Perspectives in Sexuality – serie

China today is sexually (and in many other ways) a very repressive so­ ciety, yet ancient China was very different. Some of the earliest surviving literature of China is devoted to discussions of sexual topics, and the sexual implications of the Ym and Yang theories common in ancient China continue to influence Tantric and esoteric sexual practices today far dis­ tant from their Chinese origins. In recent years, a number of books have been written exploring the history of sexual practices and ideas in China, but most have ended the discussion with ancient China and have not continued up to the present time. Fang Fu Ruan first surveys the ancient assumptions and beliefs, then carries the story to present-day China with brief descriptions of homosexuality, lesbianism, transvestism, transsexualism, and prostitution, and ends with a chapter on changing attitudes toward sex in China today. Dr. Ruan is well qualified to give such an overview. Until he left China in the 1980s, he was a leader in attempting to change the repressive attitudes of the government toward human sexuality. He wrote a best­ selling book on sex in China, and had written to and corresponded with a number of people in China who considered him as confidant and ad­ visor about their sex problems. A physician and medical historian, Dr. Ruan's doctoral dissertation was a study of the history of sex in China.

Despite the gains made by gay rights movements throughout the world, there are still areas in which homosexuals and their relationships are targeted as immoral and criminal. Sociolegal Control of Homosexuality, a comprehensive, up-to-date examination of governmental and religious reaction to issues of sexual orientation in regions - such as Asia and the Middle East - not often covered in English language publications, includes: a sampling of international legislation, both proscriptive and liberal the effects of fundamentalist religious movements new scientific information concerning the origin of sexual orientation, and much more! £/LIST£

Over the past several decades the seeming escalation of crimes involving sexually deviant, coercive, and aggressive behavior has become an increasingly serious problem, manifested in costs to both victims and society at large. The long-term psychological impact of sexual assault on adult and child victims has been documented numerous times. The costs incurred by society include a network of medical and psychological services provided to aid victim recovery, the investigation, trial, and incarceration of offenders-often in segregated units or special facilities-and the invisible but tangible blanket of fear that forces potential victims to schedule normal daily activities around issues of safety. Despite the gravity of the problem, there has been a paucity of empirical research directed at the etiology, course, remediation, and management of sexually deviant and coercive behavior. In treating these disorders and in making crucial decisions about how to manage these offenders, clinicians have been forced to rely on their personal experience. Such experience by its nature is unsystematic and lacks the validation that empirical research provides. The lack of sound empirical data addressing the problem is certainly noteworthy, though not surprising. The paucity of research in this area may well be attributable to historical scientific timidity about most aspects of sexual behavior. In 1922 Dr. Robert L.

This volume presents an updated and interactionist theory of sexual attraction, in which biologically based erotic processing biases are continually exploited or challenged by social and cultural conditions. From this perspective, social orientation is viewed as a process rather than an outcome. The author takes an interdisciplinary approach that draws upon data from anthropology, sociology, gender studies, social constructionism, behavioural and developmental psychology, evolutionary biology, genetics, endocrinology and cognitive functioning to support his theory. This text should be useful to sexologists, evolutionary biologists, psychologists and other social scientists interested in human sexuality.

John Money's career constitutes the foundation of pediatric psychoendocrinology. In this book he takes a second look at his publications on many different psychoendocrine syndromes, intersexual or hermaphroditic, with respect to sex, gender, amative orientation, and the "lovemap", (his own designation from an individual's experience of sexuality). His ultimate conclusion is that, from prenatal life onward, demasculization of development is not synonymous with feminization, nor is defeminization synonymous with masculinization. This volume will serve to illuminate the evolution of Dr. Money's work and point the way to future investigations in this field.

