 2( 2) = 5.03 ‚ ns. With regard to the social class of the heterose xual re sponde nts ‚ 34.7% were working class ‚ 63.3% were middle class ‚ and 2.0% were uppe r middle or uppe r class. O f homose xual responde nts‚ 35.2% were working class‚ 61.1% were middle class ‚ and 3.7% were uppe r middle or uppe r class ‚ c 2(2) = 0.26 ‚ ns. O f the heterose xual re sponde nts ‚ all were Asian ‚ whe re as 12.7% of the homose xual re sponde nts were identifie d as Europe an ‚ 1.8%

Lesbian Sexu ality Cross -Culturally

39

were Polyne sian ‚ and 85.5% were Asian ‚ c 2 (2) = 7.72 ‚ p< 0.05. The latte r finding is anomalous in that all homose xual re sponde nts were Filipina. Some re sponde nts perhaps exagge rated the ir Spanish background. While most Filipinos have Spanish surname s‚ these surname s do not necessarily indicate Spanish ance stry be cause the Spanish surname s were arbitrarily bestowe d upon the Filipinos by the Spanish colonize rs. No more than 1% of the Philippine population is Spanish. United States Women enrolle d in a “ V ariant Se xuality” course at a Southwe stern state unive rsity were solicite d as volunte e r research assistants betwee n 1982 and 1986. At the be ginning of each se mester for the se ye ars ‚ it was announce d to the class that lesbians of all type s and age s‚ without regard to any criteria ‚ were desired for a “ cross-cultural study of human sexuality. ” During this period le sbians conne cted with se ve ral dive rse ne tworks distribute d the questionnaire which was comple ted anonymously and re turne d by mail. During the same pe riod ( 1982 ¯1986) ‚ both male and fe male he te rosexual stude nts were aske d to distribute que stionnaire s to fe male friends. These questionnaire s were also comple te d anonymously and returne d by mail and served as a comparison group. All responde nts live d in the Phoe nix‚ Arizona ‚ metropolitan are a with a population of more than 2 million. In the Unite d State s‚ homose xual re lations are still criminalize d in nearly half of the 50 American state s. In some case s‚ the pe naltie s range up to 20 ye ars in prison. In 1986 ‚ a conse rvative U.S. Supre me Court in the Bowers v. Hardwick decision uphe ld the le gality of laws criminalizing homose xual acts. While lesbians are not often arre sted unde r such laws ‚ and a que stion remains as to whe the r lesbians can be prose cuted unde r sodomy statute s in many states‚ those living in states and municipalitie s without legal prote ction may be denie d housing ‚ access to public accommodations ‚ or may be fired from the ir jobs because they are lesbians. A persiste nt proble m in the United State s is the de nial to lesbians of the custody of their childre n from he te rosexual marriage s. American le sbians are sometimes the victims of harassme nt ‚ viole nce ‚ and even murder because of their sexual orientation. In the United State s “ le sbian ” is the preferred ge neral te rm. Until a fe w years ago ‚ the te rms “ gay” and “ gay woman ” were widely use d in Phoe nix and even today some women prefer the se terms to “ le sbian. ” The terms “ fem ” and “ butch ” or “ butchie ” are the most common te rms used by lesbians the mselves to refer to fe minine and masculine le sbians ‚ re spe ctive ly.

40

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

The te rms “ dyke ” and “ bull-dyke ” are used pejorative ly to re fe r to le sbians ‚ although some time s politically conscious lesbians may use the se words as a political state ment. Many politically oriented lesbians in the United State s obje ct to roleplaying as an exte nsion of patriarchal re pre ssion. Yet there is wide spre ad recognition that role-playing has be en a part of le sbian be havior historically and continue s to some e xte nt among olde r lesbians and those living in smalle r towns and citie s outside the mainstre am of conte mporary le sbian/fe minist thought. If many American lesbians have large ly abandone d role -playing ‚ le sbians in Pe ru ‚ Brazil ‚ and the Philippine s tend to accept it as an ordinary part of le sbian life and many active ly pe rpe tuate _it. The age s of heterose xual responde nts range d from 19 to 51 (x = 25.0) _ whereas the age s of homose xual responde nts range d from 18 to 51 (x = 32.4) . Regarding social class of pare nts of re sponde nts ‚ 10.8 of he te rosexual re sponde nts ’ pare nts were working class ‚ 35.4% were middle class ‚ and 53.8% were uppe r middle or uppe r class ‚ whereas 28.9% of pare nts of homose xuals were working class ‚ 44.4% were middle class ‚ and 26.7% were uppe r middle or uppe r class ‚ c 2 (2) = 9.96 ‚ p < 0.01. Regarding the social class of the he te rosexual re sponde nts‚ 7.7% we re working class‚ 44.6% we re middle class ‚ and 47.7% were uppe r middle or uppe r class ‚ whe re as 12.8% of homose xual responde nts were working class ‚ 59.6% were middle class ‚ and 27.7% were uppe r middle or uppe r class ‚ c 2 (2) = 4.70 ‚ ns. With re gard to e thnicity of he te rosexual responde nts‚ 43.1% were northe rn Europe an ‚ 24.6% were southe rn Europe an ‚ 16.9% were easte rn Europe an ‚ 4.6% were Black ‚ 9.2% were Hispanic-Lat in ‚ and 1.5% were Native American ‚ whe re as 64% of the homose xual responde nts were northe rn Europe an ‚ 8.9% were southe rn Europe an ‚ 17.8% were e aste rn Europe an ‚ 2.2% were Black ‚ 2.2% were Hispanic-Latin ‚ 2.2% were Asian ‚ and 2.2% were Native American ‚ c 2(6) = 9.95 ‚ ns. None of the research assistants in this proje ct knew pre cise ly why this research was be ing done and which ideas were be ing examine d. In all cases where local assistants were use d ‚ the y were told that the study was a crosscultural e xamination of sexuality in various countrie s. Exce pt for Lima ‚ the citie s in which the rese arch was conducte d are similar in size.

RESULTS AND DISCUSSION The table s that follow are those bearing most directly on the de ve lopme nt of lesbian sexuality and ide ntity. Table s I through V de al mainly with sexuality while the Table s V I and V II de al with what is usually calle d “ lesbian identity.” Chi-square analyse s of difference s betwee n he te rosexual

Lesbian Sexu ality Cross -Culturally

41

wome n and lesbians have bee n compute d and pre se nte d as well as difference s among lesbians in the four socie tie s and diffe re nce s among he te rosexual women in the four societie s. Be cause nearly all table s contain cells with fewer than five response s‚ Yate s’ correction for continuity was compute d for all table s. Chi-square analysis is not a comple tely satisfactory te chnique for unde rstanding these data be cause of the comple xity of the table s. Examining the data for ge ne ral trends is equally important. Direction of Child hood Sex Interest Table I summarize s data de aling with dire ction of childhood sex inte rest‚ which re fe rs to whe ther re sponde nts in childhood sex play we re more inte reste d in and excite d by boys or othe r girls. In childhood se x play lesbians displaye d more se xual inte rest in othe r girls than he te rosexual wome n did in boys. Le sbian sexual attractions came into play early and we can see an e merging patte rn of lesbian attractions in childhood. Thre e out of four societies re fle ct this patte rn of childhood se x play consiste nt with adult se xual orie ntation. In the U.S. more le sbians report early sex play with boys than with girls. Eve n so ‚ 27% report se x play with othe r girls. In cross-cultural perspe ctive ‚ lesbians ofte n are attracte d to othe r girls in childhood. The failure of the U.S. data to re flect this patte rn is puzzling. While Cass (1979) ‚ for e xample ‚ assumes that lesbian sexuality and identity be gin at pube rty‚ our data sugge st that le sbian sexual attractions fre que ntly e merge in childhood. Be tween 34.1% and 54.4% of lesbians in the four socie ties did not recall any childhood se xual inte rest. In thre e of four societies‚ the percentage is about the same: Brazil = 36% ; Peru = 34.1% ; Unite d State s = 34.1% . In the Philippine s‚ 54.5% of the le sbians did not re call childhood sexual inte re sts. Heterose xual women appe ar to differ from le sbians in being much le ss like ly to have had childhood sexual inte rests. Failure to report childhood se xual inte rests for he te rosexual wome n range s from 50% in Brazil to 87% in Peru. Many sociologists (e.g.‚ Gagnon and Simon ‚ 1973) e mphasize d the notion that sexual conduct is primarily social in origin ‚ re sulting from social scripts ‚ ye t little pare ntal socialization be ars upon childhood se x play. None the less‚ le sbian se xuality cle arly be gins in childhood ‚ particularly notice able in Brazil ‚ the Philippine s‚ and Pe ru. Only in the United State s are le sbians in childhood more incline d to sex play with little boys than with little girls. Presumably socialization by pare ntal norms and attitude s about childhood se x ope rate equally with regard to heterose xuals and homose xuals because all girls from the point of view of pare nts are assume d to eventually

a

13 7 8 1 29

n

22.4 12.1 13.8 0.7 50.0

%

2 29 1 6 22

n 3.3 48.3 0.7 10.0 36.7

%

Lesbian

4 0 2 0 40

n

a

% 12.2 31.7 0.0 22.0 34.1

c 2(6) = 6.59‚ ns

41

5 13 0 9 14

n

Lesbian

0.0 26.5 4.1 0.0 69.4

%

55

7 11 6 1 30

n 12.7 20.0 10.9 1.8 54.5

%

Lesbian

c 2(7) = 15.11‚ p < 0.05

49

0 13 2 0 34

n

Heterosexual

Philippines

17.5 7.9 12.7 0.0 61.9

%

44

16 12 0 1 15

36.4 27.3 0.0 2.3 34.1

%

Le sbian n

c 2(6) = 18.53‚ p < 0.01

63

11 5 8 0 39

n

Heterosexual

United States

Re sponses to the question: ‘‘In your childhood sex play‚ were you more interested in and excited by playing around with little boys or with little girls? ’’

Betwe en heterosexual wome n in the four societies: c 2 (12) = 29.83 ‚ p < 0.005 Betwe en le sbians in the four societies: c 2 (12) = 45.37 ‚ p < 0.001

c 2(6) = 27.78‚ p < 0.001

8.7 0.0 4.3 0.0 87.0

%

Heterosexual

Peru

Table I. Direction of Childhood Sexual Interest

Totals (100% ) 58 60 46 Analysis of differences Betwe en heterosexual wome n and lesbians in each socie ty:

Little boys Little girls Excited by boys but did not play Excited by girls but did not play No recall of interest

Response

He te rose xual

Brazil

Lesbian Sexu ality Cross -Culturally

43

become he te rosexual. Whate ve r the re asons ‚ it se ems cle ar that girls who are le sbians as adults were more sexually active as childre n and more like ly to have had childhood sex play consiste nt with later sexual orie ntation than girls who late r be come heterose xual. The fact that the American le sbians do not follow the patte rn of childhood sex play with othe r girls sugge sts that American data on lesbian se xuality may not be ge ne ralizable to othe r populations. Age of Fir st Awaren ess of Sexu al Attraction In Table II‚ re sponse s to two que stions are juxtapose d: “ At what age were you first aware of attraction to male s? ” and “ At what age were you first aware of attraction to female s? ” For heterose xual females‚ response s shown re flect the ir attraction to male s‚ and for lesbians ‚ re sponse s shown reflect their attraction to female s. As childre n ‚ lesbians in Brazil ‚ Pe ru‚ and the Unite d State s were aware of attraction to fe males some what late r than heterose xual wome n were aware of attraction to men. Only in the Philippine s were le sbians aware of attraction to fe males earlie r than the he te rose xual wome n we re aware of attraction to me n. This patte rn of late r aware ne ss by lesbians se ems to characte rize their se xual developme nt at several points and may re fle ct a tre nd of de laye d de ve lopme nt of le sbian sexuality which holds cross-culturally. Perhaps the most significant finding from Table II is that the “ late -bloome r” e ffect for lesbian attraction occurs in all four socie tie s. In Brazil ‚ only 1 he te rosexual woman re alize d her first sexual attraction for men after the age 17 ‚ whereas 31.1% of Brazilian lesbians realize d their se xual attraction to wome n after 17. In Peru ‚ only 2 heterose xual women re alize d the ir se xual attraction to men afte r the age of 17‚ whereas 23.8% of Peruvian le sbians re alize d their sexual attraction for wome n after 17. In the Philippine s and the Unite d State s no he te rosexual women realize d the ir attraction to men afte r the age of 17‚ whe re as 29.1% of the Philippine lesbians and 21.3% of the American le sbians realize d their attraction for wome n after 17. In othe r words‚ the late -bloome r effe ct se ems to have occurre d in all four societie s at about the same rate (20 ¯30% ). Delaye d aware ne ss of le sbian attraction to women occurred in both childhood and te e n ye ars with the most striking de laye d or late bloome r e ffect occurring afte r the age of 17 ‚ be tween 18 and 35. By age 25 all he te rosexual women in the four socie tie s were aware of their attraction to men. The same is not true for le sbians in that a small and similar percentage of lesbians in the four socie tie s did not fee l attraction to othe r wome n until they were be tween 26 and 35. This percentage is small — between 4.3 and 9.5% — but rende re d important by the fact that it occurs in

a

1 5 31 18 1 0

n

1.8 8.9 55.4 32.1 1.8 0.0

%

5 10 14 13 16 3

n 8.2 16.4 23.0 21.3 26.2 4.9

%

Lesbian

2 9 18 17 2 0

n 4.2 18.8 37.5 35.4 4.2 0.0

%

Heterosexual

Peru

2 8 12 10 6 4

n 4.8 19.0 28.6 23.8 14.3 9.5

%

Lesbian

49

0 1 13 28 7 0

n

55

3 6 15 15 13 3

n 5.5 10.9 27.3 27.3 23.6 5.5

%

Lesbian

c 2(5) = 9.74‚ ns

0.0 2.0 26.5 57.1 14.3 0.0

%

Heterosexual

Philippines

21.6 20.0 43.1 15.4 0.0 0.0

%

47

5 7 14 11 8 2

10.7 14.9 29.8 23.4 17.0 4.3

%

Le sbian n

c 2(5) = 12.87‚ p < 0.025

65

14 13 28 10 0 0

n

Heterosexual

United States

a

Response s to the question: For he te rosexual women: ‘‘At what age were you first aware of your attraction to me n? ’’ For lesbians: ‘‘At what age were you first aware of your attraction to women? ’’

Be tween heterosexual women in the four societies: c 2(12) = 55.00‚ p < 0.001 Be tween lesbians in the four socie tie s: c 2(15) = 3.48 ‚ ns

Totals (100% ) 56 61 48 42 Analysis of diffe re nce s Be tween heterosexual women and le sbians in e ach society: c 2(5) = 21.65‚ p < 0.001 c 2(5) = 4.12‚ ns

3 ¯6 years 7 ¯9 years 10 ¯13 ye ars 14 ¯17 ye ars 18 ¯25 ye ars 26 ¯35 ye ars

Re sponse

He te rose xual

Brazil

Table II. Age of First Awarene ss of Sexual Attraction to Males for Heterose xual Women and to Females for Lesbians

Lesbian Sexu ality Cross -Culturally

45

all four societies. This sugge sts a culturally unive rsal delaye d effe ct by lesbians in re alizing the dire ction of their sexual attraction. The late -bloome r effe ct is presumed to be the result of strong socialization for he te rosexual orie ntation in all socie tie s. Despite such socialization and re sulting late bloome r effe cts‚ le sbian se xual orie ntation e ventually outs as shown in othe r table s. It appe ars that lesbian se xuality can be delaye d but not prevented by cultural norms. Cross-Attraction s The que stion addre ssed by Table III is “ At what age did he te rosexual wome n fee l attracte d to othe r wome n (if at all) and at what age did le sbians fe e l attracte d to men (if at all)? ” This patte rn of attraction is calle d “ crossattraction. ” Examination of Table III sugge sts a marke d difference in patte rns of cross-attractio n be twe e n le sbian s an d he te rose xual wome n. Le sbians in all four socie tie s were conside rably more like ly to expe rience attraction to men than heterose xual women to othe r women. This patte rn is most notable in the age categorie s 10¯ 13 and 14 ¯17. In the Brazilian sample ‚ 37.2% of lesbians expe rience d attraction to men during the ye ars 10¯ 17 while only 4.8% of the heterose xual wome n expe rience d attraction to wome n during these age s. For Peruvian lesbians ‚ 28.5% expe rience d attraction to men during the se age s. If the age cate gory 7 ¯9 is include d ‚ this Peruvian figure incre ases to 40.0% while only 2.1% of the he te rosexual wome n age s 7¯ 17 e xpe rienced attraction to women. For the Philippine s 25.5% of the lesbians expe rience d attraction for men while 12.5% of the heterose xuals e xpe rienced attraction to wome n ‚ reflecting the smalle st discrepancy betwee n he te rosexuals and homose xuals for cross-attraction. In the United State s 46.8% of the lesbians e xpe rie nced attraction for men betwee n the age s of 10 and 17 while only 7.7% of heterose xual women were attracte d to wome n during these age s. This general patte rn of cross-attraction holds true whe n viewed in a somewhat diffe re nt way: the pe rcentage s of women who e xperie nce no cross-attraction at all. The percentage s of he te rosexual wome n e xpe riencing no cross-attraction range from 78.0% in Brazil to 91.7% in Pe ru. The percentage s of le sbians e xpe riencing no cross-attraction range from 31.9% in the United State s to 63.8% in the Philippine s. In summary‚ cross-attraction see ms conside rably more characte ristic of le sbians than of he te rosexual wome n regardle ss of culture and see ms to peak betwee n the age s of 10 and 17. This may sugge st that norms socializing for he te rosexual inte rest made significant impact upon patte rns of le sbian sexual attraction. Despite the se pre ssures of socialization for he t-

a

2.0 3.9 19.6 17.6 3.9 0.0 52.9

% 0 0 0 1 2 1 44

n 0.0 0.0 0.0 2.1 4.2 2.1 91.7

% 1 5 8 4 1 0 23

n

% n

a

0.0 0.0 6.4 19.1 10.6 0.0 63.8

%

3.0 0.0 6.2 1.5 6.2 4.6 78.5

%

47

5 3 10 12 2 0 15

10.7 6.4 21.3 25.5 4.3 0.0 31.9

%

Lesbian n

c 2(6) = 28.98 ‚ p < 0.001

65

2 0 4 1 4 3 51

n

Heterosexual

Unite d States

Re sponses to the question: For he te rosexual women: ‘‘At what age were you first aware of your attraction to women (if eve r)? ’’ For lesbians: ‘‘At what age were you first aware of your attraction to men (if eve r)? ’’

Betwe en heterosexual wome n in the four societies: c 2 (16) = 9.28‚ ns Betwe en le sbians in the four societies: c 2 (15) = 16.60 ‚ ns

47

0 0 3 9 5 0 30

n

c 2(3) = 4.09 ‚ ns

0.0 0.0 4.2 8.3 2.1 0.0 85.4

%

Le sbian

Philippines Heterosexual

48

1 2 10 9 2 0 27

n

Lesbian

Totals (100% ) 41 51 48 42 Analysis of differences Betwe en heterosexual wome n and lesbians in each socie ty: c 2(6) = 10.21‚ ns c 2(6) = 15.63 ‚ p < 0.025

4.9 2.4 2.4 2.4 9.8 0.0 78.0

%

He te rose xual

0 0 2 4 1 0 41

2 1 1 1 4 0 32

n

Lesbian

Peru

2.4 11.9 19.0 9.5 2.4 0.0 54.8

3¯ 6 ye ars 7¯ 9 ye ars 10¯ 13 years 14¯ 17 years 18¯ 25 years 26¯ 35 years No attraction

Response

Heterosexual

Brazil

Table III. Cross-Attraction: Age of First Awarene ss of Sexual Attraction to Female s for He te rosexual Wome n and to Males for Lesbians

Lesbian Sexu ality Cross -Culturally

47

erose xual behavior ‚ more than half of the lesbians (e xce pt in the United State s) e xpe rienced no such attraction to men. This sugge sts that le sbian sexuality is simultane ously subje ct to shaping by heterose xual norms and characte rized by conside rable tenacity and re sistance to socialization for heterose xuality. Age of Fir st Sexu al Con tact Table IV summarize s response s to the que stion ‚ “ At what age did you first have se xual contact ‚ touching genitalia ‚ e tc.? ” It is clear from the patte rn of response s that lesbians in all four countrie s re porte d e arlie r sexual contact than did heterose xual women. This patte rn is quite marke d with the gre atest difference be tween heterose xual and le sbians occurring in the Brazilian sample ‚ followe d closely by the Pe ruvian and Philippine sample s. The smalle st diffe re nce be tween he te rosexual and homose xual women was in the Unite d State s‚ whe re 55% of the le sbians had se xual contact be fore age 14 as compare d with 43.7% of the he te rosexuals. The Philippine lesbians had the least se xual contact before age 14. It is uncle ar why the lesbians in all four societies were more precocious sexually. Probably no childre n are socialize d into specific patte rns of childhood se x play. With re gard to childhood sexuality‚ childre n are gene rally le ft on their own and their sexuality is usually acted out in se crecy from adults. Adults do not gene rally socialize childre n or encourage childre n to act out se xually either heterose xually or homose xually or with males or females. If any assumptions e xisted on the part of pare nts about their childre n ’s se x play‚ they probably were vague ‚ nonspe cific image s or fears that boys might initiate se x play with the ir daughte rs. A possible e xplanation is that there is something about the de ve lopment of lesbian se xuality in childhood that is intrinsically and biologically differe nt from the de ve lopme nt of he te rosexual female se xuality. Perhaps a more probable e xplanation lies in the diffe re nce be tween the ge neral ‚ nonse xual childhood play patte rns of lesbians and heterose xual wome n. Le sbians tend to spe nd more time in general with boys ‚ often play with boys ’ toys and hobbie s‚ and are more like ly to engage in tomboyish behavior than do he te rosexual women. The se patte rns have be en reporte d by Whitam and Mathy (1991) in these same four socie tie s and more recently by Phillips and Ove r (1995) in an Australian sample . The tende ncy of le sbians as childre n to spe nd more time with boys in the ir general play activitie s may have le d to increased incide nce of childhood sex play‚ perhaps initiate d mainly by boys. In playing with boys the ir childhood play took place furthe r

a

2 1 4 23 21 0 0

n

3.9 2.0 7.8 45.1 41.2 0.0 0.0

%

1 4 12 21 17 0 0

n 1.8 7.3 21.8 38.2 30.9 0.0 0.0

%

Lesbian

3 2 2 16 13 2 0

n 7.9 5.3 5.3 42.1 34.2 5.3 0.0

%

He te rose xual

Peru

1 6 7 13 13 1 0

n 2.4 14.6 17.1 31.7 31.7 2.4 0.0

%

Lesbian

52

0 1 10 13 14 5 9

n 0.0 1.9 19.2 25.0 26.9 9.6 17.3

%

64

7 10 11 28 7 0 1

n

47

10 7 9 10 10 1 0

21.3 14.9 19.1 21.3 21.3 2.1 0.0

%

Lesbian n

c 2(6) = 9.95 ‚ ns

10.9 15.6 17.2 43.8 10.9 0.0 1.6

%

Heterosexual

Unite d States

aResponses to the que stion: ‘‘At what age did you actually indulge in some form of se xual contact— touching genitalia ‚ etc.? ’’

Betwe en heterosexual wome n in the four societies: c 2 (18) = 59.01 ‚ p < 0.001 Betwe en le sbians in the four societies: c 2 (18) = 50.33 ‚ p < 0.001

0.0 0.0 4.2 12.5 64.6 8.3 10.4

%

c 2(5) = 16.45‚ p < 0.01

48

0 0 2 6 31 4 5

n

Le sbian

Philippines Heterosexual

Table IV. Age of First Sexual Contact

Totals (100% ) 51 55 38 41 Analysis of differences Betwe en heterosexual wome n and lesbians in each socie ty: c 2(4) = 9.17 ‚ ns c 2(5) = 6.32 ‚ ns

3¯ 6 ye ars 7¯ 9 ye ars 10¯ 13 years 14¯ 17 years 18¯ 25 years 26¯ 35 years No contact

