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Celibacy
What are some of the benets and disadvantages of celibacy?
Erotic Dreams and Fantasy
What are some of the functions of sexual fantasy?
How do male and female sexual fantasies differ?
Masturbation
How have attitudes about masturbation changed since the 1800s?
Sexual Expression: The Importance of Context
What characteristics of sexual behavior lead it in positive
or negative directions?
Kissing and Touching
Why is touching important?
OralGenital Stimulation
What are the technical terms for oral stimulation of a woman
and of a man?
How have attitudes about oral sex changed over time?
Anal Stimulation
How common is anal intercourse? What are important precautions
regarding its practice?
Coitus and Coital Positions
What are some different intercourse positions?
What is an important element of Tantric sex?
225
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Sexual Behaviors
8
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226 CHAPTER 8
My sexuality has had many different dimensions during my life. My childhood
masturbation was a secret desire and guilt that I never did admit to the priest
in the confessional. “Playing doctor” was intriguing and exciting in its “naugh-
tiness.The hours of hot kissing and petting of my teenage and early college
years developed my sexual awareness. My first intercourse experience was
with a loved and trusted boyfriend. It was a profound physical and emotional
experience; years later the memory still brings me deep pleasure. As a young
adult my sexual expression alternated between periods of recreational sex and
celibacy. Within marriage the comforts and challenges of commitment; com-
bining sex with an intense desire to become pregnant; the primal experience
of pregnancy, childbirth, and nursing greatly expanded the parameters of my
sexuality. Now, balancing family, career, personal interests, my sexuality is a
quiet hum in the background. I’m looking forward to retirement and time and
energy for more than coffee and a kiss in the morning. (Authors’ files)
People express their sexuality in many ways. Sexual expression can vary greatly from
person to person, within the contexts of different relationships, and over the course of
ones lifespan. The emotions and meanings that people attach to sexual behavior also
vary widely. In this chapter, we discuss the importance of context in sexual expression
and describe a variety of sexual behaviors. We consider individuals first and later look
at couples sexual behavior. We begin with a discussion of celibacy.
Celibacy
A physically mature person who does not engage in sexual behavior is said to be celibate.
In complete celibacy a person neither masturbates nor has sexual contact with another
person. In partial celibacy an individual masturbates but does not have interpersonal
sexual contact. Celibacy is not commonly thought of as a form of sexual expression.
However, when it represents a conscious decision not to engage in sexual behavior,
this decision in itself is an expression of ones sexuality, and it may manifest a persons
sexual intelligence. Celibacy, or abstinence, can be a viable option until the context for
a sexual relationship is appropriate and positive for a given individual (Zafar, 2010).
Celibacy is most commonly associated with religious devotion; joining a religious
order or becoming a priest or nun often includes a vow of celibacy. e ideal of religious
celibacy is to transform sexual energy into service to humanity (Abbott, 2000). Mother
Teresa of Calcutta and Mahatma Gandhi of India exemplied this ideal, and they are
admired for their moral leadership (Sipe, 1990).
Historically, some women embraced celibacy to free themselves from the limitations
of the expected gender roles of marriage and motherhood. In the Middle Ages a woman
could obtain an education if she became a nun. In a convent, nuns had access to libraries
and could correspond with learned theologians. Laywomen were prohibited such privi-
leges. Elizabeth I, England’s Virgin Queen, avoided marriage to maintain her political
power, but she had several unconsummated love aairs during her rule. She entertained
proposals from numerous well-connected suitors for her own political purposes, sub-
jecting herself to repeated court inspections to conrm her virginity (Abbott, 2000).
Today many factors can lead a person to be celibate. Some people choose to be
celibate until marriage because of religious or moral beliefs. Others maintain celi-
bacy until their personal criteria for a good sexual relationship have been met. Some
complete celibacy
An expression of sexuality in which an
individual does not engage in either
masturbation or interpersonal sexual
contact.
partial celibacy
An expression of sexuality in which an
individual does not engage in inter-
personal sexual contact but continues
to engage in masturbation.
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Sexual Behaviors227 227
choose celibacy because they have experienced confusion or disappointment in past
sexual relationships, and they want to spend some time establishing new relationships
without the complicating factor of sexual interaction (Terry, 2007). A 28-year-old
man explained:
There was a period not too long ago in my life where I had been abstinent for
about four years. I had been on both sides of the cheating fence and began
to realize that sex wasn’t just something that I wanted to take, or could take,
lightly. The feelings that can be created out of a physical relationship are sim-
ply too powerful to toy around with. I was terribly afraid of being hurt again,
or of perhaps hurting someone else, so I chose not to get sexual with anyone.