Despite the gains made by gay rights movements throughout the world, there are still areas in which homosexuals and their relationships are targeted as immoral and criminal. Sociolegal Control of Homosexuality, a comprehensive, up-to-date examination of governmental and religious reaction to issues of sexual orientation in regions - such as Asia and the Middle East - not often covered in English language publications, includes: a sampling of international legislation, both proscriptive and liberal the effects of fundamentalist religious movements new scientific information concerning the origin of sexual orientation, and much more! £/LIST£

The objective of this book is to propose a theory of transvestism and secondary transsexualism, and to provide information concerning these behaviors. My view of these topics is much like that of Benjamin (1966) and nearly all other gender researchers. It holds that a syndrome of similar behaviors can be identified, ranging from fetishism through transvestism, transgenderism, and secondary transsexualism. But de­ scription is one thing and explanation of causes is another. I agree with other gender researchers (e. g. , Green & Money, 1969; Stoller, 1985c) who have concluded that the causes of transvestism and transsexualism re­ main largely unknown. But the fact that we cannot fully explain the origins of transvestism or secondary transsexualism does not mean that a comprehensive theory is impossible. Indeed, excellent theoretical statements have been proposed concerning each of these topics (Ban­ croft, 1972; Buckner, 1970; Buhrich & McConaghy, 1977a; Money & Ehrhardt, 1972; Ovesey & Person, 1973, 1976; Person & Ovesey, 1974a,b; Stoller, 1968a, 1974, 1985c). It is with considerable respect, therefore, that we acknowledge both the strong shoulders on which we stand, and also the more practical fact that we have drawn heavily upon the many contributions of these researchers. The approach I have adopted has the same scientific difficulties that confronted all of these previous workers.

The Changing Definition of Masculinity is an outgrowth of four years of developing and teaching the course "Social Factors in Male Personality" at Ohio State University, Columbus. This volume reflects, in addition to my thoughts and feelings about what should be discussed in a sex-roles course taught from a male per­ spective, the thoughts, feelings, and knowledge of scores of students, col­ leagues, and friends. These are persons who either have taken the course or discussed with me appropriate material to be included in such a course and/or book. Chapter 1, for example, is influenced greatly by the work of Eliza­ beth and Joseph Pleck's The American Man, dealing with the periods of masculinity in the United States up to 1965. The chapter also deals with emerging meanings of masculinity after 1965, and female and male responses to these meanings. The second chapter is devoted to male sex-role socialization and examines the roles of biology and environment in male socialization. It is also concerned with agents of male socialization and with male assumption of such sex-role traits as dominance, competitiveness, the work ethic, and violence. In Chapter 2, I also propose two general mas­ culine roles frequently assumed by American males which mayor may not be race-specific-the White masculine role and the Black masculine role.

The odd reader (here in England "odd" means occasional) may be interested in how a book comes about. Members of the SIECUS Board of Directors were planning a Festschrift and dinner for Mary Calderone on the occasion of her 75th birthday. One planning idea was to have a booklet, filled with brief essays from prominent sex educators, distributed between the roast beef and the ice cream. My reaction was that such "souvenirs" find their burial place in the same dusty drawer as the program from the high school prom and ticket stubs from South Pacific. I suggested a more lasting, noticeable "monument," a "proper" (as the English say) book which would draw contributions from both SIECUS and non-SIECUS scholars. 1 was too clever to be trapped as editor (in a 1974 preface, I had written "I swore 1 wouldn't edit another book"). And so I seduced Lorna Brown (into being editor). I contacted a few potential con­ tributors, suggested a few others, convinced Leonard Pace at Plenum Press that this was a worthwhile venture, and left the country. To my amaze­ ment, six months after settling in Cambridge, England, the rough draft of the book arrived along with areminder from Lorna that during the se­ duction I had promised to write an Introduction.

When is it timely to publish a synthesis of previously published and original materials from a specific discipline? I believe it to be timely when one has a sufficient amount of high-quality material covering the critical areas of that topic, when the previously published material is scattered over a wide range of journals and books, and when there is no single book that synthesizes the discipline. The treatment of sexual dysfunction emerged to the front lines of health delivery only during the past decade with the pioneering work of William Masters and Virginia Johnson. In spite of the rash of sex clinics and sex therapists that followed, preciously little solid research has been conducted on the various strategies of therapy, the means of assessing complex interpersonal sexual relation­ ships, and the manner by which clinical change is objectively assessed. No one reader can keep pace with the multitude of jounials that publish key material by sophisticated investigators. And no one investigator can cover these salient areas alone with his or her original work in a single volume. The critical papers have now been written. Ten were written specifically for this volume and thirty-three have previously appeared. This volume laces them together into a coherent pattern. Thus, the time for a synthesis in sexual dysfunction.