Response

Heterosexual

Brazil

Lesbian Sexu ality Cross -Culturally

49

from home and out of sight of pare ntal vie w‚ allowing for a greate r incidence of childhood sex play. Indire ct e vide nce for this e xplanation is provide d by the Philippine data. In Table IV Philippine le sbians have the lowest incide nce of childhood sex play. From Table V it may also be se en that the Philippine lesbians also report the lowe st incide nce —only 5.7% —of male s as the sex of the ir first se xual contact. Sex of Partner in First Sexu al Con tact With re gard to se x of partne r in first se xual contact ‚ hete rosexual wome n consiste ntly report “ males.” In Table V the percentage s of he te rosexual wome n re porting first se xual contact with males are similar: in Brazil 80.3% ‚ in Peru 84.8% ‚ in the Philippine s 83.3% ‚ and in the Unite d State s 86.2% . In contrast ‚ the se x of the first se xual partne r of the lesbians was more variable and split be tween males and fe males in a diffe rent patte rn. In Brazil and the Philippine s‚ the se x of the first se xual partne r was predominantly fe male ‚ 63.9 and 66.0% ‚ re spe ctive ly. Howe ver‚ in Pe ru and the Unite d State s the first se xual partne r of lesbians was predominantly male with 52.4% in Peru and 57.4% in the United State s. Even so‚ 47.6% of Peruvian le sbians ‚ and 42.6% of American le sbians report female s as partner in first sexual contact. Norms for he te rosexual activity again may have influe nce d the se x of first se xual contact. The first sexual contact of he te rosexual wome n se ems to have be en mainly male ‚ while that of le sbians is split about equally between male and female. Despite this splitting e ffect‚ a substantial percentage of the le sbians (be tween 42.6 and 66% ) had their first sexual contact with women. This sugge sts that de spite the e ffect of norms for he te rosexual behavior ‚ significant numbe rs of lesbians are oriente d toward wome n e ven at the outse t of their se xual activity. Age of Awaren ess That Sexu al Attraction s Were Seriou s Table VI reports re sponse s to the que stion ‚ “ At what age did you fee l that your sexual attractions were more than just playing around? ” For he terose xual women sexual attractions re fe rs to attractions for men and for le sbians se xual attractions re fe rs to attractions to women. In Table V I a conside rable pe rcentage of wome n of both sexual orientations are aware that their fe e lings were se rious before age 14. For he te rosexual wome n this range s from 20.0% for Pe ruvians to 31.7% for Brazilians and for le sbians this aware ne ss range s from 14.9% for Filipinas to 38.9% for Peruvians ‚

a

39 1 0 6

n 84.4 2.2 0.0 13.0

% 22 20 0 0

n

%

Responses to the que stion: ‘‘What was the sex of your first sexual contact? ’’

Betwee n he te rosexual women in the four societies: c 2 (9) = 8.26 ‚ ns Betwee n lesbians in the four societies: c 2(9) = 49.39 ‚ p < 0.001

31.1 63.9 3.3 1.6

% n

53

3 35 5 10

n 5.7 66.0 9.4 18.9

%

c 2(3) = 67.19 ‚ p < 0.001

83.3 4.2 0.0 12.5

%

Le sbian

Philippines Heterosexual

48

19 39 2 1

n

Lesbian

Totals (100% ) 61 61 46 42 Analysis of differences Betwee n he te rosexual women and lesbians in each society: c 2(3) = 53.36 ‚ p < 0.001 c 2(2) = 27.80 ‚ p < 0.001

80.3 3.3 1.6 14.8

%

He te rose xual

40 2 0 6

49 2 1 9

n

Lesbian

Peru

Table V. Sex of Partner in First Sexual Contact

52.4 47.6 0.0 0.0

a

Male Female Mixed group No contact

Response

Heterosexual

Brazil

86.2 10.8 1.5 1.5

%

47

27 20 0 0

57.4 42.6 0.0 0.0

%

Lesbian n

c 2(3) = 15.91 ‚ p < 0.005

65

56 7 1 1

n

Heterosexual

Unite d States

a

2 1 15 26 13 0

n

3.6 1.8 26.3 45.6 22.8 0.0

%

0 2 11 21 20 1

n 0.0 3.6 20.0 38.2 36.4 1.8

%

Le sbian

0 1 8 28 8 0

n 0.0 2.2 17.8 62.2 17.8 0.0

%

Heterosexual

Pe ru

1 1 12 14 7 1

n 2.8 2.8 33.3 38.9 19.4 2.8

0.0 0.0 28.6 38.8 30.6 2.0

%

54

0 3 5 31 13 2

n 0.0 5.6 9.3 57.4 24.1 3.7

%

Lesbian

c 2(4) = 10.40 ‚ p < 0.05

49

0 0 14 19 15 1

n

Heterosexual

Philippines

a

n

47

2 0 9 20 14 2

n

4.3 0.0 19.1 42.6 29.3 4.3

%

c 2(5) = 13.61‚ p < 0.025

63

0.0 1.6 22.2 65.1 11.1 0.0

%

Lesbian

United States Heterosexual

0 1 14 41 7 0

Response s to the question: ‘‘At what age did you fe el that your sexual attractions were more than just playing? ’’

Be tween heterosexual women in the four societies: c 2(15) = 12.60‚ ns Be tween lesbians in the four socie tie s: c 2(15) = 11.97‚ ns

%

Le sbian

Totals (100% ) 57 55 45 36 Analysis of diffe re nce s Be tween heterosexual women and le sbians in e ach society: c 2(5) = 5.93‚ ns c 2(5) = 6.62‚ ns

3 ¯6 years 7 ¯9 years 10 ¯13 ye ars 14 ¯17 ye ars 18 ¯25 ye ars 26 ¯35 ye ars

Response

Heterosexual

Brazil

Table VI. Age of First Awareness that Se xual Attractions Were Se rious

52

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

who‚ of all le sbians ‚ were aware e arlie st of the se riousne ss of their sexual attractions to othe r wome n. Awarene ss of the seriousne ss of se xual attractions before age 14‚ then ‚ is gene rally comparable in he te rosexual and homose xual wome n. If we conside r the same que stion using age 17‚ rathe r than 14 ‚ roughly three fourths of both heterose xual wome n and lesbians are aware that their sexual attractions were serious by age 17 with no marked patte rn of diffe re nce s be twe e n he te rose xual women and lesbians with re gard to this que stion. By age 25‚ practically all re sponde nts ‚ e spe cially he te rosexuals ‚ had come to the realization that the ir sexual attractions were serious and more than “ playing around. ” A small percentage of lesbians in e ach of the four countrie s— ranging from 1.8% in Brazil to 4.3% in the Unite d State s— did not re alize that their sexual attractions were se rious until afte r age 25. This sugge sts that the late -bloome r e ffect ope rate s to a slight de gre e in age of realization that sexual attractions are serious. Age of Realization of Sexu al Orientation Table V II summarize s the results of the que stion ‚ “ At what age did you re alize that you would be he te rosexual (for he te rosexual wome n) or homose xual (for le sbian wome n)? ” This item is ‚ of course ‚ more specific than the previous que stion having to do with the seriousne ss of se xual attractions ‚ and ‚ of all que stions reporte d upon ‚ measure s most dire ctly what is usually calle d lesbian iden tity. In Table VII the patte rns for he te rosexual and homose xual wome n are diffe rent from those in the previous item. Perhaps we are again se eing the e ffects of the heterose xual bias in the proce ss of socialization. In Table V II lesbians in all four societies were le ss like ly to de fine the mse lve s as le sbians before age 14 than were he te rose xual wome n to define themselve s as heterose xual. This patte rn is quite consiste nt. American women are the most atypical with 71.9% defining themselve s as heterose xual be fore age 14 and only 10.6% of the lesbians defining the mselves as lesbian before age 14. Conside ring age 17‚ it may be se en again that le sbians de fine d themselve s as le sbian conside rably late r than he te rosexual wome n defined themselve s as he te rosexual. The se percentage s range from 31.9% for American le sbians (who defined the mselves as le sbians late st) to 67.3% for Filipinas defining the mselves as lesbians by age 17. Thus ‚ again ‚ we may be see ing the e ffects of socie tal norms that emphasize heterose xually. It is appare nt from Table VII that some le sbians —as many as 30.7% in Pe ru— realize d quite early that they would be le sbians. By age 17 between roughly one third to two thirds of the le sbians realize d their future

a

n

4 0 12 22 9 0 0 0

8.3 0.0 25.0 45.8 18.8 0.0 0.0 0.0

%

1 1 7 16 24 3 0 2

n 1.9 1.9 13.0 29.6 44.4 5.6 0.0 3.7

%

Lesbian

0 1 8 12 2 0 0 0

n 0.0 4.3 34.8 52.2 8.7 0.0 0.0 0.0

%

Heterosexual

2 0 10 11 12 3 1 0

n 5.1 0.0 25.6 28.2 30.8 7.7 2.6 0.0

a

%

Lesbian

49

1 3 11 20 10 1 0 3

n

55

3 4 6 24 14 2 0 2

n 5.5 7.3 10.9 43.6 25.5 3.6 0.0 3.6

%

Lesbian

c 2(6) = 1.99 ‚ ns

2.0 6.1 22.4 40.8 20.4 2.0 0.0 6.1

%

He te rose xual

Philippine s

20.3 17.2 40.8 16.4 2.0 0.0 0.0 1.6

%

47

0 0 5 10 18 11 3 0

0.0 0.0 10.6 21.3 38.3 23.4 6.4 0.0

%

Lesbian n

c 2(7) = 47.46 ‚ p < 0.001

64

13 11 20 10 1 0 0 1

n

He te rose xual

United State s

Re sponses to the question: ‘‘At what age did you come to realize that you were going to be homosexual/heterosexual? ’’

Betwe en heterosexual wome n in the four societies: c 2 (18) = 40.41 ‚ p < 0.005 Betwe en le sbians in the four societies: c 2 (21) = 27.81 ‚ ns

Totals (100% ) 48 54 23 39 Analysis of differences Betwe en heterosexual wome n and lesbians in each socie ty: c 2(6) = 8.96 ‚ ns c 2(5) = 4.84 ‚ ns

3¯ 6 ye ars 7¯ 9 ye ars 10¯ 13 years 14¯ 17 years 18¯ 25 years 26¯ 35 years 36+ years Not applicable

Re sponse

Heterosexual

Peru

Table VII. Age of Realization of Adult Sexual Orientation

Brazil

54

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

sexual orie ntation. The re mainde r realize d this after 17. Again ‚ it may be that social norms impe de and de lay se lf-ide ntification by lesbians ‚ but such norms do not se em capable of de te rring eventual self-ide ntification as lesbian.

CONCLUSIONS AND SUMMARY The data in the pre ceding analysis sugge st a comple x patte rn of le sbian sexual de ve lopme nt in which lesbians cross-culturally appe ar to share some de velopme ntal tre nds. For e xample ‚ the data de aling with “ direction of childhood sexual interest” and “ age of first sexual contact ” sugge st that le sbian se xual developme nt often be gins to appe ar in childhood. Le sbians are more sexually pre cocious than heterose xual wome n and more inte rested in girls than he te rosexual wome n are in boys ‚ despite pre sume d socialization into he te rosexual norms of both groups. The appe arance of same -se x attraction in childhood without appare nt socialization sugge sts a biological rathe r than socially constructe d basis for the emerge nce of le sbian se xuality. Yet the influe nce of socialization upon e merging patte rns of lesbian sexuality is also sugge sted. For example ‚ data on “ age of first aware ne ss of sexual attraction ” see m to refle ct the pressure of heterose xual norms upon le sbian de ve lopme nt‚ resulting in the late-bloom er effe ct in all four societies. A similar effe ct of the influe nce of heterose xual norms is sugge sted by patte rns of cross-attraction whe re in lesbians re port conside rably more cross-attraction. The patte rn resulting from analysis of the “ sex of partne r in first sexual contact ” sugge sts the simultane ous effe cts of biology and socialization. Nearly all heterose xuals re port male s as their first sexual contact while roughly half the le sbians report first se xual contact with othe r females. Regarding the de velopme nt of se xual ide ntity‚ heterose xual women and le sbians are similar with respect to the age at which the y re alize their sexual attractions are se rious rathe r than playing around. With re gard to age of actually realizing the ir sexual orie ntation ‚ lesbians in all four socie ties are somewhat slower in re alizing the ir adult sexual orie ntation ‚ again sugge sting the impeding influe nce of socialization by heterose xual norms. It is a truism that both biological and social factors are involve d in the de ve lopme nt of sexual orientation. The analysis presented here —crosscultural analysis paire d with data from both heterose xual and homose xual wome n —e nable s us to de line ate rathe r spe cifically the impact of both biology and socialization. The emergence of le sbian sexuality and ide ntity in childhood without socialization into such behavior sugge sts an unde rlying biological basis for this be havior while atte mpts by all societies to socialize

Lesbian Sexu ality Cross -Culturally

55

emerging lesbians into he te rosexuality are only partly succe ssful for particular kinds of behavior at certain points in le sbian de ve lopme nt. Although we cannot unde re stimate the importance of the impact of the se heterose xual norms ‚ ultimate ly the y fail. Social constructionists (e .g.‚ Troide n ‚ 1988; Patte rson ‚ 1995) usually take the position that social and cultural factors create homose xual orientation. This point of view is not substantiate d by the se data. Le sbian sexuality and ide ntity are not socially constructe d; rathe r socie tie s atte mpt to destru ct e merging lesbian be havior ‚ impeding ‚ but not oblite rating ‚ its developme nt. This proce ss of de structing is only partially successful and eventually the emerging le sbian orie ntation overcome s attempts to destruct it ‚ regardle ss of the particular socie ty and its social-structura l arrange ments.

ACKNOWLEDGMENTS In conne ction with conducting fie ld rese arch we grate fully acknowle dge the he lp of the following pe rsons— in Brazil: Ce le ste Ce rvi ñ o Rivas ‚ Léa Maria Fonsê ca ‚ Maria de Lourde s Motta ‚ H édimo Rodrigue s Santana ‚ Aroldo Assun†ao‚ and Dr. Luiz Mott of the Fe deral Unive rsity of Bahia; in Pe ru: Gaby C á ceres Giró nimo P ére z‚ and membe rs of the Movimie nto Homosexual de Lima (MO HL); in the Philippine s: Profe ssors Agapito C. Tiu and Lourde s Cede ñ o of the Unive rsity of San Jose-Recoletos and Dr. Resil Mojare s and Fathe r Theodore Murnane of the Unive rsity of San Carlos‚ and We enie Ce de ñ o of Manila; in the United State s: score s of women who wish to re main anonymous. Grateful acknowle dgment is made to the Colle ge of Liberal Arts and Scie nce s at Arizona State Unive rsity for research and trave l grants in conne ction with data colle ction in Brazil ‚ Peru ‚ and the Philippine s.

REFERENCES Cass ‚ V . C. ( 1979) . Homose xual identity formation: A theoretical model. J. Hom osex. 4: 219-235. Gagnon ‚ J.‚ and Simon‚ W. (1973) . Sexual Conduct: The Social Sources of Hum an Sexuality‚ Aldine ‚ Chicago. G aia ’s G uide International (13th ed.) (1988) . Gaia ’s Guide ‚ New York. Ge bhard ‚ P. (1972) . Incidence of overt homose xuality in the Unite d State s and Weste rn Europe . In Livingwood ‚ J. ( ed.) ‚ Nation al In stitute of Men tal Health Task Force on Hom osexuality‚ NIMH ‚ Rockville ‚ MD. Gre e nbe rg ‚ D. (1988) . The Constru ction of Hom osexuality‚ Unive rsity of Chicago Pre ss ‚ Chicago. Kitzinger ‚ C.‚ and Wilkerson‚ S. ( 1995) . Transitions from heterosexuality to lesbianism: The discursive production of lesbian identities. Dev. Psychol. 31: 95-104.

56

Wh itam ‚ Daskalos ‚ Sobolewski ‚ an d Padilla

Laumann ‚ E.‚ Gagnon ‚ J.‚ Michael ‚ R.‚ and Michae ls‚ S. (1994) . The Social Organ ization of Sexuality: Sexual Practices in the United States‚ University of Chicago Press ‚ Chicago. Patterson ‚ C. ( 1995) . Sexual orientation and human de velopment: An overview. Dev. Psychol. 31: 3-11. Paz y Liberaci ó n. ( 1989) . V ol. 18 ‚ p. 1. Phillips‚ G.‚ and Over ‚ R. (1995) . Difference s betwe en hete rose xual ‚ bisexual and lesbian wome n in re calle d childhood experience s. Arch. Sex. Behav. 24: 1-20. Spartacus International G ay G uide ( 18th e d.). (1989) . Bruno Gm ü nder V erlag ‚ Berlin. Trumbach ‚ R. ( 1994) . London’s Sapphists: From three se xes to four ge nders in the making of mode rn culture. In Herdt ‚ G. (e d.) ‚ Third Sex‚ Third G ender ‚ Z one Books ‚ Ne w York. Troide n‚ R. (1988). G ay and Lesbian Identity: A Sociological Analysis‚ Ge neral Hall ‚ Dix Hills‚ NY. Weeks ‚ J. ( 1977) . Com ing Out‚ Publisher‚ London. Whitam ‚ F. (1988) . Se xuality and the Brazilian AIDS epide mic. Unpublished paper prese nted at the Socie ty for the Scientific Study of Sex‚ We stern Association annual mee ting‚ Dallas ‚ TX. Whitam F.‚ and Mathy R. (1986). Male Hom osexuality in Four Societies: Brazil‚ G uatem ala ‚ the Philippines and the United States‚ Praeger ‚ New York. Whitam ‚ F.‚ and Mathy‚ R. (1991). Childhood cross-gende r be havior of homosexual females in Brazil ‚ Peru ‚ the Philippines‚ and the Unite d States. Arch. Sex. Behav. 20: 151-170.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

Eth nic Differences in Sexu al Decision s an d Sexual Beh avior David Quad agn o ‚ Ph .D.‚1 ‚2 David F. Sly‚ Ph .D.‚1 Dian ne F. Harrison ‚ Ph.D.‚1 Isaac W. Eberstein ‚ Ph .D.‚1 an d Hosan na R. Soler ‚ M.A.1

Previou s investigators have reported ethn ic differen ces in the expression of sexual decision m akin g an d sexual beh aviors in wom en. In a sam ple of wom en of low socioeco nom ic statu s between ages 18 an d 45 ‚ we exam in ed the influ ence of ethnicity and other variables (age ‚ edu cation ‚ m arital statu s‚ an d com fort in discussing sex) on (i) who m akes decision s on the tim ing an d type of sex‚ (ii) wheth er a wom an engages in vagin al‚ oral ‚ an d an al sex‚ (iii) the frequencies of each type of sex‚ and (iv) whether or not a wom an has m ultiple partn ers. Multivariate an alyses showed that‚ in depen den t of other independ ent variables ‚ ethn icity had little direct effect on m ost variables. The notable exception was that ethn icity in fluenced join t decision m aking regarding the tim in g and type of sexual activities for Hispanic but not for African Am erican wom en . We con clu de that eth n icity con tribu tes to differen ces in sexu al behaviors bu t that other variables are equ ally im portant. KEY WORDS: African American; Hispanic; White; sexual behavior.

INTRODUCTION The nee d for a be tter unde rstanding of the se xual practice s of women ge ne rally‚ and of minority women in particular ‚ and the dynamics unde rlying the m has increased as the incide nce of HIV infe ction from he te rose xual transm ission has rise n. Curre nt data indicate that rates of HIV infe ction and AIDS are rising faster among women than among men and Re search supported by National Institutes of Health Grant HD31025. 1 Center for the Study of Population‚ Florida State University‚ Tallahasse e ‚ Florida 32306. 2 To whom correspondence should be addressed at De partment of Biological Science ‚ Florida State University‚ Tallahasse e ‚ Florida 32306-1100. 57 0004-0002/98/0200-0057$15.00/0

Ó

1998 Plenum Publishing Corporation

58

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

that a disproportionate amount of the incre ase among women is concentrate d among African Americans and Hispanics (Ce nte rs for Disease Control‚ 1995). Public health ‚ e ducation ‚ and risk-inte rvention e xpe rts have gene rally agre ed that women nee d to assume a gre ater responsibility for their sexual behavior but that their doing so de pe nds upon increasing their communication skills in discussing sexual issues with their partne rs and that power differe ntials and gende r issue s are involve d (O smond et al.‚ 1993) . Ethnicity has bee n reporte d to affect type s of se xual acts practice d ‚ the freque ncy of sex‚ and numbe rs and type s of se xual partne rs. African American wome n are less like ly than White or Hispanic women to e ngage in sexual acts othe r than vaginal intercourse (Staple s‚ 1973; Be lcastro ‚ 1985; Wilson ‚ 1986; Weinbe rg and Williams ‚ 1988; Laumann et al.‚ 1994; Smith ‚ 1994) . White women are approximate ly 30% more like ly to re ceive and give oral se x than are African Americans ‚ and Hispanics fall midway between (Laumann et al.‚ 1994) . Ethnic groups are not believe d to differ in the incide nce of vaginal intercourse ‚ but the incide nce of anal se x is highe r among he te rose xual Hispanic wome n (Laumann et al.‚ 1994; V an O ss Marin and Gome z‚ 1994) . Hispanic wome n have the fewest partne rs‚ and African American women reporte d the most (Diaz et al.‚ 1993; Dolcini et al. ‚ 1993) . Rese arch on e thnic diffe re nce s in power be tween partne rs sugge sts that communicatio n patte rns also diffe r. Hispanic culture reinforce s ge nde r role s and promote s male dominance in a relationship. The value of m achism o contribute s to a strong gende r dichotomy (V an O ss Marin and Gome z‚ 1994) ‚ so women ’s choice s and abilitie s to promote discussions and change s in a re lationship are thought to be limite d (Worth ‚ 1990) . Se x is conside red a private issue in Hispanic culture ‚ and sexual topics are not usually discusse d (Q uee n et al. ‚ 1985; Burgos and Diaz Perez‚ 1986; Gue rre ro Pavich ‚ 1986; Forre st et al.‚ 1993; V an O ss Marin and Gome z‚ 1994) . Hispanic wome n are not suppose d to be educate d in the “ ways of the se xual world. ” Rather they are e xpe cted to learn about sex from their husbands. Hispanic men may fe e l a woman is sexually pe rmissive if she raise s the subje ct of sex (Forrest et al.‚ 1993) . Be cause women are not supposed to know about sex‚ it is inappropriate for the m to bring up subje cts like sexual be haviors or condom use (V an O ss Marin and Gomez ‚ 1994) . Some have argue d that the lack of ope n communication leads unmarried Hispanic women to worry that the y will be labe le d sexually aggre ssive or “ fast ” if they attempt to initiate se xual e ncounte rs (Guerrero Pavich ‚ 1986; Van O ss Marin and Gomez‚ 1994) ‚ and this patte rn is thought to continue in marriage (Q ue en et al.‚ 1985) .

Eth nic Differen ces in Sexual Beh avior

59

Gende r re lationships among African Americans are organize d more by social than by economic factors (Staple s‚ 1973) . Among White ‚ and to some de gree Hispanic ‚ familie s‚ gende r relationships are organize d as a patriarchy in which women are financially de pende nt upon men. Some have argue d that among African Ame rican couple s ‚ me n and wome n have greate r e conomic e quality and that e conomic e quality leads to gre ater candor and more dire ct communication about se xual matte rs (Weinbe rg and Williams ‚ 1988) . O n the othe r hand ‚ numerous factors othe r than e thnicity‚ including marital status ‚ age ‚ and e ducation ‚ have bee n shown to influe nce sexual activitie s. Marrie d wome n have fe wer se xual partne rs‚ followe d by nevermarrie d‚ noncohabiting women ‚ and cohabiting unmarrie d women ‚ who report gre ater numbe rs (Laumann et al.‚ 1994) . Younge r individuals tend to have more partne rs‚ be more expe rimental in the type s of sexual be haviors the y practice ‚ and have highe r fre quencies for all se xual be haviors (Kinsey et al.‚ 1948 ‚ 1953; Hunt ‚ 1974; V an Oss Marin et al.‚ 1993a; Laumann et al. ‚ 1994). Unmarrie d individuals tend to be younge r than their married counte rparts ‚ and this difference may help e xplain the highe r numbe rs of partne rs for younge r individuals. When asked about their last se xual encounte rs‚ younge r women re port a highe r rate of active and receptive oral sex but not of anal sex (Laumann et al.‚ 1994) . Education is a less consiste nt predictor of sexual behaviors. Early studie s showe d that highe r e ducation was associate d with more varie d sexual acts (Kinsey et al.‚ 1948 ‚ 1953) ‚ but this patte rn was not found in late r studie s (Hunt ‚ 1974; Laumann et al.‚ 1994) . Laumann et al. found no relationship betwee n e ducation and numbe r of se xual partne rs‚ freque ncy of sex‚ or type of sex. In addition to the demographic variable s of age ‚ e ducation ‚ and marital status ‚ acculturation is freque ntly cited as a factor influe ncing the sexual behavior of non-native -born women. Highly acculturate d wome n are more like ly to re port multiple partne rs than are less acculturate d wome n (V an O ss Marin et al. ‚ 1993b) . In the present study‚ Hispanic wome n were include d ‚ so the role playe d by diffe re nce s in acculturation was also examined. Although age ‚ education ‚ and marital status all affect se xual activitie s‚ sex is a negotiate d act that involve s verbal and nonve rbal communicatio n. Typically ‚ a fairly pre dictable script involve s an initiator of the act and a partne r who can accept or re ject the invitation (Spre cher and McKinne y‚ 1993) ‚ so comfort in discussing sex might have an important influe nce on sexual activitie s. O ne aspe ct of being comfortable in communicatin g with one ’s sexual partne r is ability to initiate se x. Men are usually the initiators ‚ although younge r‚ marrie d‚ and cohabiting wome n are more like ly to initi-

60

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

ate se x than are olde r wome n (Bye rs and Heinle in ‚ 1989) . One interpretation of this finding is that the forme r are more comfortable in communicating the ir sexual de sires. Comfort in discussing intimate subje cts‚ in turn ‚ depends upon the general re lationship and inte raction patte rns betwee n men and women. When partne rs lack e qual “ bargaining powe r‚” communicatio n is not equal. In situations where wome n are economically de pende nt upon their partne rs or cultural traditions dictate male dominance ‚ wome n may not have e qual input into de cision making of any kind ‚ including sexual de cision making ‚ and may not fe e l comfortable in se xual communicatio n (Worth ‚ 1990; Osmond et al.‚ 1993) . Joint or mutual de cisions regarding se x would not be expe cted in situations where wome n lack power relative to their se xual partners. We inve stigate d the e xtent to which diffe re nce s in sexual be haviors pre viously attribute d to ethnicity are actually e xplaine d by othe r factors. We teste d the hypothe sis that observed difference s in who make s decisions about se xual matters‚ the type s and freque ncie s of se x behaviors ‚ and number of se xual partne rs can be explaine d by age ‚ e ducation ‚ marital status ‚ and comfort in discussing se x as well as by the interactions of ethnicity with each of the se inde pe nde nt variable s.