(Authors’ files)
At times a person can be so caught up in other aspects of life that sex is simply not a
priority. Health considerations, such as concerns about pregnancy or sexually transmit-
ted infections, can also prompt a decision not to have sexual intercourse.
Some people nd that a period of celibacy can be rewarding. ey can often refocus
on themselves during such a period—exploring self-pleasuring; learning to value their
aloneness, autonomy, and privacy; or giving priority to work and nonsexual relation-
ship commitments. Friendships can gain new dimensions and fulllment. Of the many
options for sexual expression, celibacy is one that people sometimes have considerable
trouble understanding. However, celibacy can be a personally valuable choice.
Erotic Dreams and Fantasy
Some forms of sexual experience occur within a persons mind, with or without sexual
behavior. These are erotic dreams and fantasy—mental experiences that arise from our
imagination or life experience or that are stimulated by the Internet, books, drawings,
photographs, or movies.
Erotic Dreams
Erotic dreams, and occasionally orgasm, can occur during sleep without a persons con-
scious direction. One study found that 93% of men and 86% of women reported hav-
ing erotic dreams (Schredl et al., 2004). A person might waken during such a dream
and notice signs of sexual arousal: erection, vaginal lubrication, or pelvic movements.
Orgasm can also occur during sleep; this is called nocturnal orgasm. When orgasm
occurs, males usually notice the ejaculate—hence the term wet dream or nocturnal emis-
sion. Women also experience orgasm during sleep, but female orgasm may be more
difficult to determine because of the absence of visible evidence.
Erotic Fantasy
Erotic waking fantasies commonly occur during daydreams, masturbation, or sexual
encounters with a partner. A review of research about fantasy found that about 95%
of men and women reported having experienced sexual fantasies. Comparing the con-
tent of homosexuals and heterosexuals fantasies revealed more similarities than dif-
ferences, leaving aside the sex of the imagined partner (Leitenberg & Henning, 1995).
How strongly religious individuals are appears to impact frequency and variety of erotic
nocturnal orgasm
Involuntary orgasm during sleep.
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228 CHAPTER 8
fantasies. Men and women who are less religious fantasize about sex more frequently than
those who are more religious. Further, women who are agnostic or atheist have a much
greater variety of fantasies than women with religious beliefs (Ahrold et al., 2011).
Functions of Fantasy
Erotic fantasies serve many functions. First, they can be a source
of pleasure and arousal. Erotic thoughts typically serve to enhance
sexual arousal during masturbation and partners sexual activities.
Fantasies can be a way to mentally rehearse and anticipate new
sexual experiences. Imagining seductive glances, that first kiss, or a
novel intercourse position may help a person implement such activi-
ties more comfortably.
Sexual fantasies can allow tolerable expression of “forbidden
wishes. at a sexual activity in a fantasy is forbidden can make it
more exciting. People in sexually exclusive relationships can fantasize
about past lovers or others to whom they feel attracted, even though
they are committed to a single sexual partner. In a fantasy, a person
can experience lustful group sex, cross-orientation sexual liaisons,
brief sexual encounters with strangers, erotic relations with friends
and acquaintances, incestuous experiences, sex with animals, or any
other sexual activity imaginable—all without actually engaging in it.
Another function of erotic fantasy can be to provide relief from gender-role expec-
tations. Womens fantasies of being the sexual aggressor and mens fantasies of being
forced to have sex can oer alternatives to stereotypical roles. In her rst book about
male sexual fantasy, Nancy Friday reported that one of the major themes is mens releas-
ing control in favor of passivity:
It may seem lusty and dashing always to be the one who chooses the woman, who
decides when, where, and how the bedroom scene will be played. But isnt her role
safer? e man is like someone who has suggested a new restaurant to friends. What
if it doesnt live up to expectations he has aroused? e macho stance makes the
male the star performer. (Friday, 1980, p. 274)
e notion of control, aggression, and sex can play out in dierent ways for women
and men. Although the fantasy of being forced to have sex provides an alternative to gen-
der-role expectations for men, the same type of fantasy has other meanings for women.