Over the past several decades the seeming escalation of crimes involving sexually deviant, coercive, and aggressive behavior has become an increasingly serious problem, manifested in costs to both victims and society at large. The long-term psychological impact of sexual assault on adult and child victims has been documented numerous times. The costs incurred by society include a network of medical and psychological services provided to aid victim recovery, the investigation, trial, and incarceration of offenders-often in segregated units or special facilities-and the invisible but tangible blanket of fear that forces potential victims to schedule normal daily activities around issues of safety. Despite the gravity of the problem, there has been a paucity of empirical research directed at the etiology, course, remediation, and management of sexually deviant and coercive behavior. In treating these disorders and in making crucial decisions about how to manage these offenders, clinicians have been forced to rely on their personal experience. Such experience by its nature is unsystematic and lacks the validation that empirical research provides. The lack of sound empirical data addressing the problem is certainly noteworthy, though not surprising. The paucity of research in this area may well be attributable to historical scientific timidity about most aspects of sexual behavior. In 1922 Dr. Robert L.

I have long been awe-struck by authors' claims that their books had been in the making for 5, or 10, or even 15 years. I now have a better appreciation ofthe work involved in bringing a book to press. The seeds of this project have had a long germination. The impetus for this book began more than 10 years ago when I was a graduate student in clinical psychology. Having an interest in human sexuality-and in theories on the forms of sexual attraction specifically-I was perplexed by various perspectives on this subject. Disciplines of thought that I encountered­ medicine, evolutionary biology, developmental psychology, gay/lesbian theory, social constructionism, anthropology, Marxism, Christianity, and others-perceived the issue so differently, so strongly, with almost no overlap. I was fascinated that the question ofhow and why one is attracted to either one or both sexes could elicit such conviction and divergent points of view. There seemed to be no easy way to resolve these differences. Still, what frustrated me most in my readings were several conceptual problems among the two prominent proponents of contemporary sexuality theory­ scientists and social constructionists. One ofmy first frustrations with biomedical and social scientists who write about sexuality was that they often define sexual attraction in strict behavioral terms, as completed observable sexual acts--observable in the sense that such acts or their consequences are seen by others.

Impotence. The word strikes at the bedrock of a man's worth. Its implications far exceed the inability to have a penile erection. The man is without power-inef­ fectual. Ancient statues represented with an oversized erect penis attest to the his­ toric conscious meaning of the phallus. Magnificent spires, memorial monuments, and the awe generated by the sight of rockets and missiles attest to the unconscious meaning. At the medical-superstitious level, men have invoked countless strategies for improving or restoring potency. They have included ritualistic dances, concoctions, and mechanical aids. Some survive to the present. More recently, verbal therapies have taken their place, ranging from simple exhortation to the uncovering of complex unconscious symbolic conflicts. Other therapies borrow from theories of learning, based on experiments with mice and men. The growth of modern endocrinology, with the isolation of "sex steroids," heralded another treatment strategy: hormones. Later, engineers entered with sur­ gically implantable mechanical devices. And, most recently, the technology of microsurgery has offered the possibility of physiological restoration of a compro­ mised vascular supply, a necessary component of erection.

This pUblication comprises the proceedings of a conference held at the State University of New York at Stony Brook, Stony Brook, New York, June 5 -9, 1974. The conference was jointly sponsored by the Department of Psychiatry and Behavioral Science at SUNY, Stony Brook, the Institute for Sex Research at Indiana University, and the Editor of this journal. Financing for the conference came from the National Institute of Mental Health. The initial planning for the conference was a shared effort of Stanley F. Yolles, Paul Gebhard, Richard Green, and Eli A. Rubinstein. In addition to the planning of the conference and the selection of participants, all four served as program coordinators during the conference to help ensure productive use of the limited time available. Grateful acknowledgment is given for the advice and con­ sultation of Jack Wiener, George Renaud, and Betty Pickett of the NIMH, who provided assistance in the development of the conference plans. The selection of participants was planned to permit a wide sampling of researchers working in areas of significance to the future of sex research. The titles of the papers listed in the table of contents reveal this broad approach. Furthermore, the remaining participants were included as individuals whose re­ search and scholarly interests would ensure a multidisciplinary approach to the topics under discussion.