METHOD Particip an ts Women were re cruite d from 21 diffe re nt community service /resource site s in the Miami ‚ Florida ‚ are a of the Unite d State s. The site s include d food-stamp offices‚ public health units ‚ sexually transmitte d disease clinics ‚ family-planning clinics ‚ and drug tre atment cente rs. At the time of re cruitme nt ‚ e ach woman was ap proac he d by a traine d fe male inte rvie we r matched on the basis of race and e thnic origin. The prospe ctive participant was told that a study was being carried out on “ wome n ’s general he alth issue s.” If she agre ed to participate ‚ she was assure d the information she provide d would re main confide ntial and that it was le gally prote cted unde r a Certificate of Confide ntiality grante d unde r se ction 301( d) of the Public Health Service Act. Informed consent was se cure d from all participants ‚ and the financial ince ntive s to be provide d were explaine d. E ach participant was told she could stop participating at any time. The sample analyze d in the pre se nt pape r was part of that for a large proje ct de signe d to de ve lop and evaluate a culturally sensitive HIV/AIDS risk-reduction intervention for women. Sixty-five pe rcent of all women ap-

Eth nic Differen ces in Sexual Beh avior

61

proache d who met our inclusion criteria agre ed to participate (68.6% of African Americans ‚ 65.4% of Hispanics ‚ and 61.2% of White s). To be e ligible ‚ a wome n had to be at risk for HIV/AIDS because of risky sexual behaviors or drug-use practice s‚ be tween the age s of 18 and 45‚ and not pre gnant. The total numbe r of wome n include d in the large r proje ct was 547. We exclude d 109 of the se women be cause the y were risky drug users and/or had not had any type of se x within 30 days of the pre te st inte rvie w. The 438 wome n include d in our analysis (146 non-Hispanic White ‚ 106 African American ‚ and 186 Hispanic) there fore re pre se nt a sample of currently se xually active women of low socioe conomic status (SES) whose se xual behaviors put them at risk for HIV infe ction. The sample may not be representative of othe r wome n of the same ethnicity and SES who do not use the se community se rvice resource sites or who did not meet our inclusion crite ria. Proced ures Two que stions e stablishe d ge ne rational history and e thnic origin: “ Whe re did you grow up? Was it in Miami ‚ some place e lse in the U.S.‚ or in anothe r country? ” (Marin and Van O ss Marin ‚ 1991) ‚ and “ Do you consider yourse lf Black or African American? Hispanic or Latina? White ‚ nonHispanic? O r O the r? ” The wide ly use d acculturation scale of Marin and V an O ss Marin was use d to de te rmine the acculturation le ve l of each of our participants. The te rm “ Hispanic ” is most ofte n applie d to individuals who reside in the U.S. and who were born or trace their backgrounds to one of the Spanish-spe aking nations. Thus the language use d in e veryday spee ch and that use d in thought refle cts the acculturation le vel of Hispanics. Each was aske d: (i) “ In general‚ what language do you read and spe ak? ” ; (ii) “ What language do you usually spe ak at home ? ” ; (iii) “ In which language do you usually think? ” ; and (iv) “ What language do you use with frie nds? ” The re sponde nt was give n five choice s for e ach que stion ‚ “ only Spanish ‚” “ Spanish be tter than English ‚” “ both equally‚” “ English be tter than Spanish ‚” and “ only English. ” Each woman was aske d about the timing ‚ type s‚ and freque ncie s of sexual acts she had engage d in during the past 30 days and whethe r she ‚ her partne r‚ or both toge ther made the decisions when to have sex and what type . The y were also aske d how many se xual partne rs the y had had in the past 6 months and whe the r the y “ fe lt comfortable ” discussing sexual issue s with their main se xual partne rs.

62

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

Statis tical An alys es We carried out bivariate analyse s using cross-tabular comparisons ‚ followed by logistic regre ssions. Logistic re gression was used to control for the e ffects of marital status ‚ e ducation ‚ age ‚ and comfort leve l in discussing sex with main partne r on two de pende nt variable s: (i) who makes decisions about the timing and type of sex and (ii) pe rcentage of women reporting oral and anal se x and multiple partne rs. Inte ractions of e thnicity with each of the othe r inde pe nde nt variable s (age ‚ education ‚ marital status ‚ and comfort in discussing se x) were examine d separate ly. In addition ‚ logistic regressions were performed within e thnic groups to clarify interactions. The descriptive data in Table I are base d on all cases (N = 438). Missing data due to nonre sponse or response s of not applicable are exclude d as appropri ate . Cate gorical variable s are dummy code d. Ethnicity was code d with two dummy variable s; White se rve d as the reference group. Marital status was arrange d to categorize the groups by availability of partner‚ as it has be en shown that unmarrie d men and wome n have the lowe st fre quencies of se x because of lack of a ste ady partne r (Hunt ‚ 1974; Laumann et al.‚ 1994).

RESULTS Table I pre sents the basic descriptive characte ristics of the sample . The ethnic groups did not differ in age ‚ but White s were more e ducate d than African Americans or Hispanics. African American women were least like ly to be married and most like ly not to be living with a main se x partne r. Hispanic wome n were he te roge ne ous in national origin; 32.2% were from Ce ntral America ‚ 28.4% from South America ‚ 22.6% from Cuba ‚ 10.5% from Puerto Rico ‚ and 3.2% from Mexico. Nearly 90% were born in the country of the ir e thnic origin. O n the acculturation scale of Marin and V an O ss Marin ( 1991) ‚ 74.5% fe ll in the “ low acculturation ” cate gory‚ so although the group was he te roge ne ous in national origin ‚ the y were re lative ly homoge ne ous in acculturation. All Hispanic wome n ele cted to participate in the study in Spanish. Patterns of Decision Makin g Table II shows data on who made de cisions about the timing and type of sexual activitie s in the past 30 days by e thnicity‚ age ‚ e ducation ‚ marital status ‚ and comfort in talking about se x. Among all wome n and for all

b

Values for mean age and mean ye ars of schooling are x ± SD. p < 0.05. c p < 0.01.

a

Marital status c % Married‚ living with main partner % Unmarried‚ living with main partner % Married‚ not living with main partner % Unmarried‚ not living with main partne r % Unmarried‚ no main partner 15.1 24.5 1.9 45.3 13.2

11.50 ± 1.92

12.10 ± 2.52

Mean ye ars of schooling completedb

38.9 23.0 1.0 29.3 9.1

27.86 ± 7.35

29.40 ± 2.52

Mean age in years

Measure

Black (n = 106)

All (n = 438)

a

50.5 18.4 1.1 21.6 8.4

11.71 ± 2.91

29.78 ± 8.10

Hispanic (n = 186)

Race/e thnicity

Table I. Sample Characte ristics and Marital Status with Main Sexual Partner

40.4 27.4 2.7 21.2 8.2

12.78 ± 2.22

30.03 ± 7.33

White (n = 146)

a

p < 0.05 with cross-tabular comparisons.

Sample Ethnicitya African American Hispanic White Age < 25 years 25¯ 34 years > 35 years Education < High school High school grad > High school Marital statusa Marrie d‚ living with main partner Unmarried‚ living with main partner Marrie d‚ not living with main partner Unmarried‚ not living with main partner Unmarried‚ no main partner Comfort in talking about sexa Extremely comfortable Some what comfortable Uncomfortable

15.0 19.0 10.0 18.8 13.4 14.4 17.6 14.7 14.5 15.7 15.2 13.9 25.0 15.1 15.0 12.0 19.8 28.1

31.4 5.8 13.2 9.7 16.6 16.0 17.1 8.4 16.9 5.3 12.9 25.0 21.0 35.0 12.4 11.9 21.9

Man

14.4

Woman

71.9 64.4 46.9

76.6 69.3 37.5 59.7 45.0

64.3 74.0 62.9

74.6 65.2 60.5

46.7 80.0 63.9

66.7

Both

Timing

3.6 4.0 3.1

2.9 4.0 12.5 4.2 5.0

3.9 3.1 4.5

2.2 3.9 5.9

2.9 4.2 4.2

3.9

No decision

13.6 11.9 18.8

10.5 10.9 25.0 17.6 35.0

17.1 9.8 17.5

9.0 17.7 18.3

28.6 7.9 14.6

15.0

Woman

8.4 18.8 21.9

11.1 10.9 12.5 13.4 15.0

10.1 15.2 11.3

12.0 12.7 10.0

15.2 8.4 14.6

12.1

Man

Type

71.4 63.4 50.0

72.5 71.3 50.0 63.0 40.0

67.4 67.4 64.4

73.7 64.6 61.7

48.6 76.3 66.0

66.3

Both

6.6 5.9 9.4

5.8 6.9 12.5 5.9 10.0

5.4 7.6 6.8

65.3 5.0 10.0

7.6 7.4 4.9

6.6

No decision

Table II. Pe rcentages of Women (N = 438) Reporting De cisions by the Woman‚ the Man‚ Both‚ and Neithe r on the Timing and Type of Se xual Activitie s with Main Se x Partne r

Eth nic Differen ces in Sexual Beh avior

65

cate gorie s of the inde pende nt variable s conside red ‚ the majority reporte d that decisions were made prior to sex; that is‚ when questione d about who makes the decision that sex will occur and what type it will be ‚ ve ry fe w responde d “ no de cision had be en made.” White women conforme d to the ove rall patte rn of joint decision making ‚ but African American wome n reporte d fe wer mutual de cisions and the highe st percentage of female de cision m aki ng ( Table II) . H ispan ic wom e n re porte d a m uc h high e r percentage of mutual decision making than e ithe r White or African American wome n for both measure s. Neithe r age nor e ducation influe nce d who made de cisions on the timing or type of se xual activitie s. Marital status was associate d with joint decision making. Marrie d and cohabiting women re porte d the highe st le ve ls of joint de cision making ‚ whe re as unmarrie d wome n not living with a main partne r‚ unmarrie d wome n without main partne rs‚ and marrie d women not living with their spouse s had the lowe st pe rcentage of mutual decision making and the highe st leve ls of fe male de cision making (Table II). Comfort in discussing se x was also associate d with decision making. Wome n who were more comfortable were more like ly to be involve d in mutual de cisions ‚ and those who were uncomfortable were more like ly to report e ithe r inde pende nt decisions or decisions by the man (Table II). Table III shows logistic re gression analyse s of who makes decisions about timing and type of se x. A significant e thnic diffe re nce was found; Hispanic wome n reporte d more joint decisions than White wome n ‚ but African American and White wome n did not differ. Marital status ‚ age ‚ and comfort had signific ant inde pe nde nt e ffe cts on joint de cision making. Wome n with steady available partne rs (marrie d and cohabiting) made more joint decisions. Age was inve rse ly relate d (i.e.‚ younge r women reporte d more joint de cisions than olde r women) and comfort was positive ly relate d. The re was a significant inte raction be tween ethnicity and age ; olde r White wome n re porte d significantly less joint de cision making about the timing of se x‚ and olde r African American wome n fe wer joint decision about the type of sex. Education inte racted with ethnicity on decision making about both the timing and type of sex; le ss-e ducate d Hispanic women reporte d less joint de cision making about both of the se se xual behaviors. More education was associate d with more joint de cision making about the type s of se xual behaviors practice d by White s but not those practice d by African Americans. Ethnicity showe d a significant inte raction with marital status among White s only; White women with ste ady sexual partne rs were more like ly to make joint decisions on the timing of sex. Comfort in discussing se x showed a significant inte raction with e thnicity; Hispanic wome n who were more comfortable made more joint de cisions on the type of sex‚ and White

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

66

Table III. Logistic Regression Coefficients (B) and p V alue s for Effects of Living Arrangemen ts‚ Education ‚ Age ‚ Comfort in Discussing Sex‚ Ethnicity‚ and Their Interactions on Timing and Type of Sexa Timing decisions Variable

p

Marital status Education Age Comfort Ethnicity African American Hispanic Ethnicity ´ Age Afr. Am. ´ Age Hispanic ´ Age Ethnicity ´ Education Afr. Am. ´ Education Hispanic ´ Education Ethnicity ´ Marital status Afr. Am. ´ Mar. status Hispanic ´ Mar. status Ethnicity ´ Comfort Afr. Am. ´ Comfort Hispanic ´ Comfort Constant

b

0.016 0.663 0.007 b 0.000 b 0.019 b 0.795 0.008 b 0.865 0.607 0.707 0.018 b 0.804 0.001 b 0.846 0.139 0.219 0.288 0.418 0.186

Type decisions

Exp( B)

p

Exp( B)

1.278 0.929 0.617 2.326

0.166 0.975 0.031 b 0.000 b 0.001 b 0.209 0.000 b 0.313 0.632 0.302 0.001 b 0.421 0.000 b

1.154 0.995 0.678 2.192

1.656 89.392 1.245 1.177 1.097 0.247 0.954 0.694 0.563 1.491

12.736 794.009

0.576 0.466 0.075 0.111 0.028 b 0.272

0.805 1.554 0.734 0.233 1.153 0.836 0.402 0.328

a

B = unstandardized re gression coefficient; Exp( B) = exponential of B. Significant at p < 0.01.

b

wome n who were more comfortable made more joint de cisions on both the timing and type of se x. Patterns of Sexu al Beh avior Table s IV and V show the numbe r and pe rcentage of responde nts who reporte d engaging in vaginal ‚ oral ‚ and anal intercourse in the 30 days preceding the inte rvie ws‚ the freque ncie s of these acts during the same period ‚ and the pe rcentage of wome n with more than one partne r in the past 6 months. For all women ‚ vaginal intercourse was the most common act ‚ followed by oral se x. Anal se x was re lative ly rare but more fre que nt than ge ne rally assume d (Billy et al.‚ 1993) ; 10.9% of the wome n re porte d this behavior in the past 30 days. Approximate ly 17% re porte d multiple partners in the past 6 months. Bivariate analyse s showe d that e thnicity had a significant e ffect on the reporting of sex acts as well as the freque ncie s (Table s IV and V ). Hispanic and White wome n re porte d engaging in oral se x at twice the rate of African

Eth nic Differen ces in Sexual Beh avior

67

Table IV. Percentage s of Women (N = 438) Who Reported Engaging in Vaginal ‚ Oral ‚ and Anal Se x Within the Pre ce ding Thirty Days and Having Multiple Partne rs W ithin the Prece ding Six Months

Sample Ethnicity African American Hispanic White Age < 25 years 25 ¯34 years > 35 years Education < High school High school grad > High school Marital status Married ‚ living with main partner Unmarried ‚ living with main partne r Married ‚ not living with main partne r Unmarried ‚ not living with main partner Unmarried ‚ no main partne r a Comfort in talking about sex Extremely comfortable Somewhat comfortable Uncomfortable

V aginal

Oral

Anal

Multiple partne rs

91.4

49.5

10.0

17.4

82.1 a 93.7 95.2

26.4 a 56.3 57.5

6.5 a 16.9 6.1

30.2 a 13.2 13.8

91.9 91.2 91.7

52.2 49.2 46.7

14.5 11.7 6.3

19.1 19.9 11.7

93.1 91.0 90.4

40.8 a 48.9 56.2

13.2 12.6 8.1

16.2 18.0 18.0

98.2 a 99.0 100.0 91.7 42.9

55.0 a 51.5 25.0 52.5 19.0

12.0 7.2 0.0 13.4 11.1

2.3a 8.9 0.0 32.5 59.5

98.2 99.0 93.7

57.7 a 43.1 50.0

11.9 8.1 10.0

15.7 10.8 6.2

a

p < 0.05 with cross-tabular comparisons.

American wome n. Hispanic women participate d in anal se x at nearly three times the rate of African American and White wome n (Table IV). Age was not associate d with the reporting of vaginal ‚ oral ‚ and anal sex or multiple partne rs or associate d with increased frequencie s of any sexual acts. Education did not influe nce the percentage of women re porting vaginal or anal sex or multiple partne rs‚ but more educate d wome n were more like ly to report oral sex (Table IV). No clear interaction of frequency of se x with education was evide nt‚ but highe r frequencies of vaginal and oral sex were re ported by women who had comple te d high school (Table V ). Marital status influe nced the type of se xual acts practice d and their fre quencies. Unmarrie d wome n without a main partne r we re the least like ly to engage in vaginal and oral sex‚ but the y reporte d anal sex as freque ntly as the othe r groups (Table IV ). The highe st fre quencies of vaginal and oral sex were found among marrie d and cohabiting wome n and the lowe st among unmarrie d wome n without a main sexual partne r (Table V ). Be ing comfortable in discussing se x was associate d with reporting of oral se x (Table IV ). The highe st freque ncie s of vaginal and oral se x were

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68

Table V. Percentage s of Wome n Reporting V arious Freque ncie s of V aginal ‚ Oral ‚ and Anal Se x Within the Preceding Thirty Days No. of acts 0

1 ¯3

4¯ 8 9 ¯14 > 15

No. reporting at least 1 act

V aginal sex Sample a Ethnicity African American Hispanic White Age (years) < 25 25 ¯34 > 35 a Education < High school High school grad > High school a Marital status Married ‚ living with main partner Unmarried ‚ living with main partne r Married ‚ not living with main partne r Unmarried ‚ not living with main partner Unmarried ‚ no main partne r a Comfort in talking about sex Extremely comfortable Somewhat comfortable Uncomfortable

23.7 30.6 19.8 25.7

404

3.3 0.0 1.4

25.2 33.3 20.6 20.6 15.2 32.0 23.6 29.2 33.8 27.3 14.3 24.4

87 178 139

0.8 1.2 1.8

18.4 31.2 23.2 27.2 26.0 31.5 16.3 21.8 26.3 30.0 21.8 21.8

125 165 110

0.0 0.8 2.4

19.0 40.5 23.1 17.4 26.4 23.1 19.0 31.4 25.4 29.1 18.0 27.3

121 121 161

1.2 0.0 2.7 0.0 0.0

16.6 23.0 28.1 50.0 55.6

23.8 30.0 28.1 25.0 5.6

168 100 110 8 18

1.5 0.0 3.2

21.1 26.0 21.5 31.2 22.8 43.6 17.8 15.8 50.0 30.0 10.0 10.0

269 191 30

34.5 28.0 28.1 12.5 33.3

25.0 19.0 15.4 12.5 5.6

Oral sex 0 Sample a Ethnicity African American Hispanic White Age (years) < 25 25 ¯34 > 35 a Education < High school High school grad > High school a Marital status Married ‚ living with main partner Unmarried ‚ living with main partne r Married ‚ not living with main partne r Unmarried ‚ not living with main partner Unmarried ‚ no main partne r

1

2¯ 4

>5

68.9 7.1 42.9 39.9 13.1 39.3 38.7 23.8 40.5

50.0 47.6 35.7

28 107 84

42.7 15.5 36.6 46.1 16.9 37.0 50.0 17.9 50.0

47.9 46.1 32.1

71 89 56

56.6 13.2 41.5 45.8 15.4 33.8 38.3 19.0 44.0

45.3 58.9 37.0

53 65 100

43.6 37.2 32.6 53.8 39.6 44.4 0.0 100.0 62.0 25.0

94 52 63 2 8

44.0 47.5 43.8 75.0 55.6

19.1 13.4 15.8 0.0 12.5

Eth nic Differen ces in Sexual Beh avior

69

Table V. Continued No. of acts 0 Comfort in talking about sex Extremely comfortable Somewhat comfortable Uncomfortable

1

2¯ 4

No. reporting at least 1 act

>5

a

41.9 12.0 38.0 50.0 55.1 18.2 56.8 25.0 48.4 50.0 18.8 31.2

158 44 16

Anal sex

Sample a Ethnicity African American Hispanic White Age (years) < 25 25 ¯34 > 35 a Education < High school High school grad > High school a Marital status Married ‚ living with main partner Unmarried ‚ living with main partne r Married ‚ not living with main partne r Unmarried ‚ not living with main partner Unmarried ‚ no main partne r a Comfort in talking about sex Extremely comfortable Somewhat comfortable Uncomfortable

0

1¯ 2

>5

94.6 83.1 93.9

80.0 56.6 75.0

20.0 43.3 25.0

5 30 8

85.5 88.3 94.5

66.6 57.8 66.6

33.3 42.1 33.3

18 19 6

86.8 87.4 92.5

75.0 60.0 50.0

25.0 40.0 50.0

16 15 12

88.6 92.8 86.6 100.0 88.9

63.1 57.1 60.0 0.0 100.0

36.8 42.8 40.0 0.0 0.0

19 7 15 0 2

88.1 92.9 90.0

56.2 71.4 100.0

43.8 28.6 0.0

32 7 3

a

p < 0.05 with cross-tabular comparisons.

found among wome n who were most comfortable talking about se x with a partne r (Table V). Table V I shows the results of logistic regre ssion analyse s of the reporting of oral and anal sex and multiple partne rs. V aginal sex was not include d in these analyse s because it was re porte d by almost all wome n. Ethnicity showed no inde pe nde nt effe ct on any of the measure s‚ but highe r education was associate d with gre ater re porting of oral sex. Marital status influe nced the re porting of multiple se x partne rs; unmarrie d individuals reporte d gre ater numbe rs. Age and ethnicity inte racted significantly; olde r African American and Hispanic wome n were least like ly to report engaging in oral sex. The e ffects

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Table VI. Logistic Regression Coefficients (B) and p V alue s for Effects of Marital Status‚ Education ‚ Age ‚ Comfort in Discussing Sex‚ Ethnicity‚ and Their Interactions on Report of Oral ‚ Anal ‚ and Multiple-Partner Sex Oral sex Variable Living arrange ments Education Age Comfort Ethnicity African American Hispanic Ethnicity ´ Age Afr. Am. ´ Age Hispanic ´ Age Ethnicity ´ Education Afr. Am. ´ Education Hispanic ´ Education Ethnicity ´ Living Arrange Afr. Am. ´ Liv Arrange Hispanic ´ Liv Arrange Ethnicity ´ Comfort Afr. Am. ´ Comfort Hispanic ´ Comfort Constant

p 0.888 0.047 a 0.114 0.190 0.295 0.459 0.118 0.008 a 0.007 a 0.010 a 0.035 a 0.040 a 0.017 a 0.393 0.252 0.851 0.319 0.831 0.153 0.234

Exp(B) 1.013 1.324 0.772 1.310 4.354 9.472 0.303 0.417 0.465 0.475 1.320 0.964 1.129 1.783

Multiple partne rs

Anal se x p 0.181 0.660 0.296 0.878 0.780 0.484 0.643 0.883 0.908 0.747 0.067 0.567 0.041 a 0.488 0.357 0.800 0.160 0.913 0.127 0.225

Exp(B) 0.783 1.129 0.742 1.055 12.592 3.384 1.098 0.821 0.639 0.268 0.617 1.086 0.899 3.069

Exp( B)

p a

0.000 0.875 0.080 0.312 0.576 0.307 0.751 0.427 0.274 0.230 0.826 0.584 0.945 0.886 0.639 0.928 0.808 0.689 0.820 0.305

0.367 1.063 2.051 1.722 13.730 2.188 0.551 0.515 0.762 0.963 1.180 1.032 0.742 1.183

a

Significant at p < 0.05.

of e ducation and e thnicity on re porting of oral and anal se x also inte racted significantly. More -educate d White women were more like ly to re port engaging in oral se x‚ and less-e ducate d Hispanic women were most like ly to report e ngaging in anal sex. A significant inte raction of marital status with e thnicity was evide nt in the reporting of multiple partne rs. Wome n who were marrie d or cohabiting were le ast like ly to re port multiple partne rs. Comfort in discussing se x showed a significant interaction with e thnicity in that Hispanic wome n who were most comfortable were the most like ly to e ngage in both oral and anal se x. Table VII shows the re sults of logistic re gression analyse s on the reporte d fre quencies of vaginal ‚ oral ‚ and anal sex. No inde pende nt effe ct of ethnicity was found on any measure ‚ but an inde pe nde nt effe ct of comfort in discussing se x was found on the reporting of vaginal se x. Wome n who were more comfortable were more like ly to re port highe r fre quencies. In te rms of inte ractions ‚ olde r African American women reporte d a lowe r freque ncy of both vaginal and oral sex. More -e ducate d African American wome n reporte d a lowe r incide nce of oral sex.