For women, who often learn to have mixed feelings about being sexual, this type of
fantasy oers sexual adventures free from the responsibility and guilt of personal choice
(Critelli & Bivona, 2008). Research indicates that almost twice as many women as men
fantasize about being forced to have sex (Maltz & Boss, 1997). One study found that
62% of women have had one or more fantasies about rape (Bivona & Critelli, 2009).
Another study found that women who reported having fantasies of being forced to have
sex had more positive feelings about sex in general than women who did not have such
fantasies. e research also showed that forced-sex fantasies are not usually an indica-
tion of having had past abusive experiences (Critelli & Bivona, 2008). It is important to
emphasize that enjoyment of forced-sex fantasies does not mean women really want to
be raped. A woman is in charge of her fantasies, but as a victim of sexual aggression she
is not in control.
Male/Female Similarities and Differences in Sexual Fantasy
Mens and womens fantasy lives have some aspects in common. First, the frequency
of fantasy is similar for both sexes during sexual activity with a partner. Second, both
Vasko Miokovic/Vetta/Getty Images
Sexual fantasies can take you to times and places that are
impractical or impossible in real life.
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Sexual Behaviors229 229
men and women indicate a wide range of fantasy content. A research summary of het-
erosexual male/female content of sexual fantasy (Leitenberg & Henning, 1995) found
notable differences:
Mens fantasies are more active and focus more on a womans body and on what
they want to do to it, whereas womens fantasies are more passive and focus more
on mens interest in their bodies.
Mens sexual fantasies focus more on explicit sexual acts, nude bodies, and physi-
cal gratification, whereas women use more emotional context and romance in
their sexual fantasies. Similarly, a more recent study of reactions to types of erotic
stories found that women reported arousal to both suggestive and explicit erotic
stories, whereas men experienced a significant increase in arousal only to explicit
erotic stories (Scott & Cortez, 2011).
Men are more likely to fantasize about multiple partners and group sex than are
women.
Men are more likely to have dominance fantasies, whereas women are more likely
to have submission fantasies.
Fantasies: Help or Hindrance?
Erotic fantasies are generally considered a healthy and helpful aspect of sexuality
(Goleman, 2006). Many sex therapists encourage their clients to use sexual fantasies as
a source of stimulation to help them increase interest and arousal. Research found that
people who felt less guilty about sexual fantasies during intercourse reported higher
levels of sexual satisfaction and functioning than did others who felt more guilty about
having sexual fantasies (Cado & Leitenberg, 1990). Sexual fantasies help some men
and women experience arousal and orgasm during sexual activity. Conversely, a lack
of erotic fantasy and a focus on nonerotic thoughts can contribute to problems of low
sexual desire and arousal (Boss & Maltz, 2001; Purdon & Watson, 2011).
Some people decide to incorporate a particular fantasy into their actual sexual
behavior with a partner. Acting out a fantasy can be pleasurable; however, if it is uncom-
fortable for a partner, is counter to ones value system, or has possible negative conse-
quences, one should consider the advantages and disadvantages of acting it out. For
some people, fantasies are more exciting when they remain imaginary and are disap-
pointing when acted out.
Several Internet activities and technologies present an intermediate step between
private fantasy and actual behavior. Sharing and developing ones sexual fantasies
online—in chat rooms, during online multiplayer erotic games, and with webcam tech-
nology—involve revealing the fantasies, usually to strangers. Interestingly, talking about
fantasies online with strangers does help some individuals take the step of expressing
their previously private sexual imaginings and interests to their actual partners.
Individuals who have experienced sexual abuse as children are sometimes troubled by
intrusive, unwanted sexual fantasies. Developing new fantasies based on self-acceptance
and loving relationships can be a part of healing for these individuals (Boss & Maltz,
2001). As with most other aspects of sexuality, what determines whether fantasizing
is helpful or disturbing to a relationship is its meaning and purpose for the individuals
concerned.
Although most of the available research supports sexual fantasy as helpful, in some
situations sexual fantasies can be problematic. For example, some men have diculty
experiencing orgasm during intercourse because the idiosyncratic sexual fantasies they
require for intense arousal are discordant with their partner’s sexual behavior (Perel-
man, 2001). Fantasizing privately during sex with a partner can erode intimacy in the
© jwblinn/Alamy
People use webcam technology to act
out fantasies with other individuals.