As editor of the series "Perspectives in Sexuality: Behavior, Research, and Therapy," I consider it a major scholarly achievement to publish selected proceedings of the Second International Congress of Sexology. Never before have so many professional organizations supported such a conference or so many scholars, from so many coun­ tries, participated in such a conference. Eighteen countries were represented; over one hundred papers were presented. The Congress and these proceedings mark an historical mile­ stone for sexology in international scientific cooperation. The collaboration of so many researchers from diverse disciplines fur­ ther illuminates the interdisciplinary approach. The papers pre­ sented reflect the challenge accepted by scientists to compare varieties of techniques and programs, to develop new theories and creative approaches in their investigations, and to initiate sci­ entific study of heretofore taboo areas of inquiry. Clearly, sexology has come of age. It takes its place among the respected scientific disciplines. This monumental achievement, the Second International Congress of Sexology, signals the emer­ gence at the international level of Sexology as Science. Richard Green ix Preface The Second International Congress of Sexology was held in Montreal, Canada on October 28-31, 1976. Researchers of interna­ tional acclaim from eighteen countries presented progress reports in specialities as endocrinology, neurophysiology, infertility, contraception, sexual dysfunction, ethics in sex research and sex education. The Congress, whose theme was "international progress in sexology," had as its scientific objective a wide range of sub­ jects concerning the interdisciplinary study of sexology from many areas of the world.

As new faculty members in the Section of Psychiatry and Human Behavior at Brown University, we began collaborating on research into assessment and treatment of sexual problems in the fall of 1975. Although each of us arrived with clinical and research in­ terests in the broad field of sexual problems, the idea for this book grew out of our early discussions and a consensus on the future direction of research. We noted that there had been an extremely rapid increase in knowledge of human sexual behavior as well as sexual disorders and their treatment over the last few decades. It has also become increasingly apparent that sexual problems, broadly conceived, comprise a sizable fraction of the problems for which people seek treatment, and that, although the treatment of sexual problems was achieving some success, treatment was for the most part slow, costly, and without any guarantee of successful outcome. Furthermore, there were many people with sexual prob­ lems for whom treatment was not available. With these ideas in mind, it seemed timely for investigators in the field of human sex­ uality and its disorders to turn their attention to the problem of prevention. Organizing a symposium on the topic enabled us to invite leading investigators in the study of sexual behavior to address this area. The chapters in this volume are an outgrowth and refinement of the formal papers delivered at the symposium, which was held in the spring of 1976.

In the decade-and-a-half since I coedited Transsexualism and Sex Reassignment (Green & Money, 1969), remarkable changes have occurred with Harry Ben­ jamin's "transsexual phenomenon" (1966). Formerly, when writing about this condition in scientific journals, it was necessary to define the term transsex­ ualism. Now the lay public recognizes it. Even the American Psychiatric Asso­ ciation acknowledges it as a "disorder," with its inclusion in the Third Edition of its Diagnostic and Statistical Manual (1980). Although this "elevation" to the status of mental illness may seem a Pyrrhic victory, it is a recognition of the legitimacy of transsexual ism as a source of human suffering. The controversy that surrounded the decisions in the early patient cases to perform sex-change surgery has largely dissipated. The cries of "collusion with delusion," principally from psychoanalysts, have quieted. The dire predictions of psychosis and/or suicide following surgery as the "last psychic defenses are cut away" have almost never been realized. By contrast, many postoperative patients consider the surgery to have been life-saving. Medical centers worldwide have incorporated programs for evaluating and treating persons requesting sex reas­ signment. Elaborate guidelines for patient management have been developed by an international organization of health care professionals (Harry Benjamin Inter­ national Gender Dysphoria Association, 1981). Harry Benjamin's child has come of age.