Eth nic Differen ces in Sexual Beh avior

71

Table VII. Logistic Regression Coefficients (B) and p V alue s for Effects of Marital Status‚ Education ‚ Age ‚ Comfort in Discussing Sex‚ Ethnicity‚ and Their Interactions on the Reported Frequencie s of Vaginal ‚ Oral ‚ and Anal Sex V aginal se x

Oral se x

Anal sex

Variable

p

Exp(B)

p

Exp(B)

p

Exp( B)

Marital status Education Age Comfort Ethnicity African American Hispanic Ethnicity ´ Age Afr. Am. ´ Age Hispanic ´ Age Ethnicity ´ Education Afr. Am. ´ Education Hispanic ´ Education Ethnicity ´ Mar. Status Afr. Am. ´ Mar. Status Hispanic ´ Mar. Status Ethnicity ´ Comfort Afr. Am. ´ Comfort Hispanic ´ Comfort Constant

0.962 0.863 0.818 0.045 a

¯ 0.015 0.020 0.180

0.003

0.783 0.193 0.772 0.553

0.023 0.116 0.026 0.054

0.932 0.915 0.886 0.937

0.007 0.009 ¯ 0.013 0.007

0.782 0.895

0.097 0.041

0.487 0.573

0.248 0.181

0.940 0.710

0.027 0.120

0.056 a 0.213

¯ 0.294 ¯ 0.212

0.048 a 0.234

¯ 0.308 ¯ 0.205

0.971 0.224

¯ 0.005 ¯ 0.212

0.734 0.724

0.051 0.055

0.062 0.524

¯0.288 ¯0.100

0.992 0.618

0.061 0.455

0.274 0.138

0.192 0.326

¯ 0.096 0.164

0.745 0.129

0.731 0.483 0.746

0.001

¯ 0.079

0.193

0.782 0.906

¯ 0.041 ¯ 0.022

0.092 0.360 0.756

0.953 0.135 1.040

0.016 0.357 0.982

¯0.184

a

Significant at p < 0.05.

DISCUSSION We conclude that many observed ethnic diffe re nce s in wome n ’s sexual practice s are at least partially e xplaine d by othe r factors. Decision s on Tim in g an d Typ e of Sexu al Activity It is clear that the women in this study did make decisions regarding the timing and type of sex or at least be lie ve that they did so. Sexual practices are normally ne gotiate d by the partne rs‚ and if a woman influe nces the decision proce ss‚ she can pote ntially avoid risky be haviors and sugge st prote ctive one s such as condom use. Participation in de cision making did differ with ethnicity. Hispanic women re porte d the highe st levels of joint decision making on both the timing and type of se x‚ and African American wome n re porte d the lowe st leve ls of joint decision making and the highe st le ve ls of fe male decision making (Table II). Logistic regre ssion indicate s that ethnicity had a significant inde pe nde nt effe ct on joint decision making;

72

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

Hispanic women were more like ly to make joint de cisions on both the timing and type of se x. No inde pende nt effe ct of e thnicity is se en for African Americans on decision making (Table III). O n the basis of the literature conce rning Hispanic ge nde r re lationships and the dominant role of the male ‚ it is surprising to find such a high percentage of Hispanic wome n re porting mutual de cision making on sex. Pe rhaps our re sult is due to the high pe rcentage of marrie d Hispanic wome n in the study‚ as we found married and cohabiting women reporte d the highe st occurrence of mutual de cision making (Table II). It has be en reporte d ‚ however‚ that e ven in marriage many Hispanic wome n have a subordinate role (Que en et al.‚ 1985). Le ss acculturate d wome n are more traditional in re lationships and maintain more traditional patte rns in gende r-relate d issue s (Marin and V an O ss Marin ‚ 1991) . Almost 75% of our Hispanic sample were classifie d as being in the low-acculturation category. Logistic re gression analyse s indicate d that the low- and high-acculturatio n wome n did not differ significantly on any de cision-makin g measure s‚ so acculturatio n le vels cannot explain the effe ct of being Hispanic on joint decision making. We know of no pre vious attempts to e xamine decision making about se xual m atte rs in lower class culturally dive rse women. Pe rhaps the patte rn of gende r re lationships in Hispanic wome n doe s not extend to de cisions about the timing and type of se x. Alte rnative ly‚ the conce pt of joint de cision making may diffe r with ethnicity; some wome n may inte rpre t “ joint de cision making ” as meaning the y did not obje ct. In addition ‚ joint de cision making may be regarde d as socially de sirable and may the re fore be overre porte d. The finding by bivariate analysis that African American wome n were more like ly to make inde pe nde nt decisions about the timing and type of sex is consiste nt with the literature ‚ as might be expe cted in view of their greate r e conomic influe nce . Marital status may also play a role in the increased amount of inde pe nde nt de cision making among African Americans. African American women were the le ast like ly to be living with a main se x partne r‚ and this living arrange ment produce d more inde pe nde nt decision making and less joint de cision making on the timing and type of sex (Table II) ‚ but when othe r factors were controlle d for ‚ be ing African American did not have a significant inde pende nt e ffect on de cision making (Table III). Logistic regre ssion analyse s re veals significant inde pende nt effe cts of marital status ‚ age ‚ and comfort on joint de cision making (Table III). Age and joint de cision making were inve rse ly relate d; younge r wome n were more like ly to make joint decisions. Wome n who did not live with a main sex partne r were also less like ly to make joint de cisions. Comfort and joint

Eth nic Differen ces in Sexual Beh avior

73

decision making were positive ly relate d; more comfortable wome n reporte d more joint de cisions. Wome n who are comfortable in discussing se xual matte rs with their partne rs were probably those who had more e qual relationships. Alte rnative ly‚ some reports of comfort may simply have re fle cted wome n ’s comfort with their le ve ls of se xual discussions ‚ even if those discussions were minimal. The effe ct of ethnicity interacte d significantly with those of age ‚ e ducation ‚ marital status‚ and comfort in discussing sex in te rms of decision making about the timing and type of sex. Olde r White and African American wome n were le ss like ly to make joint decisions about the timing and type of sex‚ re spe ctively. Le ss-educate d Hispanic wome n reporte d fe wer joint de cisions on both the timing and type of sex. More education was associate d with more freque nt joint decisions in White s but not in African Americans. Marrie d White wome n or those with ste ady sexual partne rs were more like ly to report joint de cisions about the type of se x practice d. Hispanic women who were comfortable in discussing sex were more like ly to re port joint decisions on both timing and type of se x. Oth er Depen den t Variables Bivariate analyse s confirms e arlie r studie s showing ethnic differences in the pe rcentage of women re porting the occurrence of oral and anal sex‚ multiple partne rs‚ and freque ncie s of sexual acts (Table s IV and V ). African American women reporte d the lowe st occurre nce of oral sex and the highest of multiple partne rs‚ and Hispanic women reporte d the highe st occurre nce of anal se x. Whe n all othe r variable s were controlle d ‚ howe ve r ‚ logistic re gression reve als no significant inde pende nt e ffect of ethnicity on the reporting of oral and anal se x and multiple partne rs (Table VI). The se findings conflict with those of many past studie s re porting diffe re nce s in sexual practice s among ethnic groups (Dolcini et al.‚ 1993; Laumann et al. ‚ 1994) . Perhaps our sample of women of low SES diffe rs from past sample s of Hispanic and African American wome n ‚ or perhaps factors othe r than ethnicity explain the difference . Significant inte ractions be tween e thnicity and age ‚ education ‚ marital status and comfort discussing se x were found on the reporting of oral and anal se x and multiple partne rs. O lde r African American and Hispanic wome n were le ast like ly to report oral sex. These findings for age are in ge ne ral agre e ment with past findings in that younge r women te nd to be more e xpe rime ntal. Why younge r minority wome n reporte d highe r le ve ls of oral se x than did White s is not clear. Pe rhaps the more wide spre ad aware ne ss of a varie ty of se xual acts in the media and HIV/AIDS preven-

74

Quadagno ‚ Sly‚ Har rison ‚ Eberstei n ‚ an d Soler

tion message s has influe nced the sexual behaviors of these wome n. Oral sex may be pe rceive d to be le ss risky than vaginal se x be cause the typical message portrays unprote cted vaginal intercourse as an e xtre mely risky behavior. O ral sex is not discusse d as often in pre ve ntion message s‚ and this difference may account for its pre vale nce in this group of women. In particular ‚ many of the pre vention message s are aime d at minority women. A significant inte raction e xisted betwee n ethnicity and education on the reporting of oral and anal se x. More -e ducate d White wome n we re more like ly to re port oral sex than were comparable African Americans and Hispanics ‚ and less-e ducate d Hispanic women were most like ly to re port anal sex. Education has be en pre viously found to have be en positive ly corre late d with varie ty in se xual acts‚ but our findings are the re ve rse for Hispanics and African American women. Regression analysis indicate that marital status was significantly associate d with the re porting of multiple partne rs (Table V I). Women not living with a sexual partne r were more like ly to have multiple partne rs. Logistic regre ssion reve als an inde pe nde nt effe ct of comfort in discussing sex on the reporting of vaginal sex. Wome n who were more comfortable were more like ly to re port highe r fre que ncie s. Fe w significant inte ractions be tween ethnicity and age ‚ education ‚ marital status ‚ and comfort in discussing sex were found in the se variable s. O lde r African American wome n reporte d a lowe r freque ncy of both vaginal and oral se x. Moreeducate d African American wome n re porte d a lower incide nce of oral sex. In summary‚ the literature contains many reference s to e thnic difference s in various aspe cts of sexual be havior. In many cases these conclusions were base d upon bivariate associations ‚ and many studie s faile d to control for confounding variable s such as e ducation and marital status. O ur analyses clearly indicate that ‚ when a limite d numbe r of factors are controlle d ‚ ethnic difference s diminish to a large degre e. It is important to note othe r factors influe ncing these behaviors ‚ including contrace ptive use and religiosity‚ were not controlle d in our study. To a large extent ‚ bivariate differe nce s be twe e n e thnic groups re fle ct composition al diffe re nce s and/or differences in the input of othe r explanatory variable s. The re is‚ howe ve r‚ some evide nce of residual e thnic diffe re nce s in these variable s after othe r controls are applie d. Theore tical issue s in sociology and minority studie s conce rning the meaning of culture and the way in which inte rgroup difference s in culture or social organization affe ct group characte ristics are rele vant he re . Furthe r work is ne cessary to isolate those aspe cts of group membership that are associate d with difference s of the type observed he re.

Eth nic Differen ces in Sexual Beh avior

75

REFERENCES Be lcastro ‚ P. ( 1985) . Se xual behavior difference s be twee n African Ame rican and White students. J. Sex Res. 21: 55-67. Billy‚ J.‚ Tanfer ‚ K. ‚ Grady‚ W.‚ and Klepinger ‚ D. (1993). The sexual be havior of me n in the United States. Fam . Plann. Perspect. 25: 52-60. Burgos‚ N. M.‚ and Diaz Perez ‚ Y. I. (1986) . An exploration of human se xuality and the Puerto Rican culture. J. Soc. Work Hum . Sex. 4: 135-150. Bye rs ‚ E. S.‚ and He inlein‚ L. (1989) . Predicating initiations and refusals of sexual activities in married and cohabiting heterosexual couple s. J. Sex Res. 26: 210-231. Ce nters for Dise ase Control. (1995) . Update: AIDS among-wom e n-United States ‚ 1994. Morbid. Mortal. Weekly Rep. 44: 81-84. Diaz ‚ T.‚ Buehle r‚ J.‚ Castro‚ K.‚ and Ward ‚ J. ( 1993) . AIDS trends among Hispanics in the United States. Am . J. Public Health 83: 504-509. Dolcini‚ M.‚ Catania‚ J.‚ Coates ‚ T.‚ Stall‚ R.‚ Hudes ‚ E.‚ Gagnon ‚ J. ‚ and Pollack‚ L. (1993) . De mographic characte ristics of heterosexuals with multiple partners: The national AIDS behavioral surveys. Fam . Plann . Perspect. 25: 208-214. Forrest‚ K.‚ Austin‚ D.‚ V aldes ‚ M.‚ Guentes ‚ E.‚ and Wilson‚ S. (1993). Exploring norms and beliefs related to AIDS pre vention among California Hispanic men. Fam . Plann. Perspect. 25: 111-117. Guerrero Pavich ‚ E. ( 1986) . A Chicana pe rspective on Mexican culture and sexuality. Sex. Ethnocult. Soc. Work 4: 47-65. Hunt‚ M. (1974). Sexual Behavior in the 1970s ‚ Playboy Pre ss ‚ Chicago. Kinsey‚ A. C.‚ Pomeroy‚ W. B.‚ Martin ‚ C. E.‚ and Gebhard ‚ P. H. (1948) . Sexual Behavior in the Hum an Male‚ W. B. Saunders‚ Philadelphia. Kinse y‚ A. C.‚ Pome roy‚ W. B.‚ and Martin ‚ C. E. ( 1953) . Sexual Behavior in the Hum an Fem ale ‚ W. B. Saunde rs ‚ Philadelphia. Laumann ‚ E.‚ Gagnon ‚ J.‚ Michael ‚ R.‚ and Michae ls‚ S. (1994) . The Social Organ ization of Sexuality‚ Unive rsity of Chicago Pre ss ‚ Chicago. Marin ‚ G.‚ and Van Oss Marin ‚ B. (1991) . Research with Hispanic Populations ‚ Applied Social Research Methods Series‚ Sage ‚ Newbury Park‚ CA. Osmond ‚ M.‚ Wambach ‚ K.‚ Harrison ‚ D.‚ Byers ‚ J.‚ Le vine ‚ P.‚ Imershe in‚ A.‚ and Quadagno ‚ D. (1993) . The multiple jeopardy of race ‚ class and gende r for AIDS risk among women. G ender and Society 7: 99-120. Quee n‚ S.‚ Habenste in‚ R.‚ and Quadagno ‚ J. (1985). The Fam ily in Various Cultures‚ 5th ed. ‚ Harper and Row‚ New York. Smith‚ T. ( 1994) . Attitudes toward sexual permissiveness: Tre nds‚ corre lates‚ and behavioral connections. In Rossi‚ A. (ed.) ‚ Sexuality Across the Life Course ‚ University of Chicago Pre ss ‚ Chicago ‚ pp. 63-98. Sprecher ‚ S.‚ and McKinney‚ K. (1993) . Sexuality‚ Sage ‚ Newbury Park ‚ CA. Staples ‚ R. (1973) . The African American Wom en in America: Sex‚ Marriage and the Fam ily‚ Nelson Hall ‚ Chicago. Van Oss Marin ‚ B.‚ Gome z‚ C.‚ and Hearst ‚ N. (1993a) . Multiple heterosexual partners and condom use among Hispanics and non-Hispanic whites. Fam . Plann . Perspect. 25: 170-174. Van Oss Marin ‚ B.‚ Tschann ‚ J.‚ Gome z‚ C.‚ and Ke geles ‚ S. (1993b) . Acculturation and ge nder differences in sexual attitudes and behaviors: Hispanic vs. non-Hispanic White unmarried adults. Am. J. Public Health 83: 1759-1761. Van Oss Marin ‚ B.‚ and Gomez ‚ C. (1994). Latinos‚ HIV disease ‚ and culture: Strategies for HIV pre vention. In Cohen‚ P.‚ Sande ‚ M. ‚ and Volberding‚ P. (eds.) ‚ The AIDS Knowledge Base ‚ Little ‚ Brown‚ New York‚ pp. 10.8-1 ¯10.8-13. Weinberg ‚ M.‚ and Williams‚ C. ( 1988) . African American se xuality: A test of two theories. J. Sex Res. 25: 197-218. Wilson‚ P. ( 1986) . African Ame rican culture and sexuality. J. Soc. Work Hum . Sex. 4: 29-46. Worth‚ D. (1990) . Minority women and AIDS: Culture ‚ race and gender. In Feldman ‚ D. (e d.) ‚ Culture and AIDS‚ Praege r‚ Ne w York‚ pp. 111-135.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

Predictors of Unprotected Sexual Con tacts in HIVInfected Person s in Switzerlan d Dom in iqu e Eich -Höchli ‚ M.D.‚1 ‚3 Matth ias W. Niklowitz ‚ Ph.S.‚1 Ulrich Clem en t‚ Ph .D.‚2 Ru edi Lüth y‚ M.D.‚1 an d Milos Opravil ‚ M.D.1

Predictors of sexual risk behavior with regular an d casu al partners am ong HIV-infected heterosexual an d gay persons were addressed. Sociodem ographic data as well as self- and interviewer-reported data on sexual behavior were obtain ed from 117 asym ptom atic HIV-infected persons enrolled in the Zurich part of the Swiss HIV Cohort Study (SHCS). Participants who reported sexual intercou rse at least on ce (vagin al an d/or anal) without condom use in the 6 m on ths prior to interview were considered to have risk behavior. Sexual risk behavior was analyzed separately in con tacts with regular an d casual partn ers. In the 6-m on th preinterview period ‚ 92% (108 of 117) of the HIV-infected study popu lation reported sexual contacts ‚ and 30/117 (26% ) had at least one un protected vaginal an d/or an al contact. Am on g 93 persons using con dom s‚ 25% of the heterosexual and 10% of the hom osexual participan ts reported breakage of the condom . The m ain predictor for un protected sexual behavior with regular partn ers was an elevated num ber of contacts. Predictors for sexual risk behavior with casual partn ers were the com bination of alcoh ol an d sexual encou nters and the change of sexual behavior sin ce the epidem ic of AIDS. These findin gs did not differ between persons with hetero- an d hom osexual behavior. Con siderin g that these contacts m ay have passed the virus on to the seron egative popu lation ‚ that the probability of un safe sex in creased with the growin g num ber of con tacts‚ an d that the nu m ber of condom breakages was remarkable ‚ it is im perative that this group be edu cated and m otivated to take the active role in in sisting on safer sex practices in each encou nter. Supported by Swiss Nationalfonds Grant 4026-26868 ‚ and EMDO Foundation. 1 Departme nt of Me dicine ‚ Division of Infectious Diseases and Hospital Epidemiology‚ University Hospital‚ R ä mistrasse 100 ‚ CH-8091 ‚ Z urich‚ Switzerland. 2 Psychosomatic Clinic‚ University Hospital Heidelberg‚ Ge rmany. 3 To whom correspondence should be addre ssed. 77 0004-0002/98/0200-0077$15.00/0

Ó

1998 Plenum Publishing Corporation

78

Eich -Hö ch li ‚ Niklowitz‚ Clem ent ‚ Lü th y‚ an d Opr avil

KEY WORDS: HIV -infected pe rsons; se xual risk behavior; re gular partners; casual partne rs; Switzerland.

INTRODUCTION Switzerland is among the Europe an countrie s with the highe st pre valence of HIV infection and AIDS: 19 ‚814 persons had teste d HIV-positive (corresponding to 0.3% of the population in Switze rland) and 4 ‚014 had Aids by December 31‚ 1994 (Anonymous ‚ 1994) . Prevale nce of HIV testing appe ars to be much highe r in Switze rland than in othe r Europe an countrie s or the Unite d State s (Jeannin et al. ‚ 1994) . As the annual numbe r of ne w sexually acquire d HIV infe ctions appe ars to have stabilize d ove r the last fe w years ‚ from the biological point of vie w‚ the HIV e pide mic may be fue led by a re lative ly small numbe r of se ropositive persons (men or wome n) who engage in unprote cted se xual activitie s. To unde rstand the sexual mode of transmission ‚ we have to conside r the psychosocial perspective which include s information about the HIV status and the “ ne gotiate d ” (Kippax et al.‚ 1993) se xual behavior betwee n two persons inde pe nde nt of their serostatus (Dawson et al.‚ 1994; Doll et al.‚ 1990; Marks et al.‚ 1994) . A large numbe r of seropositive pe rsons‚ e spe cially men having anal inte rcourse ‚ engage in unprote cted se xual behavior with othe r seropositive persons (Marks et al.‚ 1994) . Although the ge neral knowle dge of how to avoid HIV infe ction is e stablishe d ‚ change s in sexual behavior have be en limite d (Conne ll et al.‚ 1990; Diaz et al.‚ 1994) ‚ condoms are used more ofte n (van den Hoeck et al.‚ 1990; Casadonte et al.‚ 1990; V anichse ni et al. ‚ 1993; Watkins et al.‚ 1993) ‚ but the y are not use d consiste ntly by HIV infe cted as well as uninfe cted pe rsons (Friedman et al. ‚ 1994) . Q uestions about the attitude towards condoms ‚ the re sponsibility towards one ’s health ‚ se lf-e ste em ‚ and social competence have not be en addre sse d in the conte xt of se xual risk behavior in HIV-infe cted pe rsons. This study was conducte d to obtain information about the se issues in HIV-infe cted pe rsons with he te ro- and homose xual high-risk behavior with regular and casual se xual partne rs. Understanding the different circumstance s of sexual encounte rs that trigge r high-risk be havior should help to develop spe cific pre vention strate gie s.

METHOD Subje cts were 117 asymptomatic HIV-infe cted patie nts who were recruite d in 1989 at the outpatie nt clinic of the Division of Infectious Diseases

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at the Unive rsity Hospital in Z urich ‚ Switze rland. Their participation in the study was voluntary ‚ and all signe d an informe d consent. Data were tre ated anonymously. The participants were concurre ntly registe re d in the Swiss HIV Cohort Study (SHCS; Lede rge rber et al..‚ 1944) . Data were colle cted by two inte rviewers‚ instrume nts were always administe re d in the same sequence. Data Collection The inte rview gathe re d data on the sociode mographic and biographical background and a history of se xually transmitte d dise ase (STDs). The que stionnaire (HIPS; Heusse r et al.‚ 1992) consists of a se lf- and a clinical rating ‚ asks for the numbe r of sexual contacts ‚ the be havior during the se contacts ‚ the use of condoms ‚ the influe nce of alcohol and/or illicit drugs during the se contacts ‚ the information of the HIV status of the partne r‚ he alth beliefs‚ and behavioral competence in the pre vious 6 months. We defined risk behavior as se xual contacts (anal and/or vaginal; insertive /receptive ) without re gular condom use ‚ which means that a person had unprote cted sexual contact at least once within the 6 months pre vious to the assessment. The sexual risk be havior was analyze d se parate ly for contacts with re gular and casual partne rs. Regular partne rs were defined as a re lationship of more than 3 months duration without e xcluding relationships with othe r partne rs at the same time; casual partne rs were occasional se xual encounte rs. The groups in this study were built with two factors: First ‚ se xual orientation and the behavior in the pre vious 6 months that was congrue nt for the 6-month period before the assessment. The se cond is former intrave nous drug use. HIV-infe cted individuals were aske d about their alcohol and/or drug consum ption ( intoxic ation) during se xual e ncounte rs within the last 6 months. We did not inte rvie w for the quantity of drinking and/or drug consumption in combination with sexual e ncounte rs. Q uestions about the ability to talk with a ne w partne r about the use of condoms ‚ insisting on their use ‚ and the te chnical ability to use the m gave us a self-asse ssment of the competence of the participants to practice safe-sex methods. Indicator s To e xplore the relationship betwee n risk behavior and attitude towards condom use ‚ we defined out of the questionnaire (HIPS; Heusse r et al. ‚

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1992) the Condom Attitude Inde x (CAI) consisting of 4 items (Cronbach ’s a = .84) : The highe r the score of the CAI‚ the more physical ave rsion towards the condom. With two more indice s we e xamine d the responsibility toward he alth in our study population. The Exte rnal Health Locus of Control Inde x (EHLCI‚ 6 ite ms‚ Cronbach ’s a = .78) means that good he alth is a matter of luck: The highe r the value s of the EHLCI‚ the more fate is responsible for one ’s he alth. A high score of Health Disregard Inde x (HDI‚ 5 ite ms‚ Cronbach ’s a = .75) implie s bad health and is the conse quence of disre garding one ’s he alth. The Self-Acce ptance /Social Competence Inde x (SASCI) measure s se lf-e ste em and competence in expre ssing one ’s ne eds and desires. A high score of SASCI (7 ite ms‚ Cronbach ’s a = .85) means that high se lf-e ste em is combine d with ade quate social competence in relationships. Lim itation s of Data The study sample is not large ‚ howe ver it is re pre se ntative of the SHCS in gende r distribution and has the same proportion of pe rsons with he terose xual risk behavior. The dive rgence in the othe r subgroups of risk behavior and distribution of age is of no statistical importance in the following bi- and multivariate calculations. Howe ver‚ conclusions for HIV-infe cted persons in gene ral cannot be drawn as most of the participants were living in urban areas of Switze rland. Finally‚ all data are based upon se lf-report and were not validate d e xte rnally. Statis tical An alys es Differences in subgroups were compute d with a two-taile d chi-square test for categorical variable s. Pre dictors measure d at inte rval level were te ste d with the t test. Risk factors which were plausible or confirme d by research were prove d by corre lation statistics. V ariable s with p value s < .10 were e ntere d into multiple logistic re gression analysis.

RESULTS A sociode mographic de scription is shown in Table I. The study population consiste d of 86 (73% ) men and 31 (27% ) wome n. At the time of initial e xamination (in 1990) ‚ the mean age was 34 ye ars (SD _ _ = 9) men (x = 35.0 ‚ SD = 8.6) were significantly olde r than wome n (x = 29.7 ‚ SD = 7.9 ‚ p < 0.001). The risk for acquisition of HIV infe ction was homose xual

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Table I. Comparison of Sociodemographic Characteristics of This Sample (n = 117) and the Asymptomatic HIV -Infecte d Persons of the Swiss HIV Cohort Study (n = 472) at the Same Time Span Swiss HIV cohort study (N = 742)

This study (N = 117)

Sex Men Women Age (years) 20 ¯29 30 ¯39 40 ¯61 Risk of acquisition of HIV a Heterose xual be havior Homosexual behavior Intravenous drug use b Educational level Low Medium High c Profe ssional status Low Medium High Unknown

%

n

%

n

73 27

86 31

72 28

533 209

44 36 20

51 42 24

23 51 26

168 383 191

19 55 26

22 64 31

17 35 48

125 258 359

11 64 25

13 75 29

14 62 23 1

16 73 27 1

a

The definition of he terosexual behavior he re means no homose xual behavior and iv drug use. b Low: primary school; me dium: se condary school; high: college . Data not assessed for Swiss HIV cohort study. c Low: no professional e ducation; me dium: employees ‚ working persons; high: pe rsons in leading professional positions. Data not assessed for Swiss HIV cohort study.

risk behavior in 55% (64 men ‚ 14 of the m be ing bise xual) ‚ intrave nous drug use in 26% (16 male ‚ 15 female) ‚ and he te rosexual _ source of infection ‚ in 19% (6 male ‚ 16 fe male). Forme r iv drug users (x = 28.6 ye ars ‚ SD = 3.5) were significantly younge r (p < 0.001) than homose xual men and persons with othe r risks for HIV infe ction. All participants had had sexual encounte rs since 1980. In the previous 6 months 44 had had heterose xual ( 2 of the m only pe tting) and 64 homose xual (3 of the m only pe tting) contacts (103 persons had had oral ‚ vaginal ‚ or anal contacts). About half of the sample of this study conside red themselve s “ well” or “ very well” informe d about AIDS ‚ about a quarte r “ not so well” and the last quarte r “ poorly” or “ very poorly. ”

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Compare d to the asymptomatic persons enrolle d in the SHCS (Lederge rber et al.‚ 1994) ‚ our sample shows the same male to female ratio (see Table I) ‚ a highe r percentage of persons in the 20 ¯29 years category‚ a lower percentage in the 30¯ 39 category‚ and a similar percentage in the olde r persons. Regarding the risk of HIV acquisition ‚ this study is comparable to the SHCS in pe rsons with heterose xual risk be havior. Participants with homose xual risk be havior are ove rre pre se nte d he re ‚ forme r drug users unde rre pre se nte d. Unprotected Sexu al Con tacts O f 44 heterose xually active persons ‚ 9 re porte d at le ast one unprote cted vaginal/anal contact within the last 6 months with their re gular partners and 9 at least one with casual partne rs‚ 2 of them reporting both. In this group ‚ the re were no contacts with e ithe r fe male or male prostitute s. O f 64 homose xually active persons ‚ 11 had at least one unsafe anal contact with re gular partne rs and 4 with casual partne rs‚ 1 of the m reporting both. They communicate d no se xual risk behavior with prostitute s. O verall ‚ 30 of 117 (26% ) re porte d at le ast one unprote cted se xual contact within the last 6 months. Adding the unprote cted oral contacts to the vaginal and anal one s‚ the numbe r of persons with unprote cted se xual encounte rs reache s 69% (71 of 117) . Con dom Use Data on sexual activity and condom use are shown in the Table s II and III. O f the 44 heterose xually active persons ‚ 42 used a condom at least once in all varie ties of se xual activity. Thirty-one re porte d no rupture using the condom and 11 of 42 expe rience d a bre akage of the condom during vaginal intercourse. In the group of 64 men with active homose xual behavior‚ 51 made use of a condom at le ast once. Five men re porte d a bre akage of the condom ‚ e ach time during anal inte rcourse . In summary‚ he terose xually active persons expe rience d significant more bre akage s of condom (p < 0.05) than homose xually active one s. Serostatu s of the Su bject ’s Partn er In the group of he te rosexually active pe rsons‚ 28 (64% ) of the se 44 had an HIV-negative re gular partne r‚ 5 (11% ) had a HIV-positive partne r‚ and 4 (9% ) did not know their partne r’s status. Focusing on the 9 persons

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Table II. Sexual Activity‚ Condom Use ‚ and Knowledge About HIV Status of Partner Persons with heterosexual behavior (n = 44) a

%

n

70 20 16

31 9 7

41 20 11

18 9 5

95 25

42 11

% HIV ¯

% HIV +

% unknown

64 18

11 9

9 18

Regular partners Vaginal contacts At least once unprotected Unprotected ejaculation Casual partners Vaginal contacts At least once unprotected Unprotected ejaculation Condom use At least once use d b Condom bre akage

Knowledge About HIV -Status of the Partner Re gular partne rs Casual partners a b

No unprotected anal sex‚ no contacts with prostitutes/suitors. Vaginal contacts only.

Table III. Sexual Activity‚ Condom Use ‚ and Knowledge About HIV Status of the Partners Persons with homose xual be havior (n = 64) a

%

n

28 13 5 28 11 8

18 8 3 18 7 5

23 5 2 23 5 2

15 3 1 15 3 1

80 8

51 5

% HIV ¯

% HIV +

% unknown

25 8

20 11

16 45

Regular partners Anal contacts (active ) At least once unprotected Unprotecte d ejaculation Anal contacts (passive) At least once unprotected Unprotecte d ejaculation Casual partne rs Anal contacts (active ) At least once unprotected Unprotecte d ejaculation Anal contacts (passive) At least once unprotected Unprotecte d ejaculation Condom use At least once used b Condom breakage

Knowledge About HIV -Status of the Partne r Regular partners Casual partners a b

No unprotected contacts with suitors/streetboys. Anal contacts only.

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with risk behavior in their steady partne rship ‚ 6 of the se partne rs were uninfe cted ‚ 2 seropositive ‚ and 1 had no knowle dge about he r status. In he te rosexually active pe rsons‚ 8 (18% ) of the casual partne rs‚ were HIV-ne gative ‚ 8 (18% ) unknown ‚ and 4 ( 9% ) HIV-positive ‚ whe re as in the group of persons behaving at risk‚ 3 of the casual partne rs were not infe cted ‚ 2 were infe cted ‚ and anothe r 3 did not know their partne r’s HIV status. Sixte e n (25% ) of the regular partne rs of subje cts with homose xual behavior ( Table III) we re HIV -ne gative ‚ 13 ( 20% ) HIV -positive ‚ and 10 (16% ) did not know their HIV status. Two re gular partne rs were not infe cted ‚ 4 were se ropositive ‚ and for anothe r 4 the serostatus was not known in the persons behaving at risk. In the group of casual partne rs‚ 5 (8% ) were HIV -negative ‚ 7 (11% ) HIV-positive ‚ and 29 (45% ) had no knowle dge about their HIV status. All 4 casual partne rs of the persons be having at risk did not reve al the ir serostatus. Alcoh ol an d Drug Use Twenty-four study participants ‚ 21 men ( 24% ) and 3 women (10% ) ‚ had several encounte rs while unde r influe nce of alcohol. Twenty-nine persons ‚ 23 men (27% ) and 6 wome n (19% ) ‚ had se x while using recreational drugs mostly using cannabis and phe ncyclidine (PCP) ‚ including opioids ‚ hallucinoge n ‚ inhalants ‚ se dative s‚ and hypnotic substance s‚ cocaine ‚ and no crack. Sexu ally Tran sm itted Disease an d Other In fectiou s Diseases Sin ce 1980 In this study‚ a former STD is conside re d relevant in changing sexual risk be havior towards safer sexual behavior. Sixty one persons (52% ) of our study population re porte d at le ast one pre vious or actual episode of STD. Homose xuals had a highe r incide nce of STD infe ction (p < 0.05) than former iv drug use rs and pe rsons with othe r HIV risk factors. O ne third (n = 41) reporte d to have had at least one infectious disease othe r than STD (31 he patitis) . Attitu des Towar ds Safer Sex O f the sample ‚ 97 (84% ) persons were convince d that safe r se x effe ctive ly pre ve nts HIV infection. This opinion correlate d neither with age nor

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with educational and profe ssional status. O n the contrary‚ a positive attitude towards condom use correlate d significantly with the acceptance of safer se x (p < 0.05) . Bivar iate An alys es We inve stigate d the e ffect of all variable s derive d from rese arch in this fie ld. We found significant correlations be tween fre quency of sexual encounte rs‚ talking about use of condoms ‚ insisting upon their use ‚ and SASCI on one hand and se xual risk be havior with re gular partne rs on the othe r hand. Additionally ‚ the variable “ forme r infe ctious disease s” correlate d bivariate ly at the 0.1 le vel with this type of risk behavior. In sexual risk encounte rs with casual partne rs‚ there were significant correlations with the fre quency of these se xual contacts ‚ se x while unde r influe nce of alcohol and while using re creational drugs ‚ and the change of sexual behavior since the AIDS epide mic. Multivariate An alyses We analyze d pre dictors for sexual risk behavior in regular and casual contacts for the entire sample (e.g.‚ pe rsons with hetero- ‚ homose xual risk behavior and iv drug use) including all variable s correlating bivariate ly with p < 0.10 into logistic re gression analysis (Table IV ).

Table IV. Predictors of Unprotected Contact with Partner: Multivariate Mode l Based on Variables That We re Significant (p < 0.10) in the Bivariate Analyses Adj. odds ratio for risk behavior

V ariable

95% CI

With re gular partne r (n = 96) History of STD Age Talking about condom use Insisting on condom use Sum of contacts with regular partner Condom Attitude Index

1.45 1.03 0.71 2.35 1.02 1.06

0.73 ¯2.87 0.95 ¯1.11 0.72 ¯1.54 0.95 ¯5.76 1.01 ¯1.03 0.89 ¯1.27

With casual partner (n = 99) Combined drunkenness and sex Combined drugs and sex Sum of contacts with casual partner Change of behavior due to AIDS

0.19 0.68 0.99 5.96

0.06 ¯0.58 0.33 ¯1.41 0.98 ¯1.01 1.81 ¯19.79

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In the 6 months prior to the inte rvie w‚ 108 out of 117 study participants were sexually active ‚ 5 of them only with petting. Data on seve n individuals were incomple te ‚ re ducing the sample to 96 for pe rsons having sexual contacts with regular partne rs. The most significant pre dictor for high-risk be havior was the numbe r of sexual e ncounte rs with a regular partner (Table IV ). Anothe r predictor was the ability to insist on condom use : The bette r this ability‚ the fewer risks were take n. These two predictors remaine d significant when re ducing the statistical mode l. For risk behavior with casual partne rs‚ 99 persons had a comple te data set. The bivariate finding that more fre que nt sexual encounte rs increased the probability of high-risk behavior disappe ared in the multivariate analysis whe re as the change d behavior due to thre at by AIDS and the fact of sexual encounte rs during alcohol influe nce re maine d significant predictors for unsafe se x practice s e ver in the reduce d multivariate mode l.

DISCUSSION Se xual activity is an inte gral part of everyday life ‚ whether one is HIVpositive or not. O ur re sults show that over a course of 6 months ‚ 108 of 117 HIV-infe cted pe rsons re porte d sexual activity‚ 103 persons having oral ‚ vaginal ‚ or anal contacts and 5 only petting. During this time ‚ howe ve r‚ 26% of the 103 se xually active patie nts had an unprote cted vaginal or anal sexual contact at le ast once and 26% of the he te rosexually and 10% of the homose xually active pe rsons expe rience d a breakage of condom . More ove r‚ most of the study participants behaving in a risky manne r had HIV-negative partne rs or had no knowle dge of their partne r’s HIV status. Although pre ve ntion programs in Switze rland stress the importance of avoiding unsafe se x in e ach situation ‚ two thirds of our HIV-infe cted persons e ngage d at least once in unsafe se xual be havior including oral sexual practice s. Should this be interpre te d as a failure in the pre vention efforts? In the se persons ‚ more than half reporte d only unprote cted oral contacts. This indicate s a differe ntiate d reaction to the prevention message s: O n one hand ‚ they did not utilize the condom in each situation; on the othe r hand ‚ the y fre que ntly made use of a condom in vaginal or anal contacts. As more than two thirds of our sample re porte d safe r sex‚ the HIV prevention e fforts have had an impact on the population. O ur study shows that the more sexual contacts a pe rson has ‚ the highe r is the probability of having unsafe se x. Kelahar et al. ( 1994) discuss the same findings in HIV-ne gative pe rsons with homose xual be havior. They sugge st that more sexual opportunitie s le ad to a gre ater like lihood of unsafe sex. O ur finding is true for both hetero- or homose xual be havior and sexual

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contacts with regular or casual partne rs. In the casual partne rs‚ this e ffect disappe ars multivariate ly. O bvious re asons for the patie nts ’ inability to maintain safer se x are the situational conte xt‚ one ’s frame of mind ‚ as well as that of the sexual partne r. This last point ‚ the significant othe r in a sexual relationship has not bee n studie d and the refore is not discusse d he re. Recent studie s could not de monstrate that individual sexual risk-taking is influe nce d by the consumption of alcohol on specific occasions (World Health O rganization ‚ 1994) . Pe rry et al. (1994) found that heavy alcohol use and fre quent high-risk se xual behavior occurred among the same individuals ‚ but the re was no evide nce for a causal link be tween alcohol use and unprote cted se xual activity in a group of bar-going HIV-negative gay men. In our study we e nquire d about the quantity of alcohol consumption in ge ne ral and intoxication in differe nt patte rns of sexual contacts. Analyzing the whole sample of HIV-infe cted pe rsons without diffe rentiating betwee n regular and casual partne rs‚ our re sults show no corre lation between alcohol and sexual risk behavior. In casual contacts ‚ howe ve r‚ alcohol consumption induce s risk be havior. This finding is in contradiction with that of Pe rry et al. Thus‚ in our HIV-positive persons ‚ alcohol consumption plays two diffe rent roles de pending on the stability of the se xual e ncounte r. Alcohol has bee n implicate d as a se xual promote r‚ an aphrodisiac at lower quantity of consumption ‚ or excuse for othe rwise unacce ptable se xual practices (Perry et al. ‚ 1994) . We sugge st that in re gular partne rships ‚ the role of alcohol doe s not influe nce safe sex behavior. In casual se xual contacts ‚ on the contrary‚ a situation with many unknown aspe cts creating te nsions ‚ alcohol is an important promotor. It makes unacce ptable be havior acce ptable and sexual practice s unsafe in our HIV-positive persons. The bivariate corre lation of “ re creational ” drug use while having se xual contacts and sexual risk be havior disappe ars in the multivariate logistic regre ssion. The se data show that consumption of re creational drugs (e xcluding crack) has no predictive function for sexual risk be havior in regular partne rships ‚ but conside ring the bivariate corre lation ‚ it is important in sexual contacts with casual partne rs. The e ffect of impairing judgme nt and disinhibiting normally controlle d behaviors (Kenne dy et al.‚ 1993) can be due to mind-alte ring drugs and alcohol which confirms the former findings in HIV-negative study sample s. Whether the partne r was re gular or casual ‚ risk behavior among he terose xual and homose xual study participants was not affe cted by the knowle dge of the ir partne r ’s se rostatus. Unexpe ctedly‚ risk be havior was not limite d to HIV-positive partne rs‚ but an ove rwhe lming numbe r of study participants re porte d unprote cted se xual contacts with HIV-negative partners or without knowle dge of the partne r’s HIV status. Our data of highrisk behavior among gay men are consiste nt with Dawson et al. (1994) and

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Doll et al. (1990) and are in contradiction to the pre vention tactic of 100% compliance with safe r se x methods. This sugge sts a “ silent agre e ment” between partne rs in which each is re sponsible for his own health and be ars his own risk. Furthe r interventions should stress the social responsibility of the seropositive person to avoid passing on the HIV ‚ especially in situations where the partne r’s status has not be en discusse d be fore. The availability of and the attitude towards condoms as well as the capability to insist successfully in condom use are e sse ntial for risk prevention (de Wit et al.‚ 1993) . As in both homo- and he te rosexual encounte rs with regular partne rs‚ risk be havior correlate s with the inability of insisting on condom use . This is of no importance in se xual encounte rs with casual partne rs. O mitting the use of condoms among regular partne rs agre e s with de Wit et al. ‚ who found that HIV-negative gay men with a less positive attitude towards condom use and men with lowe r personal efficacy re garding condom use were more like ly to have unsafe sex with casual partne rs. The freque ncy of condom bre akage s in HIV-infe cted se xually active persons causes conce rn ‚ be cause the bre akage happe ne d in vaginal and anal contacts of our study population. Reasons for the re porte d bre akage are spe culative but two are probable : Breakage due to storage proble ms (e .g. ‚ expire d e xpiration date ‚ storage unde r me chanical stress) or wrong handling (e.g.‚ damage due to finge rnails ‚ wrong lubricants ‚ or contact with sun tan) may play an important role . Whe n sexually active pe rsons follow the message s to prevent HIV transmission and especially when some have to overcome the dislike of condoms in vaginal and/or anal intercourse ‚ bre akage of a condom is highly de motivational. Pe rsons with low se lf-e ste em may not be able to insist on safer se x practice s whe n involve d with a dominant partne r or in pe rsonal crisis situations. While the root cause is differe nt‚ pe ople with low social competence are also more like ly to engage in high-risk be havior either be cause they lack the communication skills to e xpre ss the ir desire for safe r sex or because their pe rsonal viewpoint on the subje ct is unde rdevelope d. A person with a low SASCI may fee l that engaging in unprote cted sex conve ys their total acceptance of their partne r. Is our risk definition as a prope r answer to safe behavior in sexual encounte rs? O ne could argue that in the pre se nt study a person who has had many contacts and is 99% “ safe ” is conside re d incorre ctly at risk‚ while a person with a single contact who happe ne d to have a condom available or an insisting partne r is conside re d inaccurate ly at no risk. An important argume nt supporting this risk definition is that the numbe r of se xual contacts and the variable “ safe ” or “ not safe ” are two inde pende nt factors. So‚ the risk of HIV transmission is present in e ach unprote cted sexual encounte r. The gradie nt of risk is be tween “ risk” and “ no risk” and there fore

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the information about numbe r of contacts adds information about the person behaving at risk and the situational conte xt. Some situational factors as alcohol consumption or drug use in se xual contacts are predictors of unsafe se xual be havior ‚ whe re as othe r factors such as dynamic aspe cts of the conte xt in which risk be havior happe ns were not our focus. Last but not le ast‚ in practical situations ‚ proble ms and be havior are almost “ bivariate.” O ne quarte r of our HIV-infe cted pe rsons engage d at least once in unsafe se xual behavior in the prior 6 months ‚ Furthe rmore ‚ most of their re gular and casual partne rs were HIV-ne gative or with unknown HIV status. Take n in account the growing numbe r of infe cted pe rsons‚ prevention programs should stress the importance of avoiding unsafe se x in each situation. Additionally ‚ in persons with he te ro- and homose xual risk behavior the se nse of re sponsibility should be stre sse d. So‚ the prevention program should call atte ntion to the role of alcohol consumption and drug use as promote rs to reduce te nsions ‚ especially in casual contacts. Finally ‚ the remarkable numbe r of persons reporting condom bre akage s implie s an exte nsion of the pre ve ntion programs. Effective condom use is the re sult of a se quence in which all elements have to fit ‚ beginning with storage and ending with corre ct handling. So the message “ e ve r condom use ” should be enlarge d to “ use condom e ver and cle ver.”

REFERENCES Anonymous. (1994) . Bull. Bundesam tes fü r G esundheitswesen (BAG) ‚ 37: 616. Casadonte ‚ P. P.‚ De s Jarlais ‚ D. C.‚ Friedman ‚ S. R.‚ and Rotrose n‚ J. P. (1990) . Psychological and behavioral impact among intravenous drug users of learning HIV test results. In t. J. Addict. 25: 409-426. Connell‚ R. W.‚ Crawford‚ J.‚ Dowse tt. G. N.‚ Kippax‚ S.‚ Sinnott‚ V .‚ Rodden ‚ P.‚ and Be rg ‚ R. (1990) . Dange r and context: unsafe anal sexual practice among homosexual and bisexual me n in the AIDS crisis. ANZJS 2: 187-208. Dawson ‚ J. M.‚ Fitzpatrick‚ R. M.‚ Reeve s‚ G. Boulton ‚ M.‚ McLean ‚ J. ‚ Hart ‚ G. J.‚ and Brookes ‚ M. (1994) . Awareness of sexual partne rs ’ HIV status as an influence upon high-risk sexual behavior among gay me n. AIDS 8: 837-841. de Wit‚ J. B. F.‚ van Grie nsve n‚ G. J. P.‚ Kok‚ G.‚ and Sandford‚ T. G. M. ( 1993) . Why do homose xual me n re lapse into unsafe se x? Pre dictors of resumption of unprotecte d anoge nital intercourse with casual partne rs. AIDS 7: 1113-1118. Diaz ‚ T. ‚ Chu‚ S. Y.‚ Conti‚ L. ‚ Sorvillo‚ F. ‚ Checko ‚ P. J.‚ He rmann ‚ P.‚ Fann ‚ S. A.‚ Frederick ‚ M.‚ Boyd ‚ D.‚ Mokotoff‚ E.‚ Rietme ijer‚ C. A.‚ He rr ‚ M.‚ and Samuel ‚ M. C. (1994). Risk behaviors of persons with heterose xually acquired HIV infection in the United States: Results of a multistate surveillance project. J. AIDS 7: 958-963. Doll‚ L. S.‚ O ’Malley‚ P. M.‚ Pershing‚ A. L.‚ Darrow ‚ W. W.‚ Hessol ‚ N. A.‚ and Lifson‚ A. R. ( 1990) . High-risk sexual behavior and knowledge of HIV antibody status in the San Francisco City Clinic Cohort. Health Psychol. 9: 253-265

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Friedman ‚ S. R.‚ Jose ‚ B.‚ Neagius ‚ A.‚ Goldstein‚ M.‚ Curtis‚ R.‚ Ildefonso‚ G.‚ and Mota ‚ P. (1994) . Consistent condom use in relationships between seropositive injecting drug use rs and sex partners who do not inject drugs. AIDS 8: 357-361. Heusser ‚ R.‚ Tschopp ‚ A.‚ Beuttler ‚ H. J.‚ Gutzwlller‚ F.‚ and the research group of the HIV Pre vention Study. (1992) . Determin ants of condom use — Re sults from the Swiss HIV Cohort Study. Abstract B ook‚ V ol. 2 ‚ V IIIth International Confe re nce on AIDS ‚ Amsterdam ‚ July 1992 ‚ D466 ‚ PoD 5478. Je annin ‚ A.‚ Dubois-Arber ‚ F.‚ and Paccaud ‚ F. (1994) . HIV testing in Switzerland. AIDS 8: 1599-1603. Ke lahar ‚ M.‚ Ross ‚ M. W.‚ Rohrshe im ‚ R ‚ Drury‚ M.‚ and Clarkson‚ A. (1994). Dominant situational determination of se xual risk behavior in gay men. AIDS 8: 101-105. Ke nnedy‚ C. A ‚ Skurnick‚‚ J.‚ Wan ‚ J. Y.‚ Quattrone ‚ G. ‚ She ffet‚ A.‚ Quinones‚ M.‚ Wang ‚ W.‚ and Louria‚ D. B. (1993) . Psychological distress ‚ drug and alcohol use as correlates of condom use in HIV -se rodiscordant heterose xual couples. AIDS 7: 1493-1499. Kippax‚ S.‚ Crawford J. ‚ Davis ‚ M.‚ Rodden ‚ P.‚ and Dowse tt G. (1993) ‚ Sustaining safe sex: A longitudinal study of a sample of homosexual men. AIDS 7: 257-263. Lede rgerber ‚ B.‚ von Overbeck ‚ J.‚ Egger ‚ M.‚ Lü thy‚ R.‚ and the Swiss HIV Cohort Study (1994) . The Swiss HIV Cohort Study: Rationale ‚ organisation and selecte d baseline characteristics. Soz. Praeven tivmed. 39: 387-394. Marks‚ G.‚ Ruiz‚ M. S.‚ Richardson ‚ J. L.‚ Reed ‚ D.‚ Mason ‚ H. R. C.‚ Sotelo‚ M.‚ and Turner ‚ P. A. (1994) . Anal intercourse disclosure of HIV infection among seropositive gay and bisexual me n. J. AIDS 7: 866-869. Perry‚ M. J.‚ Solomon‚ L. J.‚ Winett‚ R. A.‚ Ke lly‚ J. A.‚ Roffman ‚ R. A.‚ Desiderato ‚ L. L.‚ Kalichman ‚ S. C.‚ Sikkema‚ K. J. ‚ Norman ‚ A. D.‚ Short‚ B.‚ and Steve nson ‚ L. Y. (1994) . High risk se xual behavior and alcohol consumption among bar-going gay men. AIDS 8: 1321-1324. van den Hoe ck ‚ A.‚ van Haastre cht ‚ H. J. A.‚ and Coutinho‚ R. A. (1990) . Heterose xual behavior of intravenous drug users in Amsterdam: Implications for the AIDS e pidemic. AIDS 4: 449-453. Vanichseni ‚ S.‚ Des Jarlais D. C.‚ Choopanya‚ K.‚ Friedmann ‚ P.‚ Wenston ‚ J.‚ Sonchai ‚ W.‚ Sotheran ‚ J. L.‚ Raktham ‚ S.‚ Carballo‚ M.‚ and Frie dman ‚ S. R. (1993). Condom use with primary partners among injecting drug use rs in Bangkok‚ Thailand and Ne w York City‚ Unite d States. AIDS 7: 887-891. Watkins‚ K. E. ‚ Metzge r ‚ D.‚ Woody‚ G. ‚ and Mc Le llan‚ A. T. (1993) . Dete rminants of condom use among intrave nous drug users. AIDS 7: 719-723. World Health O rganization. (1994) . Alcohol and HIV /AIDS ‚ Re port on a consultation ‚ Regional office for Europe ‚ WHO ‚ Denmark.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

A Neuropsych ologic Profile of Hom osexual an d Heterosexu al Men an d Wom en Dom on ick J. Wegesin ‚ Ph.D.1 ‚2

To exam in e the applicab ility of psychosexual differen tiation theory to the developm ent of sexu al orien tation ‚ heterosexu al (HT) wom en ‚ HT m en ‚ lesbian s‚ an d gay m en (20 per group) com pleted a lexical-decision /seman tic m on itoring task (LD/SM) to assess verbal ability‚ as well as a Water Level Task (WLT) and two Mental Rotation (MR) Tasks designed to assess spatial ability. All tests have been shown to differen tiate HT m en an d wom en. Results replicated previously reported sex differences between the HT m en an d wom en. Further‚ gay m en perform ed akin to HT wom en on the verbal task and the MR tasks‚ bu t not in the WLT. Lesbian s‚ however‚ prim arily perform ed in a sex-typical m an ner. The dissociation in sex-atypicality between lesbian s an d gay m en is discussed in relation to neurobiological factors related to the developm ent of both sex-dim orphic cogn itive ability an d sexual orientation . KEY WORDS: psychosexual differentiation; homosexuality; mental rotation; lexical decision.

INTRODUCTION Recent neuropsychologic studie s have bee n e mploye d as a means of unde rstanding the etiology of se xual orientation. This approach supple ments neuroanatomic and ne urophysiologic approache s which have examined difference s in brain structure and brain function be tween homose xual Supported by National Institutes of Health grant to the Cente r for Research in Learning ‚ Pe rception and Cognition and grants to Professor Charles A. Nelson of the Institute of Child Deve lopment. 1 Center for Research in Learning ‚ Perception and Cognition and the Institute of Child Deve lopment‚ University of Minne sota‚ Minneapolis‚ Minnesota. 2 To whom correspondence should be addre ssed at the Sergievsky Center of Columbia University‚ 630 West 168th Street ‚ Box 16 ‚ New York ‚ New York 10032. 91 0004-0002/98/0200-0091$15.00/0

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(HM) and heterose xual (HT) individuals (e.g.‚ Le Vay‚ 1991; Reite et al. ‚ 1995) . Some of the neuropsychologic data sugge st that the cognitive patte rns of gay men differ from those of HT men on measure s that gene rally elicit sex differences (Gladue et al.‚ 1990; McCormick and Wite lson ‚ 1991; Sande rs and Ross-Fie ld ‚ 1986) . However‚ at le ast two studie s have faile d to re ve al e ffects of se xual orie ntation (Gladue and Baile y‚ 1995; Tuttle and Pillard ‚ 1991) . Little is known about cognitive abilitie s of le sbians ‚ though the four publishe d reports sugge st that lesbians do not diffe r significantly from HT wome n. (Gladue and Baile y‚ 1995; Gladue et al.‚ 1990; Hall and Kimura ‚ 1993; Tuttle and Pillard ‚ 1991). Theoretically‚ this body of data has been generated in the framework of psychose xual differentiation ‚ i.e.‚ the developme nt of physical and behavioral differences between the sexes. Homosexuals are thought to follow sexatypical patte rns of psychose xual diffe re ntiation such that the y de velop neurocognitive ly in the direction of their opposite -sex HT cohorts. This hypothe sis is supporte d by studie s of gender-role behavior which indicate that gay men and lesbians are much more like ly to report sex-atypical historie s of childhood behavior than HT men and women (d = 1.31 for men‚ d = 0.96 for women; Baile y and Zucker‚ 1995). The most promine nt theory accounting for the relation between homose xuality and sex-atypical cognitive abilitie s implicate s the role of pre natal se x hormone s (Meyer-Bahlburg ‚ 1993). Pre natal hormone theory sugge sts that high concentrations of androgenic hormone s are require d during the period of sexual differentiation of the brain to masculinize the neural substrate s rele vant to sexual orientation and ne urocognitive function. Without the masculinizing effects of androgenic hormone s‚ a female-type d ne ural substrate results. Nonhuman animal studie s provide evide nce consiste nt with this theory. Prenatal manipulations of androge ns during critical periods can induce se x-atypical re productive and nonre productive behaviors (Beatty‚ 1992; Gorski ‚ 1985) . Prenatal hormone manipulations are also associate d with the de velopme nt of se x-spe cific ne ural dimorphism (Breedlove ‚ 1994) . Furthe r‚ human studie s of psychoe ndocrine populations sugge st that prenatal sex hormone s are important in the developme nt of se xual orientation. Sex atypicalitie s in prenatal hormone level have been correlate d with increased bi- and homose xuality in these populations (Dittmann et al.‚ 1992; Ehrhardt et al.‚ 1985; Mone y et al.‚ 1984) . Of rele vance to the current report are data sugge sting that prenatal hormone s are also relate d to sexually dimorphic cognitive abilitie s (Berenbaum and Snyde r‚ 1995; Helleday et al.‚ 1994; Hier and Crowley‚ 1982; Hines‚ 1990; Hine s and Green ‚ 1991; Nass and Baker‚ 1991; Nyborg and Nie lson ‚ 1981; Reinisch and Sande rs‚ 1992; Reinisch et al.‚ 1991). Sex-dimorphic ability is found in only a limite d subset of ve rbal and spatial tasks‚ the se exhibiting a fe male and male advantage ‚ re spe ctive ly.

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Difference s base d on se xual orientation have also bee n re porte d on the same tasks (at least in men). The sizes of the se diffe re nce s are consiste ntly large r in te sts of spatial ‚ as compare d to verbal ‚ ability. Two aspe cts of spatial cognition have shown reliable se x differences: mental rotation (MR) and spatial perception (Linn and Pe te rse n ‚ 1985) . MR tasks involve maintaining and manipulating an inte rnal re pre sentation of two-dime nsional (2-D) or three-dime nsional ( 3-D) obje cts and gene rally elicit the large st se x difference see n in the cognitive abilitie s literature . Effe ct size s are large r for 3-D te sts (d = 0.90; Masters and Sande rs‚ 1993) compare d to 2-D tests (d = 0.26; Linn and Petersen ‚ 1985) . In studie s including gay men ‚ re sults have be en mixe d. Thre e studie s have reporte d that HM me n score significa ntly lowe r than HT men (Gladue et al.‚ 1990; McCormick and Wite lson ‚ 1991; Tkachuck and Z ucke r‚ 1991) and three studie s faile d to find significant e ffects (Gladue and Baile y‚ 1995; Hall and Kimura ‚ 1993; Tuttle and Pillard ‚ 1991) . Effect size s are marginally large r for 3-D MR te sts (d @ 0.39 3; Gladue and Baile y‚ 1995; Gladue et al.‚ 1990; Tkachuck and Z ucke r‚ 1991) than for 2-D MR te sts (d @ 0.31; McCormick and Wite lson ‚ 1991; Tuttle and Pillard ‚ 1991). Five studie s have reporte d that le sbian score s did not differ from scores of HT women (Gladue and Baile y‚ 1995; Gladue et al.‚ 1990; Hall and Kimura ‚ 1993; Tkachuck and Zucker‚ 1991; Tuttle and Pillard ‚ 1991) . A male advantage ‚ though more mode rate ‚ also e xists in te sts of spatial perception (d = 0.64; Linn and Pe te rse n‚ 1985). In these tests‚ subje cts must determine spatial relationships with re spe ct to the orie ntation of their own bodie s‚ in spite of distracting information. A classic exemplar of spatial perception is Piage t and Inhelde r’s Water Le vel Test (WLT) (1956) . The WLT re quire s subje cts to draw or to identify the line of the water leve l (which is always horizontal) in a glass tilted at varying de gre es. Se x difference s be come significant in adole scence (Linn and Pe te rse n ‚ 1985) and consiste nt in adulthood (Thomas et al.‚ 1973) . WLT studie s including gay men have ge ne rally re vealed that HT men outpe rform gay men (Sande rs and Ross-Field ‚ 1986; Gladue et al.‚ 1990; McCormick and Witelson ‚ 1991) — though not all (Gladue and Baile y‚ 1995; Tkachuck and Zucker‚ 1991) (d @ 0.33) . Again ‚ lesbian pe rformance has not bee n shown to diffe r from that of HT wome n (Gladue and Baile y‚ 1995; Gladue et al.‚ 1990; Tkachuck and Z ucke r‚ 1991) . Diffe rence s be twee n men and women on tests of verbal ability are smalle r than those se en in spatial tasks. A meta-analysis including multiple type s of verbal function reveale d an effe ct size of 0.11 (Hyde and Lynn ‚ Effect sizes were calculated independently for each study comparing gay me n and HT men ‚ then weighted based on the sample size and ave raged across studies.

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1988) . O f the various te sts of ve rbal ability ‚ wome n typically outpe rform men on tests of verbal flue ncy (Harshman ‚ Hampson ‚ and Be renbaum ‚ 1983; Lezak‚ 1983) . V e rbal flue ncy re late s to “ the ability to retrieve words that belong to a specified category in a give n time period ” (Sattle r‚ 1986 ‚ p. 710) . Of the cognitive process listed in Hyde and Lynn ’s meta-analysis (1988) ‚ ve rbal production (spoke n and writte n) relate s most closely to verbal fluency and was associate d with the large st e ffect sizes of the verbal abilitie s in their study. Effe ct sizes were large r for adults over age 19 (d = 0.45) than for the childre n (> 4 ye ars) and adults combine d (d = 0.33) . A handful of studie s has e xamine d differences in verbal fluency be tween HT and HM individuals. Gene rally‚ significant diffe re nces be twe en HT men and gay men have not be en obtaine d ‚ though tre nds in the expe cted direction —gay men pe rforming more similarly to HT women and be tter than HT men —have bee n re porte d (Gladue et al.‚ 1990; McCormick and Witelson ‚ 1991) . No differences have bee n found in ve rbal flue ncy ability betwee n le sbians and HT wome n (Gladue et al.‚ 1990) . The curre nt study was de signe d to examine ve rbal and spatial ability in HT and HM men and wome n in an atte mpt to (i) replicate pre vious reports on mental rotation and spatial perception ‚ (ii) asse ss difference s in le xical-de cision ability be tween HT men ‚ HT women ‚ gay me n ‚ and le sbians ‚ and (iii) furthe r test the applicability of the psychose xual diffe re ntiation the ory to the de ve lopme nt of homose xual orie ntation. It was hypothe sized that HT men would obtain the highe st scores on tests of spatial ability. HT women and gay men were expe cted to outpe rform the HT men on the le xical-de cision task. Finally ‚ base d on psychose xual differentiation the ory‚ le sbians were pre dicted to produce more male -typical spatial and verbal score s— though this prediction is at odds with the limite d e xpe rime ntal data available on lesbians ’ performance .

METHOD Su bjects Hete rosexual men (20) and women (20) were primarily volunte er unde rgraduate and graduate stude nts solicite d through unive rsity bulle tin board notice s and word of mouth. Gay men (20) and le sbians (20) were solicite d through bulle tin board notice s poste d at unive rsity homophilic organizations ‚ ele ctronic bulle tin board notice s‚ a unive rsity booth at the local annual Gay Pride fe stival ‚ and word of mouth. Six of the unde rgraduate subje cts participate d in orde r to receive course credit. Due to limite d research funds only a subse t of the recruitment media adve rtise d an hono-

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Table I. Group Me ans (Standard Deviations) of Participant Characte risticsa Group

SOS

Age

Education

Le sbians

5.7 (0.14)

32.6 (7.1)

17.8 (2.7)

HT women

1.3 (0.09)

24.5 (5.4)

16.4 (3.1)

Gay men

6.2 (0.14)

32.2 (4.9)

16.5 (1.3)

HT men

1.3 (0.10)

25.6 (6.4)

16.1 (3.0)

a

S O S ¯ S e xu a l O r i e n t a t i o n S c a l e ( r a n g e 1 ¯ 7 ) ; H T ¯ heterose xual. Main effect of Sexual Orientation for Age; F(1 ‚ 76) = 30 ‚ p < 0.01. n = 20 in each group.

rarium of $10 for participation. Subje cts recruited through those media (10 HT and 17 HM) re ceived the $10. O thers participate d without mone tary compe nsation. Participants were not se lected base d on ethnicity; howe ve r‚ only native -English spe akers were invite d to participate . The sample was primarily Caucasian. Subje cts were informe d that the y would be participating in a re search proje ct examining how the left brain and the right brain proce ss ve rbal and spatial inform ation. The re se arch hypothe se s to be te ste d were not reve ale d. Informed conse nt was obtaine d from all subje cts afte r the e xpe rime ntal procedure had bee n explaine d. Subje ct variable s are describe d in Table I. Measures Subject Variables Handedn ess Questionn aire. Hande dne ss was assessed using a 14-ite m hand-pre ference questionnaire adapte d from O ldfie ld (1971) that include d items to asse ss familial sinistrality. Ite ms include d unimanual skills (throwing a ball ‚ using an erase r‚ e nte ring numbe rs on a calculator ‚ brushing te eth ‚ cutting with scissors‚ hammering a nail) and bimanual skills (thre ading a nee dle ‚ dealing cards ‚ stirring contents of bowl ‚ washing dishe s).4 Nine participants were exclude d from this sample because the y indicate d non-righthande d preference for more than one of the items. Sexual Orientation Scale. Se xual orie ntation was assessed by a Sexual O rientation Scale (SO S) adapte d from Kle in et al. (1985) . Participants rated the mse lve s on a Kinse y-type scale (1 ¯7) for Se xual Attraction ‚ Se xual 4

Two items showed gre ater variability/lower consistency suggestive of decreased reliability in assessing hande dness and were thus not used (threading a nee dle ‚ de aling cards).

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Thoughts and Fantasie s‚ Sexual Be havior ‚ and Se xual Identity. Participants were include d in the HT group if they had ave rage d scores of either 1 or 2 on the SO S and in the HM group if the y had ave rage d scores from 5 to 7. Six participants scoring in the bise xual range ( 3¯4) were exclude d from this sample . Paper-and-Penc il Tests Water Level Task. Subje cts comple te d a pape r-and-pe ncil ve rsion of the Wate r Le ve l Task (WLT). Subje cts were tested using a 8 1 /2 inch ´ 5 1/2 inch WLT bookle t in which each page containe d a line drawing of a bottle . O n the front cover the bottle was vertical and a horizontal line representing the wate r le ve l indicate d that the bottle was about one -half full. Subje cts use d a straight e dge rule r and pe n to draw in the wate r line in the subseque ntly presented bottle s. The y were give n unlimite d time to comple te the task and were aske d not to use the ruler measure ment markings to calculate volume . The WLT bookle t was compose d of 20 bottle drawings tilte d 15 ‚ 30‚ 55 ‚ 70 ‚ or 85 ° to the left or right. Each of the 10 line drawings was pre se nte d twice . The orde r of the bottle s was randomize d in e ach bookle t. Each of the 20 e stimate s was scored on a pass/fail basis. An “ e rror” was recorded if the subje ct’s e stimate dive rged more the 3 ° from the correct horizontal line . Subje ct total score s are e xpre sse d as the numbe r of errors out of 20. Mental Rotation. Subje cts comple ted a pape r-and-pe ncil version of the Vande nbe rg and Kuse 3-D Mental Rotation (V -K MR) te st ( 1978) . The V-K MR Test containe d 20 items in five se ts of four ite ms. Each ite m consiste d of a crite rion figure ‚ two corre ct alte rnative s‚ and two incorre ct one s or “ distracte rs.” Corre ct alte rnative s were always ide ntical to the crite rion in structure but were shown in a rotate d position. The te st was administe red in two 3-min se ctions of 10 ite ms e ach. Com pu terized Tasks Mental Rotation . Subje cts were prese nte d with pairs of 3-D figure s take n dire ctly from the V-K MR test (1978) . By pressing a button in their le ft hand ‚ subje cts trigge re d the be ginning of e ach trial bringing a pair of 3-D figure s onto the screen. Half of the pairs were mirror-re ve rse d image s of one anothe r and half were identical. Rotation conditions were such that 20% of the items were not rotate d from one anothe r ( 0° rotations) ‚ 40% of the ite ms were rotate d e ithe r 60° or 100 ° from one anothe r (small rotations) ‚ and 40% of the items were rotate d either 140 ° or 180 ° from one

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anothe r (large rotations) . Participants comple te d two runs with 50 randomly presented pairs pe r run. The pair of figure s was cente re d and subte nde d 6.8 ° of visual angle to the le ft and right of cente r. The figure s were pre se nte d for 4000 msec. The ir disappe arance was followe d by 2000 msec of blank screen. The e nd of the trial was marke d by the pre sentation of an audio stimulus (an audible click pre se nte d from a spe aker situation behind the occlusion scree n). Subje cts were instructe d to pre ss the button in the ir right hand if they believe d the two figure s to be ide ntical in structure but pe rhaps shown in a rotate d position. No response was require d if the figure s did not match one anothe r regardle ss of their rotation. Subje cts had 6000 msec to re spond which corre sponde d to the appe arance of the figure s until the prese ntation of the end-of-trial click. Lexical-Decision /Sem an tic Mon itoring. Participants comple ted a le xicaldecision/se mantic monitoring (LD/SM) task. Stimuli consiste d of a set of ‘‘pseudowords ’’ and “ re al words.” Pse udowords were pronounce able nonwords created by combining two re al English words (e.g.‚ book + lick = blick) . The re al words were divide d into two groups. Half of the real words belonge d to one of thre e se mantic categorie s‚ animals ‚ fruits ‚ and ve getable s (Se mantic words) while half did not (control words) . Control words and semantic words were matched on freque ncy and le ngth. The ave rage word fre que ncy ac ross all words was 10.5 9 ( Kuc e ra an d Fran cis ‚ 196 7) . Pseudowords were matche d to the re al words on length. Throughout the LD/SM task‚ subje cts maintaine d fixation on a central point on the scree n. The words were presented randomly for 175 msec either to the right or to the left of the fixation point ‚ and on a leve l with it; the intertrial inte rval varie d be tween 1450 and 1550 msec. The maximal visual angle for the most late ral le tters of the words was 2.5 °. Subje cts pressed a button held in their righ t han d whe n e ve r th e y de t e c te d a ps e udoword on th e sc re e n . Pseudowords appe ared 33% of the time . No response was require d for the semantic or control words (each at 33.5% probability). Depe nde nt measure s of interest for the LD/SM task include d “ Pse udoword Hits‚” i.e.‚ correct pse udoword identifications ‚ and “ Semantic False Alarms‚” i.e .‚ pressing the button to a semantic word. Subje cts comple te d four 50-word blocks. Subje cts were informe d of the se mantic category before each block.

Data Analysis All analyse s we re conduc te d using BMDP386 Dynam ic program s (Dixon ‚ 1988). O ne- and two-way ANOV As were performed using program 7D and all repe ated measure s analyse s of variance were pe rforme d using program 2V . Whe n the sphe ricity test produce d epsilon value s le ss than

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.90 ‚ probability value s were corrected using the Greenhouse Geisse r procedure. A poste riori comparisons were performed using Neuman Keul’s Stude ntized Range Te st ( a = .05). RESULTS Table II contains means score s and standard deviations for the verbal and spatial tasks of the four groups. Table III lists the e ffect sizes for diffe re nce s be tween HT men and HT wome n ‚ le sbians and HT wome n ‚ gay men and HT men ‚ and men and wome n overall. An ove rview of the group differences on the de pe nde nt measure s are displaye d in Fig. 1. Su bject Variables The HT men ‚ HT wome n ‚ gay men ‚ and le sbians participating were right-hande d ‚ betwee n the age s of 18 and 41 and matched on ye ars of e ducation. Though e fforts were made to match participants on rele vant subje ct

Fig. 1. O verview of the cognitive differences be tween HT men and women as well as the pre valence of se x-atypical performance see n in gay men and lesbians. Table III provides effe cts size s of these differe nce s.

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Table II. Group Means ( ± Standard Deviations) for Depe ndent V ariables Measures Paper & Pencil Mental rotation WLT Computerized MR hits MR RTs Pseudoword hits Semantic FAs

Lesbians 16.1 ± 6.76 7.5 ± 7.47

3.0 4023.0 29.2 1.2

± ± ± ±

1.1 463 1.9 .419

HT women 13.8 ± 8.04 8.9 ± 7.65

2.9 3966.6 27.0 .9

± ± ± ±

1.1 432 3.3 .241

Gay men

HT men

13.5 ± 8.02 4.7 ± 5.70

19.1 ± 7.75 4.1 ± 5.36

2.8 4020.3 27.2 1.4

± ± ± ±

0.9 542 2.6 .449

3.4 3891.1 25.6 2.2

± ± ± ±

1.0 427 3.6 .488

Table III. Effe ct Sizes for Depe ndent V ariablesa

Me asure s

All subjects Me n vs. women

Women Lesbian vs. HTW

Paper & Pencil Mental rotation WLT

0.18 0.58

0.3 0.17

0.15 0.08 ¯0.61 ¯0.51

¯ 0.13 0.84 ¯ 0.19

Computerized Adjusted MR hits MR RTs Pseudoword hits Semantic FAs

0.06

Men He terosexuals Gay men vs. HTM HTM vs. HTW

¯ 0.71 ¯ 0.12 ¯ 0.67 ¯ 0.27 0.52 0.48

0.67 0.74

0.49 0.17 ¯ 0.42 ¯ 0.91

a

Positive value s indicate that the first group listed performed be tter (more correct responses or fewer errors) on the depe ndent measure.

variable s (hande dne ss‚ age ‚ and education) ‚ difficulty with recruitment (especially with the lesbian group) did not allow pe rfect matching. A Se x ´ Sexual O rie ntation ANOVA on Age reve ale d that homose xual participants were significantly olde r than the he te rosexuals (Table I). The possibility that Age contribute d to effe cts of Sexual Orie ntation was tested by regre ssing Age on the depende nt cognitive measure s across all groups. In no case was Age a significant predictor of performance ‚ thus arguing against its influe nce on the re sults. Other work has also re porte d that age e ffects do not account for diffe re nce s betwee n heterose xual and homose xual individuals (Gladue and Baile y‚ 1995) . Furthe r‚ motivational factors may have diffe red betwee n participants who received mone tary compe nsation or course credit and those who volunte e red. ANOV As comparing compe nsate d vs. uncompe nsate d participants on the depende nt cognitive measure s re ve aled

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no significant e ffects. It was conclude d that compe nsation did not significantly influe nce performance . Pap er-an d-Pencil Tests Water Level Task An ANOV A on the numbe r of errors on the WLT re ve aled a main effe ct of Se x: F(1 ‚ 75) = 6.52 ‚ p < 0.05. Both groups of men had fe wer errors compare d to wome n. No e ffects of or interactions with Sexual O rientation were obse rve d.

Mental Rotation An interaction be tween Se x and Se xual Orie ntation ‚ F(1 ‚ 76) = 5.18 ‚ p < 0.05 ‚ on the V-K MR test reveale d that HT men tende d to outscore the HT women and gay men. Lesbians scored in be tween the two groups and did not differ significantly from e ithe r. Com puterized Tasks Mental Rotation A Se x ´ Se xual O rie ntation ´ Rotation (0 ‚ small ‚ large ) re pe ate dmeasure s ANOV A on adjuste d hits (correct hits minus false alarm s at e ach rotation) produce d a main e ffect of Rotation ‚ F(2 ‚ 144) = 98.01 ‚ p < 0.0001. As predicte d ‚ more corre ct hits and fe wer false alarms were made to the nonrotate d ite ms compare d to the rotate d ite ms (p < 0.05) . The two leve ls of rotation (small vs. large ) did not diffe r significantly from e ach othe r. A Rotation ´ Sexual O rientation inte raction ‚ F(2‚ 144) = 6.93 ‚ p < 0.01 ‚ reveale d that while HT and gay participants did not diffe r on the unrotate d items or items with small rotations ‚ the HT subje cts tende d to perform bette r on ite ms with large rotations. By e xamining the overriding Rotation ´ Se x ´ Sexual O rie ntation inte raction shown in Fig. 2‚ it is appare nt that the significant Rotation ´ Se xual O rientation interaction is due mainly to diffe re nce s betwee n gay and straight men at the large rotations _ (x = 1.80 vs. 2.86) . Both groups of wome n pe rforme d similarly at all rotations. The anticipate d Sex ´ Se xual O rientation interaction obtaine d in the pape r-and-pe ncil version of the MR task did not reach significance

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Fig. 2. Illustration demonstrating that the Rotation ´ Sexual Orientation interactions derives primarily from the diffe re nce be twe e n gay an d H T m e an to rotate d item s. Women performe d similarly across all rotate d items.

(F = 2.17). None the less‚ the group means were ide ntically orde red ‚ sugge sting re lative consiste ncy be tween the two tests. A Se x ´ Se xual O rie ntation ´ Rotation (0‚ small ‚ large ) repeate d-me asure s ANOVA on targe t re action time s (RTs) re vealed a main effe ct of Rotation ‚ F(2 ‚ 146) = 359.34 ‚ p < 0.0001. Participants responde d faste r to unrotate d ite ms compare d to rotate d ite ms. As with Adjuste d Hits‚ a Rotation ´ Sexual Orie ntation inte raction was obtaine d for RTs‚ F(2 ‚ 146) = 4.07 ‚ p < 0.05. HT subje cts tende d to respond more quickly to unrotate d items and ite ms with small rotations. HM subje cts te nde d to re spond faster to ite ms with large rotations. HM subje cts demonstrate d a speed-accuracy trade -off at large rotations —pe rforming faste r ye t le ss accurate ly. Lexical-Decision /Sem antic Monitoring A Se x ´ Se xual O rie ntation re pe ated-me asure s ANOV A on correct button presses to pseudowords re ve aled main e ffects of Sex and Sexual O rientation. Women corre ctly ide ntifie d more pse udowords than men ‚ F(1 ‚

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74) = 7.4 ‚ p < 0.01 ‚ and gay and lesbian participants corre ctly identifie d more pse udowords than the HT men and women ‚ F(1 ‚ 74) = 7.6 ‚ p < 0.01. Pre vious re search on sex and sexual orientation differences in language processing sugge sts that group differences on the LD/SM task also emerge in reaction to semantic words but not to control words. Give n women ’s supe rior ve rbal flue ncy skills ‚ they were pre dicte d to commit fewer false alarms to semantic words than men. And‚ if gay men’s se mantic verbal abilitie s are more fe male-typical ‚ then the y should commit fewer false alarms than the HT men. To te st the se pre dictions a Se x ´ Sexual O rie ntation ANOVA was conducte d on se mantic false alarms. A main effe ct of Se x was reve ale d. As pre dicte d ‚ wome n committed fe wer false alarms than men ‚ F( 1‚ 73) = 4.76 ‚ p < 0.05. The interaction of Sex ´ Se xual Orie ntation did not reach significance in this analysis ‚ sugge sting that gay men ’s semantic proce ssing did not diffe r significantly from those of the HT men ‚ though a tre nd for a cross-se x shift was evide nt. Le sbians did not show a cross-sex shift but instead pe rforme d like the HT wome n.

DISCUSSION The re sults of this study re plicate a large body of data showing supe rior me ntal rotation and spatial pe rception abilitie s in HT men compare d to HT wome n (Linn and Pe te rse n ‚ 1985; Maste rs and Sande rs‚ 1993) ‚ and supe rior le xical-de cision ability in HT wome n compare d to HT me n (Bole s‚ 1984) . The y also partially re plicate e arlie r ne uropsychologic re ports showing that the cognitive patte rns of gay men diffe r from those of HT me n but do not e xactly paralle l those of HT wome n (Gladue et al. ‚ 1990; Hall and Kimura; 1993; McCormick and Wite lson ‚ 1991; Sande rs and Ross-Fie ld ‚ 1986; Tkachuck and Z ucke r‚ 1991) . The re sults contrast studie s re porting no diffe re nce s be twe e n gay me n and HT me n (Baile y and Z ucke r‚ 1995; Tuttle and Pillard ‚ 1991) . Furthe r‚ the se re sult are consiste nt with prior studie s showing that the cognitive patte rns of le sbians te nd not to diffe r from those of HT wome n (Gladue and Baile y‚ 1995; Gladue et al. ‚ 1990; Tkachuck and Z ucke r‚ 1991; Tuttle and Pillard ‚ 1991) . The applicability of psychose xual diffe rentiation theory to the homosexual data is re liant on significant se x difference s be tween HT men and wome n. Results re ve al sexually dimorphic pe rformance on all of the e xperime ntal tasks except on the compute rize d version of the MR task. As shown in Table III‚ effe ct size s range from medium to large according to Cohen ’s standardize d guide line s (1987). Though the means on the com-

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pute rize d ve rsion of the MR task were orde re d as expe cted ‚ the differences did not reach significance . This re sult was une xpe cted give n the sex difference s re porte d on the pape r-and-pe ncil version of the MR task and give n results from othe r studie s reporting se x difference s in MR ability (Linn and Pe te rse n ‚ 1985; Maccoby and Jacklin ‚ 1974; Maste rs and Sande rs ‚ 1993) . However‚ the se null e ffects are like ly explaine d by the fixe d time inte rval used on the MR ERP task. Give n that MR sex diffe re nce s are manife st in spee d and not accuracy (Kail et al. ‚ 1979; Pick ‚ 1988) it follows that equating the allotte d time across groups might diminish the group diffe re nce . Still one might predict differences in RTs on the compute rized task. However‚ after subje cts estimated the amount of time allotte d for each re sponse ‚ they may have maximize d the time that the y used during that period to ve rify the ir re sponse s since “ spe eded response ” was not emphasize d in the task instructions. RTs to small and large rotations did not significantly diffe r from each othe r‚ providing furthe r support of this hypothe sis. None the less‚ significant se x differences betwee n HT men and women on the othe r spatial and verbal measure s provide a framework by which to e valuate the pe rvasive ness of se x atypicality in the pe rformance of the le sbians and gay men ‚ and correspondingly ‚ the applicability of the theory of psychose xual diffe rentiation to the se neuropsychologic data. O ve r all the te sts‚ gay men primarily scored in a fe male -direction compare d to HT men and lesbians score d in a male-dire ction compare d to HT women. Though the se trends are not all significant ‚ the consiste ncy by which they occurred is note worthy. A composite of se x typical and sex-atypicality abilitie s was reveale d in gay men ’s ve rbal and spatial measure s. For the MR task‚ gay men performed ide ntically to HT wome n —both groups being outpe rformed by HT men. Two othe r studie s using a 3-D MR task have reporte d a similar diffe re nce betwee n HT men and gay men (Gladue et al. ‚ 1990; Tkachuck and Z ucke r‚ 1991) while one study faile d to find a diffe re nce (Gladue and Baile y‚ 1995) . The diffe re nce in effe ct sizes betwee n studie s showing intrase x diffe rence s and the Gladue and Baile y study not showing a diffe rence is quite striking (d = 0.86 vs. d = 0.05) . This discrepancy is furthe r complicate d by the fact that all four studie s use d the same standardize d V-K MR test. This disparity may be accounte d for by diffe rent methods used in administe ring the MR test. Spe cifically‚ only Gladue and Baile y ( 1995) gave subje cts 10 min to comple te the 20 test ite ms‚ while the othe rs maintaine d a 6-min time limit. Given that diffe re nce s in MR ability are manife st in spee d and not accuracy‚ the extra 4 min in the Gladue and Baile y study may have be en sufficie nt to eliminate the group diffe re nce s. Note ‚ though ‚ that the y did report sex diffe re nce s betwee n HT men and wome n using

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the 10-min method. Howe ve r‚ psychose xual diffe rentiation theory would pre dict that the intrase x difference would be more subtle than the inte rse x difference ‚ as is se emingly the case he re. That is‚ reduce d pre natal androge n exposure doe s not re sult in a comple tely feminize d neural substrate in gay men ‚ simply a shift in that dire ction. In sum ‚ it see ms that differences betwee n gay men and HT men on MR ability do e xist‚ but that the diffe re nce s are more subtle than differences re porte d be tween HT men and wome n. Sex-atypical pe rformance was also see n in gay men ’s le xical-de cision ability. This is the first study to e xamine le xical-de cision ability in homosexual sample s; however‚ tre nds towards female-typical patte rns in gay men have be e n re porte d using othe r ve rbal me asure s‚ e .g. ‚ ve rbal flue ncy (McCormick and Witelson ‚ 1991; Gladue et al.‚ 1990) . Sex-typical performance in gay men was reve ale d on the spatial perception te st (WLT). Prior studie s examining WLT ability in gay men have yielde d mixe d re sults; though most indicate a more fe male -typical patte rn in gay men (Gladue et al. ‚ 1990; McCormick and Witelson ‚ 1991; Sande rs and Ross-Fie ld ‚ 1986) some show a male -typical patte rn (Gladue and Baile y‚ 1995; Tkachuck and Zucker‚ 1991) . Differences in te st administration and te st scoring did not account for the se discrepancie s (Wege sin ‚ 1995) . Howe ver‚ within group variance on the WLT is ofte n large and may play a role in the inconsiste nt re sults re porte d thus far. Se x atypicality in le sbians ’ pe rformance was much less pervasive than that see n in gay men. A nonsignificant tre nd towards male-typical pe rformance was re vealed in measure s of MR ability. The majority of measure s‚ including those of spatial pe rception and ve rbal ability ‚ indicate d that lesbians pe rforme d more like HT wome n than HT men. These re sults do not support the prenatal hormone and psychose xual diffe re ntiation theories of homose xual developme nt ‚ but are consiste nt with earlie r work which include d lesbian participants (Gladue and Baile y‚ 1995; Gladue et al.‚ 1990; Tkachuck and Zucker‚ 1991; Tuttle and Pillard ‚ 1991). Two e xplanations may account for the dissociation in se x-atypical be havior se en betwe e n le sbians and gay men. First ‚ a lack of male -typical pe rformance in le sbians may be due in part to variability of hormone le vels in adulthood. “ Activating ” effe cts of se x hormone s have be en shown to influe nce adult cognitive pe rformance . Androge n tre atment in fe male-tomale transse xuals is associate d with an incre ase in spatial pe rformance and a de crease in ve rbal flue ncy‚ while androge n deprivation and e stroge n treatme nt in male -to-fe male transse xuals is associate d with de crease d spatial ability and incre ased ve rbal flue ncy (V an Gooze n et al.‚ 1995) . Fluctuations of hormone s during the menstrual cycle may have impacte d upon

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their cognitive performance . Estroge n ‚ lute inizing hormone ‚ and follicle stimulating hormone (FSH) have be en shown to facilitate pe rformance on tasks on which wome n typically e xce l and impe de pe rformance on tasks on which men e xce l (Hampson ‚ 1990) . Give n that menstrual phase was not controlle d in the curre nt study‚ it is possible that diffe rence s betwe e n the female groups in menstrual-cycle phase may have confounde d the de te ction of group diffe re nce s in the ne uropsycholo gic te sts. Subse que nt studie s should colle ct menstrual phase data to safeguard against this potential confound. Alternative ly‚ the dissociation in patte rns of se x atypicality in gay men and le sbians may be re lated to a similar dissociation see n in patte rns of childhood se x atypicality. Gay me n re port (re trospe ctively) significantly highe r rate s of se x atypicality in childhood than do lesbians (Baile y and Zucker‚ 1995) . Additionally ‚ in adulthood gay men show greate r se x atypicality in gende r role identity than do le sbians (Gladue et al.‚ 1990). Thus ‚ it may be that the psychoe ndocrine the ory of psychose xual diffe re ntiation pre se nte d here applie s to a smalle r subse t of le sbians than gay men and that alte rnative mechanisms are more important in the de ve lopme nt of female as oppose d to male se xual orientation. Differe nt de ve lopme ntal pathways for male and female homose xuality have be en sugge ste d in othe r expe rimental re sults. Hame r and colle ague s (Hu et al.‚ 1995) reporte d that a genetic marker associate d with homose xuality in men ‚ Xq28 ‚ was not found in wome n. Highe r concordance rates for homose xual orientation is reporte d in male twins compare d to fe male twins (Whitman et al.‚ 1993; Baile y et al.‚ 1993) . Sexual orientation se ems to be less dichotomous in wome n. For example ‚ in nonhe terose xual samples‚ women score more in the bise xual range compare d to men (Baile y‚ 1995) . Furthe r‚ a recent study sugge sted that female sexual orie ntation doe s not correspond to sexual arousal ‚ i.e .‚ no differences betwee n HT women and lesbians were reveale d in their physiological response s to scene s of heterose xual se x and le sbian sex (Laan ‚ 1995) . Finally‚ opinion surve ys of gay men and le sbians also show marked diffe re nce s. Me n almost always report that they were “ born gay‚” while wome n ’s response s are more diverse (Le ver‚ 1994 ‚ 1995) . This body of data along with the curre nt re sults sugge st that the de ve lopme ntal mechanisms unde rlying a homose xual orientation may diffe r betwee n le sbians and gay men. In conclusion ‚ give n the relative ly de crease d prevale nce of se x atypicality in le sbians compare d to gay men — both in the ir childhood historie s and in the ir adult ne uropsychologic profile —the psychose xual diffe rentiation the ory se ems more applicable to the de ve lopme nt of homose xuality in men compare d to wome n.

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ACKNOWLEDGMENTS The work is base d on the doctoral disse rtation of D. J. Wegesin while an Eva O. Mille r Fellow at the Unive rsity of Minne sota. I grate fully acknowle dge my re se arch advisor ‚ Dr. Charle s A. Nelson ‚ for his support ‚ unde rgraduate research assistants ‚ Kelly Christie nsen ‚ Elena Z ubalake ‚ Bob McDonald ‚ Lisa Marescalco ‚ and Isabe lle Rosso for their labors ‚ Dr. Heino Me ye r-Bahlburg for his comments on earlie r drafts of this manuscript ‚ and ‚ finally ‚ the subje cts for their participation.

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Piage t‚ J.‚ and Inhelde r‚ B. (1956) . The child ’s conception of space. Ne w York: Humanities Pre ss. Pick‚ A. (1988) . Sex differences in cognitive abilities: An ecological approach. Paper prese nted at American Association for the Advancement of Science ‚ Boston ‚ MA. Re inisch‚ J.‚ and Sanders ‚ S. (1992) . Prenatal hormonal contributions to sex differences in human cognitive and personality developme nt. Handbook Behav. Neurobiol. 11: 221-244. Re inisch‚ J. ‚ Z iemba-Davis ‚ M.‚ and Sande rs ‚ S. ( 1991) . Hormonal contributions to sexually dimorphic behavioral deve lopment in humans. Psychoneuroendoc rinology 16: 213-278. Re ite ‚ M.‚ Shee der ‚ J.‚ Richardson ‚ D.‚ and Teale ‚ P. (1995) . Cerebral laterality in homosexual males: Preliminary communication using magne toence phalography. Arch. Sex. Behav. 24: 585-593. Sande rs ‚ G.‚ and Ross-Field‚ L. (1986) . Sexual orientation and visuo-spatial ability. Brain Cognit. 5: 280-290. Sattler‚ J. M. (1990) . Assessm ent of Children ‚ 3rd ed.‚ Je rome M. Sattler‚ San Diego ‚ CA. Thomas ‚ H. ‚ Jamison ‚ W .‚ an d Hu mme l ‚ D. D. ( 1973) . O bse rvation is insufficie nt for discovering that the surface of still water is invariantly horizontal. Science 181: 173-174. Tkachuck ‚ J.‚ and Z ucker ‚ K. J. (1991). The relation among sexual orientation‚ spatial ability‚ hande dness‚ and recalled childhood gender identity in women and me n. Poster prese nted at the International Academy of Sex Research ‚ Barrie ‚ Ontario‚ Canada. Tuttle ‚ G. ‚ and Pillard R. (1991) . Se xual orientation and cognitive abilities. Arch. Sex. Behav. 20: 307-318. V ande nbe rg ‚ S. G. ‚ and Kuse ‚ A. R. ( 1978) . Me ntal rotations‚ a group te st of three dimensional spatial visualization. Percept. Motor Skills 47: 599-604. Van Gooze n‚ S. H. M.‚ Cohen‚ Kettenis ‚ P. T.‚ Gooren ‚ L. J. G.‚ Frijda ‚ N. H. ‚ and Van de Poll ‚ N. E . ( 1995) . Ge nde r differe nce s in be havior: Activating e ffects of cross-se x hormones. Psychoendocrin ology 20: 343-363. Wegesin ‚ D. J. (1995). Functional verbal asymmetries and spatial ability in heterosexual and homose xual me n and wome n: E vide nce from e ve nt-relate d potentials. Unpublishe d dissertation ‚ University of Minnesota. Whitam ‚ F. L.‚ Diamond ‚ M.‚ and Martin ‚ J. (1993) . Homosexual orientation in twins: A report on 61 pairs and three triplet sets. Arch. Sex. Behav. 22: 187-206.

Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 1‚ 1998

BOOK REVIEWS Child ren of Ch oice: Freedom an d the New Reprodu ctive Techn ologies. By Joh n A. Robertson. Prince ton Unive rsity Press‚ Prince ton ‚ New Jersey‚ 1994 ‚ 281 pp.‚ $29.95. Reviewed by Fiona L. Tasker‚ Ph.D.1

Children of Choice is a well-writte n ‚ thought-provoking book addre ssing a host of concerns within the controve rsial are a of re productive te chnology. It is ambitious in scope ‚ cove ring the main technological advance s‚ and conseque nt e thical conside rations ‚ in both the pre vention of pre gnancy and the facilitation of fe rtility. Chapte rs 3 and 4 are devote d to abortion ‚ contrage stive drugs ‚ and long-lasting contrace ptive drugs. Chapte rs 5 and 6 conside r assiste d reproductive technique s for treating infe rtility with in vitro fertilization (IV F) and the use of donate d gametes to overcome infe rtility. Chapte rs 7 and 8 conside r the implications of genetic screening and gene tic manipulation. O ne of the book’s strengths is also the conside ration of e thical issues across chapte rs with re gard to whe ther legal inte rvention is justifie d. The subtitle of the book ‚ in fact ‚ should be “ Procreative Liberty.” Procreative libe rty is the principle de fine d by Robertson to asse ss the le gal and ethical issue s raised by technological advance s in reproduction. Procreative libe rty is de fine d as the fre edom to de cide whe the r or not to have offspring. Chapte r 2 is devote d to e xpounding the principle as a fundamental human right. In e sse nce ‚ to deny someone the choice whether to reproduce or not ‚ is to de ny them a crucial se lf-defining de cision. Procre ative libe rty has bee n long e stablishe d as a basic moral and legal value when conception and pre gnancy occur through coitus. Furthe rmore ‚ the right to separate sex from reproduction is widely acce pted in free dom of access to

Departme nt of Psychology‚ Birkbe ck College ‚ Unive rsity of London‚ Male t Street ‚ London WC1E 7HX England.

1

109 0004-0002/98/0200-0109$15.00/0

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1998 Plenum Publishing Corporation

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contrace ption. Robe rtson ’s cogent argume nt is that re spe ct for procreative libe rty should be no diffe re nt if re production is facilitate d by artificial means. Robe rtson conside rs the main e thical argum ents levie d at the rapid e xpansion of reproductive te chnology: inte rfe re nce with nature ‚ re spect for pre natal life ‚ welfare of offspring ‚ impact on the traditional family‚ effe cts on wome n ‚ costs ‚ acce ss‚ and consume r prote ction. Whe n conside ring the e thics of maternal and pate rnal conduct that may unre asonably harm offspring ‚ or gene tic manipulation ‚ Robe rtson de e ms that pre natal welfare inte re sts are paramount and there fore justify appropriate legal prote ction. Howe ve r‚ in the main ‚ he conside rs that the se obje ctions fail to justify gove rnme ntal re striction of contrage stive age nts and long-lasting contrace ption ‚ IV F‚ the use of donate d gam e te s‚ and surrogac y. Individual s should be fre e to de cide for themselve s whe the r or not to se ek assiste d re production ‚ without le gal restriction. Robertson is not in favor of le gislation to coe rce wome n into using contrace ption or te rminating pre gnancie s whate ve r the circumstances. For e xample ‚ in chapte r 4 he conclude s that: Unle ss voluntarily chose n . . . the use of Norplant or other contrace ptives can rarely be justified as a solution to problems of allegedly irresponsible reproduction. Its most defensible application is with se verely retarded females who are at risk of se xual exploitation or rape. In other situations . . . its intrusiveness and effe ct on procreation make it highly suspect. Child abuse rs ‚ HIV wome n‚ welfare mothers ‚ and tee nage rs have interests in procre ation or bodily integrity which mandatory use of Norplant violate s. Ne ither protection of future offspring nor conse rvation of public funds are compe lling enough reasons to justify intrusions on such basic rights. (p. 93)

In Robertson ’s vie w‚ procre ative libe rty is essentially an individual matte r. From this premise ‚ he laudably de ve lops the argume nt that unmarrie d couple s have the same rights to re productive choice as married couple s and furthe r e xte nds this to single he te rosexuals and to lesbians and gays. Howe ver‚ the central proble m with procreative choice as a practical principle is: Whose choice should pre vail whe n the interests of the partie s involve d conflict? To this ‚ Robertson is unable to provide an easy answe r. In the argume nts raging ove r abortion and use of contrage stive drugs ‚ should the mothe r’s choice pre vail ove r the fathe r’s and when should the fe tus ’s rights be conside red in the de cision? Robe rtson argue s that the re is a strong moral and legal basis for supporting a woman ’s choice to avoid unwante d re production. However‚ he provide s no clear answe r as to when the fe tus ’s inte rests also nee d to be conside red. Robertson optimistically hope s that the ne w contrage stive technologie s‚ which enable e arly termination before the embryo has implante d in the ute rus ‚ will mean that termination will be possible before many (but not all) would conside r the

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pote ntial offspring ’s stake . O bviously ‚ some women will bene fit from be ing able to choose to use contrage stive drugs ‚ such as RU486. Howe ver‚ the re will always be othe rs who do not obtain access to contrage stive age nts but who have to te rminate a pregnancy at a late r stage (e .g.‚ those who are initially ambivale nt towards their pre gnancy be cause of its accide ntal nature ‚ their social or e conomic situation ‚ or because they await the re sults of later pre natal scree ning) . Younge r wome n ‚ the le ss well educate d ‚ the le ss afflue nt‚ and those marginalize d in socie ty always have bee n less like ly to obtain acce ss to e arly abortions (Richardson ‚ 1993) . Contrage stive technology ‚ the re fore ‚ will be unlike ly to re duce the ne ed of many wome n for late r abortions. The issue of whose procre ative choice dese rve s to be prioritize d is also at the cente r of the debate in chapte r 6 over collaborative re production. Do those with a ge ne tic stake in the fetus (e.g.‚ sperm or egg donors) have the same procreative rights as the social pare nts? The issue is at its most complicate d in case s of dispute ove r the pare ntage of a child from a surrogate mothe r whe re the interests of the birth mothe r‚ who may also be ge ne tically re late d to the child ‚ could conflict with the inte re sts of the social mother and the child ’s fathe r. Here ‚ Robe rtson recommends that preconception contracts be e nforced ‚ unle ss they have not bee n free ly ente red into or the re alization of the contract endange rs the welfare of the child. My main criticism of the book is that Robertson large ly ne gle cts the socioe conomic context that ope rates to constrain free choice in reproduction. If the evaluation of procre ative choice is the most e thical way of making de cisions about ne w reproductive te chnologie s‚ then those involve d should have the right to make that choice irrespective of whether the y have the financial re sources to buy it. For e xample ‚ as Robertson acknowle dge s‚ the chance s of having a child after one cycle of IV F are le ss than 20% and vary conside rably de pe nding upon the nature of the proble m ‚ the woman ’s age ‚ and the clinic attende d (Human Fertilisation and Embryology Authority ‚ 1994) . O n the othe r hand ‚ the cost of tre atme nt is betwe en $5‚000 ¯7‚000 per cycle ‚ with often two or thre e cycles trie d be fore pre gnancy is achie ved or the tre atment program dee med unsucce ssful. Without effe ctive public funding of fertility tre atment ‚ IV F is an option only ope n to those able to afford to make that choice . Robe rtson howe ve r draws back from this conclusion: a rights approach to reproductive technology is not an imprimatur on all uses of that technology. It does not require that the state subsidize or otherwise encourage the use of all re productive te chniques ‚ and provide s no immunity from moral condemnation ‚ pe rsuasion ‚ or noncoercive instruction in how that technology should be use d. Thus not all forms of collaborative reproduction need be subsidized‚ eve n if health insurance should or doe s cover some infertility tre atment. (p. 234)

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Robertson is arguably succe ssful in establishing the right of the individual (or couple ) to make reproductive choice s. Howe ve r‚ he doe s not aim to he lp them make that choice ‚ or come to terms with the issues when the ir choice is not re alize d. The book is not aime d at counse lors working in fe rtility or family-planning clinics. The book ‚ however‚ doe s provide a rigorous re view of the curre nt le gal situation across the Unite d State s‚ although the conte xt of ne w re productive technologie s else where is le ss well cove red. The refore ‚ it will be especially valuable for re ade rs interested in le gal and medical ethics.

REFERENCES Human Fertilisation and Embryology Authority. ( 1994) . Annual Report‚ HFEA ‚ London. Richardson ‚ D. ( 1993) . Wom en ‚ Motherh ood an d Ch ildrearin g‚ Macmillan ‚ Basingstoke ‚ England.

Sexu al Precocity: Etiology ‚ Diagn osis ‚ an d Man agem en t. Edited by G . D. G rave an d G . B. Cutler. Raven Press‚ New York‚ 1993 ‚ 300 pp.‚ $93.50. Reviewed by Susana P. Cam pos ‚ M.D.‚2 and David E. Sandberg ‚ Ph.D.3‚4

Advance s in the unde rstanding of the neuroendocrine control of pube rtal maturation and reproduction by gonadotropin-re le asing hormone have e xplode d in the last two de cade s. This volume is the compilation of clinical and laboratory inve stigations of 79 internationally recognize d scientists on pre cocious sexual maturation pre se nte d at a confe re nce sponsore d by the National Institute of Child Health and Human Deve lopme nt in October 1990. The text is divide d into three se ctions: Central Pre cocious Pube rty‚ Gonadotropin-Ind e pe nde nt Se xual Pre cocity‚ and Gonadal Control Mechanisms. Individual chapte rs provide background information ‚ study methods ‚ results ‚ a discussion ‚ and summary. Unfortunate ly‚ there is a good deal of redundancy on the normal physiology of pube rtal maturation ‚ definition of sexual precocity‚ and goals of the rapy‚ which are include d re pe atedly in the introduction of seve ral chapte rs; however‚ this means that an individual Center Manilla‚ Philippines. Division of Child & Adolesce nt Psychiatry and Pe diatric Psychiatry‚ Children’s Hospital of Buffalo‚ 219 Bryant Street ‚ Buffalo‚ New York 14222-2099. 4 To whom correspondence should be addre ssed. 2 Medical 3

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inte reste d in a particular topic can obtain a compre hensive tre atment of the subje ct from a single chapte r. Most chapte rs are care fully prepare d ‚ thorough ‚ and authoritative ‚ providing useful information appropriate for both the generalist and the practicing endocrinologist. Pragmatic information about the clinical prese ntation ‚ diagnosis ‚ and medical manage ment of sexual pre cocity is offered. Thought-provoking treatme nt options are presente d ‚ and variable individual re sponse s are made evide nt. Howe ver‚ seve ral of the e xpe rie nce update s ‚ involve ve ry small sample s‚ le ading to que stions about the gene ralizability of the conclusions. Each chapte r is e xte nsive ly re fe re nce d with bibliographic e ntrie s through 1991. This provide s a quick source of primary and fairly curre nt re fe re nce s. The difficult dile mma of whethe r or not to treat a child with either early (but normal) pube rty or pre cocious sexual maturation are addre ssed in chapte rs 2 and 11. The bioche mical characte ristics of the available gonadotropin-re le asing hormone agonists (GnRHa) are discusse d to guide the clinician ’s choice of the age nt that will be st produce comple te pituitary desensitization. Curre ntly‚ optimism re volve s around the therape utic use of GnRHa for re versible suppre ssion of the re productive axis as the se have bee n shown to have few short-te rm side effe cts‚ to effe ctively arrest progression of se condary se xual characte ristics ‚ and to improve adult height pre dictions. Kreiter‚ Cara‚ and Rose nfie ld balance the some times undue optimism with a warning of caution about the pote ntial for indiscriminate use of the rapy (chapte r 11) and they propose criteria on which to base medical inte rvention. Rational de cisions re quire an unde rstanding of the natural history of se xual pre cocity‚ including the e ntire clinical spe ctrum ranging from nonprogre ssive pre mature the larche to rapidly progre ssive sexual pre cocity (chapte r 10) as well as the e fficacy of GnRHa the rapy in modifying the outcome . Modalitie s available for monitoring GnRHa suppre ssive e ffects are numerous. Radiologic (chapte r 16) and laboratory technique s (chapte rs 2 and 15) are clearly shown to be ne cessary to assess bioche mical suppre ssion ‚ as growth param ete rs and physical e xamination findings lack sensitivity ‚ spe cificity‚ and/or pre cision. Usefulne ss of measuring gonadal ste roids is limite d by the assay methods which are gene rally unable to distinguish between truly prepube rtal value s and those indicative of e arly pube rtal developme nt and by the timing of the blood sample . Thus ‚ the use of the GnRHa stimulation test is regarde d as the most stringe nt way to assess suppre ssion. Studie s on adult heights in precocious pube rty after GnRHa the rapy (chapte rs 5 and 6) and analysis of growth data in childre n with central precocious pube rty (chapte r 8) indicate that although GnRHa therapy has a beneficial effe ct on long-te rm growth ove r that se en in untre ated childre n ‚ adult stature is still be low ge ne tic pote ntial. Data re garding

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growth pote ntial and adult heights vary base d on the predictive models use d. The Tanne r-White house mode l‚ the Bayle y-Pinne au table s and calculations of z scores of height base d upon bone age ‚ and the Infancy¯Childhood ¯Pube rty Mode l‚ whose individual validity is difficult to assess‚ can each unique ly influe nce the asse ssment of therape utic benefit. The discussions on gonadotropin-inde pende nt se xual precocity‚ which include testotoxicosis and McCune -Albright syndrome (MAS) ‚ provide an exce llent e xample of the importance of conve rge nce of clinical observations and basic scie nce re search in the unde rstanding of previously elusive conditions. A paracrine te stis-stimulating factor is propose d as the etiologic cause of testotoxicosis (chapte r 21) ‚ and constitutive activation of G s prote in le ading to ove ractivity of the cyclic AMP signalin g pathway and autonom ous ovarian function is shown to be responsible for the MAS phe notype (chapte r 22). The rationale for treatme nt of the se conditions with spironolactone ‚ testolactone ‚ ke toconazole and subse que ntly with GnRHa are very clearly pre se nte d (chapte rs 18‚ 19 ‚ and 23) . Although pre vention of psychosocial maladjustme nt is re pe atedly cited as one of the goals of the rapy in the manage ment of sexual precocity‚ this volume lacks eve n one chapte r devote d to addre ssing psychosocial and psychose xual issue s as de alt with by be havioral clinicians and rese archers and by pe diatric endocrinologists. Chapte r 11 comes close st to unde rtaking this task and chapte r 27 asks questions but doe s not provide answe rs. Reade rs of this journal will be disappointe d to find that the marked advance s in the endocrine manage ment of precocious pube rty have apparently not bee n paralle led by similar progre ss in psychoe ndocrine research. The condition of pre cocious pube rty offers be havioral rese arche rs with unique opportunitie s to addre ss questions pertaining to the influe nce of sex hormone s on a range of be haviors (social and se xual) and neurocognitive function during human developme nt. Unde r normal circumstance s‚ behavior is influe nced by both socialization and pube rtal processe s which are age -de pende nt and occur in synchrony. This situation make s it difficult to assess the unique contribution of e ach set of variable s. In contrast ‚ precocious pube rty represe nts an uncoupling of the two proce sse s to a marked degre e ‚ allowing the rese archer to obse rve the influe nce of sex hormone stimulation in the relative absence of the typical intra- and extrafam ilial socialization patte rns of childre n who progre ss through pube rty within the normal chronological age range . More over‚ the fact that GnRHa can rapidly suppre ss the pituitary¯gonadal axis allows for a comparison of various behaviors of inte re st unde r the influe nce of ste roids and then again subseque nt to suppre ssion of this e ndocrine axis.

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The reade r of this volume may pe rceive a bias that exists among endocrinologists to go to gre at lengths to preserve adult he ight pote ntial. This goal appe ars to be drive n by the implicit assumption that short stature is associate d with significant psychosocial morbidity‚ a belief that may be unfounde d (Sandbe rg et al.‚ 1994) . Conce rns about adult height are appare ntly not counte rbalance d by comparable attention to the timing of pube rty. It is note d that gonadotropin se cretory activity and pube rtal progre ssion represent a broad spectrum: At one end lies the normal state of infre quent activity during e arly childhood and ‚ at the othe r‚ the pre cocious and rapidly progre ssive state of high activity (chapte r 11). Be cause haste ne d pube rtal developme nt is thought to compromise adult he ight pote ntial ‚ a strategy has develope d among some clinicians to e ithe r de lay the onset of pube rty altoge ther or to re tard its progre ssion whe n first evide nt. Reite r and Kulin (chapte r 27) allude to the tre atment option of providing GnRHa to short childre n with normal timing of pube rty which would theore tically allow for a prolonge d pe riod of growth. A combination of growth hormone and GnRHa tre atments have bee n attempte d in such cases. This approach doe s not conside r the possible negative psychosocial and psychose xual se que lae of de laye d pube rty (Mazur and Cloppe r‚ 1991). The clinical state of precocious pube rty and its attendant medical manage ment also provide s clinicians the opportunity to learn more about how the young child pe rceive s the the rape utic inte rve ntion. Give n that the child with precocious pube rty will receive repeate d physical (including ge nital) e xam inations ‚ which are commonly pe rforme d by multiple he alth care provide rs‚ there exists the possibility that the child will expe rience the se eve nts as a form of nosocomial se xual abuse (Mone y and Lamacz ‚ 1987) . Additional knowle dge on this topic is crucial be fore it can be stated confide ntly that the pote ntial psychosocial be ne fits of increases in pre dicted adult he ight outwe igh the distress associate d with re pe ated genital examinations of the child and daily or monthly inje ctions of GnRHa. Despite the stated shortcomings regarding the psychosocial and psychose xual aspe cts of precocious pube rty‚ this volume fulfills its primary goal of re viewing the rapid advance s ove r the last de cade in the etiology ‚ diagnosis ‚ and e ndocrine manage ment of se xual precocity. Furthe rmore ‚ it presents the re ade r with the existing controve rsie s and the ve nue s ope n for furthe r inve stigation. This volume will be of inte rest and valuable assistance to anyone who provide s medical care to childre n who e xpe rie nce precocious sexual maturation. It will also provide the be havioral clinician with important medical background information useful in psychoe ducational inte rventions.

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REFERENCES Mazur ‚ T. ‚ an d Cloppe r ‚ R. R. ( 1991) . P ube rtal disorde rs: Psychological and clinical manageme nt. Endocrinol . Metab. Clin. N. Am. 20: 211-230. Mon e y‚ J. ‚ and Lam acz ‚ M. ( 1987) . Ge nital e xamin ation and e xposure e xpe rie nce d as nosocomial sexual abuse in childhood. J. Nerv. Ment. Dis. 175: 713-721. Sandberg ‚ D. E. ‚ Brook ‚ A. E. ‚ and Campos‚ S. P. ( 1994) . Short stature: A psychosocial burde n re quiring growth hormone therapy? Pediatrics 94: 832-840.

Sexu ality. By Kathleen McKin ney an d Su san Sprecher. Sage Publications ‚ Newbury Park ‚ California ‚ 1993 ‚ 184 pp. ‚ $14.95 (softcove r) ‚ $29.95 (hardcove r). Reviewed by Ilana P. Spector‚ Ph.D.5

In this volume ‚ McKinne y and Spre cher re view the e xpre ssion of se xuality in the context of close relationships. It has be en gene rally re cognize d in the fie ld of se xuality that re lationship and se xual factors impact upon one anothe r in a re ciprocal manne r. As part of the Sage serie s on close relationships ‚ the se authors assemble mate rial in support of this mode l. McKinney and Spreche r (1991) previously e dite d a similar volume on this topic (se e re view by Hatfie ld ‚ 1994) ‚ and ‚ although there is overlap be tween the se two works ‚ the current volume explore s sexual be haviors and concerns as the y occur in different type s of relationships ‚ whe re as the pre vious volume was organize d around topics such as communication ‚ je alousy ‚ and personality factors. Also ‚ this volume has an increased focus on re se arch ‚ and include s many up-to-date studie s that appe ared postpublication of the e arlie r volume . The purpose of this volume is to e xamine three type s of sexually base d primary re lationships (which are defined as those re lationships where the persons involve d have le gitimate e xpe ctations that sexual exchange s or interde pe nde nce will occur): dating ‚ cohabiting ‚ and marital re lationships. The authors propose to use multidisciplinary perspectives‚ and to e xamine both he terose xual and homose xual relationships wherever possible . It is cle ar that they succe ed at this ende avor ‚ although ‚ as they note in the pre face ‚ their cove rage of homose xual re lationships is limite d by a “ de arth of research on this topic ” (p. xiv) . In the first chapte r‚ the authors describe how attitude s towards sexuality diffe r by re lationship type (e .g.‚ marital ‚ dating ‚ cohabiting ‚ e xtramariDouglas Hospital‚ 6875 LaSalle Boule vard ‚ V erdun ‚ Quebec H4H 1R3 ‚ Canada.

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tal) . Particular e mphasis is place d on the ever-changing attitude s towards pre marital se x. Factors such as acce ssibility of birth control methods ‚ the wome n ’s movement ‚ and the media ’s portrayal of sexuality are cited as e xplanations for incre asing pe rmissive ne ss‚ and the possibility of a new trend towards conse rvative ness due to AIDS is presented. In the second chapte r‚ diffe re nt stage s and type s of attraction are characte rized. Romantic and sexual attraction are compare d and contraste d in te rms of pre dictors. This is followe d by a third chapte r on how se xual decisions are made and how se x is initiate d. The importance of sexual scripts is highlighte d: couple s are “ like actors following a script provide d to them ” (p. 62) . The authors portray the conve ntional script as follows: a partne r is sele cted of approximate ly the same age and background ‚ the couple has sex at the end of an evening in a private location such as the bedroom afte r dating for a certain amount of time ‚ and the y e ngage in a specified seque nce of se xual be haviors (passionate kissing ‚ breast and genital touching ‚ perhaps oral ¯genital sex‚ and finally intercourse). The pe rvasive ne ss of this script may be either disappointing to those couple s who romantically believe d that their first sexual encounte r was unplanne d and impulsive ‚ or relieving for those who ne rvously imagine that inte nse or de taile d plans and de cisions are re quire d for that spe cial “ first time .” Either way‚ the authors note that “ very little of . . . se xual behavior is truly spontane ous” (p. 62). The fourth chapte r de scribes the fre quency and type of se xual behaviors in diffe re nt re lationships. The authors re port that cohabiting couple s have more fre que nt se xual inte ractions than either dating or married couples‚ and that marrie d couple s’ se xual fre quency de cline s ove r time . The fifth chapte r revie ws how sexual satisfaction re late s to othe r aspe cts of the relationship. The association among re lationship satisfaction ‚ conflict ‚ and sexual be haviors is e xplore d ‚ and the importance of se xual communication is note d. There is an e spe cially interesting section on the meaning of se x within relationships: “ se x is more than a physical act . . . much more than physical sensations ge t e xpre sse d ” (p. 100) . Se x is portraye d as symbolizing se lf-disclosure ‚ affe ction and love ‚ interdepende nce ‚ re lationship mainte nance ‚ and exchange . The final chapte r focuse s on se xual coe rcion or assault. Studie s are cited reporting that the prevale nce of marital sexual assault is be tween 10 ¯ 15% ‚ and that force d sexual inte rcourse in high school and colle ge fe males is be tween 10¯ 25% . The authors describe how variable s such as amount of force used and location of the incide nt can influe nce attitude s towards the victims and pe rpe trators of sexual coe rcion. In a frighte ning depiction ‚ it is re vealed how many high school stude nts approve of forced sexual inte rcourse in relationships such as marriage ‚ or in situations such as whe re

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the couple has be en dating for more than 6 months ‚ where the male spe nds a lot of money on the fe male ‚ or whe re the fe male ge ts the male sexually excited. O ne wonde rs what kind of message s socie ty give s to youths through media and othe r cultural ve hicle s that allow the m to see se xual assault as acceptable unde r any circumstance s. The e pilogue provide s a valuable asse ssment of the literature on sexuality and re lationships. The authors point out the se x difference s found in many studie s‚ including men be ing more pe rmissive ‚ and be ing more like ly to initiate sexual inte ractions ‚ to e ngage in e xtramarital se x‚ and to misinte rpre t sexual interest. Me n are also like ly to be more tolerant of and less victimize d by se xual coe rcion. These sex difference s are explore d within a biopsychosocial context. Finally ‚ methodological concerns and dire ctions for furthe r research are re viewed. An impre ssive aspe ct of this volume is the succe ssful integration of the ory and re se arch. Each chapte r feature s re le vant theories which are e xtracte d from a numbe r of fields of study including psychology ‚ sociology ‚ communication s‚ and family systems. To evaluate the the orie s‚ e mpirical studie s are pre se nte d and critique d. Each chapte r is accompanie d by a description of the appropriate research methods and scales that are available to measure the give n constructs. The vast amount of literature is also concise ly pre se nte d in a scholarly manne r. The authors examine d different sexual stage s of close re lationships. Given this focus‚ discussion of some important stage s were negle cted. For example ‚ it would have be en inte resting to include a re view of sexual behaviors and attitude s that are e xpe rienced while couple s are trying to conceive and during pregnancy. Also‚ give n our growing aging population ‚ a depiction of what happe ns to se xual relationships as couple s age toge ther would have bee n valuable . Finally‚ as the authors themselve s point out ‚ the epide mic of AIDS has sure ly shifte d se xual attitude s and behaviors in developing close relationships ‚ and hope fully future writings on changing se xual relationships will include this topic. This volume provide s a wealth of information that would be use ful to reade rs with an inte re st in sexual behavior and/or in close re lationships. The dual focus on theory and re se arch make this volume a valuable tool for re searche rs‚ stude nts ‚ and clinicians alike . It is well-organize d ‚ informative ‚ and e njoyable reading.

REFERENCES Hatfield‚ E. (1994) . Re view of Sexuality in Close Relationships. Arch. Sex. Behav. 23: 479-481.

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McKinney‚ K.‚ and Spreche r ‚ S. (Eds.). (1991) . Sexu ality in Close Relationships ‚ Erlbaum ‚ Hillsdale ‚ NJ.

Boys an d Girls Apart: Ch ild ren ’s Play in Can ad a an d Polan d. By Steph en Richer. Carle ton Unive rsity Pre ss‚ O ttawa ‚ O ntario ‚ 1990 ‚ 162 pp. ‚ $17.95 (Cdn) . Reviewed by Jaipaul L. Roopnarine ‚ Ph.D.6

The origin of ge nde r-diffe rentiate d activitie s in young childre n and their implications for cognitive and social de ve lopme nt have garne red a good deal of inte rest ove r the last four de cade s. Witne ss‚ for example ‚ the numbe r of anthropologic al‚ sociological ‚ and psychological studie s that have docume nted gende r-relate d diffe re nce s in the social activitie s of childre n and pare nts across dive rse culture s. The more recent studie s‚ particularly those that have be en conducte d in pre industrialize d societie s‚ are e spe cially note worthy because the y have attempte d to docume nt concomitant sociohistorical factors embe dde d in the cultural niche that may contribute to gende r-diffe re ntiate d outcome s in the process of early socialization. To this end ‚ this monograph by Richer explore s ge nde r and cultural diffe re nce s in childre n ’s image s of ge nde r via childre n ’s drawings in two socie ties that are disparate in sociopolitical ide ology. For the most part ‚ the book is tie d toge ther nice ly with exce llent illustrations of childre n ’s sketches/drawings. The first two chapte rs atte mpt to lay bare a framework for unde rstanding ge nde r diffe re nce s through an examination of childre n ’s drawings. Care is take n to point out key sociopolitical and economic attribute s about life in Canada and Poland. More specifically ‚ ge nde r differentiation in the home ‚ wage ine quality‚ and the role of church and school in pe rpe tuating gende r ine quality are discusse d sometimes drawing on the work of Enge ls and contemporary rese archers. The competitive nature of Canadian society is juxtapose d against the colle ctivistic ideology of socialist Poland. The expe ctation may be that in socialistic societies play encompasse s the coope rative spirit while in capitalistic societies emphasis on “ rugge d individualism ” may e ncourage participation in competitive activitie s. While this issue is discusse d again ‚ it gets lost because of a lack of marked cultural differences in the nature of childre n ’s play activitie s and be cause the ge nde r-re lated differences are so ubiquitous in both societie s. Departme nt of Child and Family Studies‚ Syracuse University‚ Syracuse ‚ New York 132441250.

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Chapte rs 3 and 4 discuss quite cogently the e xpre ssion of gende r and cultural difference s in the play practice s de picted in the childre n ’s drawings. The findings large ly follow traditional conceptions of ge nde r role with less marked cultural diffe re nce s. Chapte r 3 would have profite d from a more thorough re vie w of the sizable child de ve lopme nt lite rature on gende r cle avage across culture s that focuse s on the composition of childre n ’s groups and play activitie s the reby stre ngthe ning the purpose for a crossnational comparison; howe ve r‚ chapte r 4 doe s a good job of going beyond the standard practice ‚ evide nt in the play literature ‚ of e xamining childre n ’s social comme rce. Dime nsions of space ‚ size ‚ e nvironme ntal detail ‚ and emphasis on “ the self ” are richly discusse d. This se gme nt of the book is solid. The final two chapte rs of the book provide discussions of change and the differe nt structural e lements within socie ty that are possible targe ts for inte rve ntion. The author draws upon his e arlie r work to provide a post hoc comparison of change s in se x-role stere otyping following syste matic efforts by re form-minde d e ducators in O ntario schools to he ighte n aware ne ss about ge nde r ine quality. The author displays inte grity and se nsitivity in discussing the post hoc comparison and the efforts of school personne l to addre ss gende r stere otyping. Nee dless to say‚ the change s in gende r-diffe rentiate d activitie s were disappointing de spite conce rted programmatic e fforts. The book e nds with an e xamination of certain socie tal/institutional contradictions and some variations in ge nde r roles. An attempt is made to cast play activitie s in “ autote lic ” te rms with some nice e xample s furnishe d of modifications of childre n’s games that may invite gre ater coope ration than competitive ness. Additionally ‚ this last chapte r e ncourage s the reade r to re fle ct on the possible conse que nce s of ge nde r ine quality.

8 REVIEWS Sexual Precocity - Etiology, Dx, & Mgmnt.

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9 REVIEWS Sexuality By Kathleen McKinney & Susan Sprecher

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10 REVIEWS Boys & Girls Apart - Children's Play in Canada & Poland

file:///D|/...1998)/10%20REVIEWS%20Boys%20&%20Girls%20Apart%20-%20Children's%20Play%20in%20Canada%20&%20Poland.txt[31/10/2011 8:15:19 AM]