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230 CHAPTER 8
relationship. One study found that college students had a double standard about their
own sexual fantasies versus their partner’s. Study participants of both sexes thought
that fantasizing about someone other than their partner was normal and did not jeop-
ardize the exclusivity of the relationship. However, the idea that their partner fantasized
about someone else made the participants feel jealous and threatened, as though the
fantasy was a kind of unfaithfulness. e most threatening fantasy a partner could have
was about a mutual friend or classmate rather than a fantasy about someone who in
reality was an unlikely rival, such as a movie star (Yarab & Allgeier, 1998).
In some cases fantasy can inuence a person to act in a way that harms others. is
outcome is of particular concern in the case of people who sexually assault children
or adults. A person who thinks that he or she is in danger of committing such an act
should seek professional psychological assistance.
Masturbation
In this textbook the word masturbation is used to describe self-stimulation of ones genitals
for sexual pleasure. Autoeroticism is another term used for masturbation. We discuss some
perspectives on and purposes of masturbation and specific techniques used in masturbation.
Perspectives on Masturbation
Masturbation has been a source of social concern and censure throughout Judeo-
Christian history. This state of affairs has resulted in both misinformation and consid-
erable personal shame and fear. Many of the negative attitudes toward masturbation
are rooted in early Jewish and Christian views that procreation was the only legitimate
purpose of sexual behavior. Because masturbation obviously could not result in con-
ception, it was condemned (Wiesner-Hanks, 2000). During the mid-18th
century, the evils” of masturbation received a great deal of publicity in the
name of science, largely because of the writings of a European physician
named Samuel Tissot. He believed that semen was made from blood and
that the loss of semen was debilitating to health, and he wrote vividly
about the mind- and body-damaging effects of self-abuse. This view of
masturbation influenced social and medical attitudes in Europe and North
America for generations, as reflected by an encyclopedia of health pub-
lished in 1918, which describes the following symptoms of masturbation:
e health soon becomes noticeably impaired; there will be general
debility. . . . Next come sore eyes, blindness, stupidity, consumption,
spinal aiction, emaciation, involuntary seminal emissions, loss of all
energy or spirit, insanity and idiocy—the hopeless ruin of both body
and mind. (Wood & Ruddock, 1918, p. 812)
In the 1800s, sexual abstinence, simple foods, and tness were lauded
as crucial to health. e Reverend Sylvester Graham, who promoted the
use of whole-grain ours and whose name is still attached to graham crack-
ers, wrote that ejaculation reduced precious vital uids. He beseeched
men to abstain from masturbation and even marital intercourse to avoid
moral and physical degeneracy. John Harvey Kellogg, a physician, carried
Grahams work further and developed the cornake to help prevent masturbation and
sexual desire. (Kellogg believed that bland food dampened sexual desires.) Other tech-
niques to control masturbation included bandaging the genitals, tying ones hands at
SEXUALHEALTH
From American Sex Machines, Copyright © 1996, Hoag Levins. Used by permission of Adams Media.
All rights reserved.
This lockable metal genital pouch with
leather straps, patented in 1910, was
designed to prevent masturbation by
patients in mental hospitals.
masturbation
Stimulation of one’s own genitals to
create sexual pleasure.
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Sexual Behaviors231 231
night, performing a clitoridectomy, applying carbolic acid to the clitoris, and suturing
foreskins shut, as well as employing mechanical devices (Planned Parenthood Federa-
tion of America, 2003).
Freud and most other early psychoanalysts recognized that masturbation does
not harm physical health, and they saw it as normal during childhood. However, they
believed that masturbation in adulthood could be a sign of “immature sexual develop-
ment and the inability to form good sexual relationships.
Views today reect conicting beliefs about masturbation; some of the traditional
condemnation still exists. For example, in 1976 the Vatican issued a Declaration on
Certain Questions Concerning Sexual Ethics, which described masturbation as an
“intrinsically and seriously disordered act. is perspective was maintained in 1993 by
Pope John Paul II’s condemnation of masturbation as morally unacceptable. Many reli-
gious fundamentalists have negative attitudes about masturbation (Ahrold et al., 2011).
Indeed, some individuals abstain from masturbation because of their religious beliefs.
I don’t masturbate, because I’ve learned from my church and my parents that
sexual love in marriage is an expression of God’s love. Any other kind of sex
diminishes the meaning I will find with my wife. (Authors’ files)
In contrast to negativity about masturbation, beginning in the 1970s, feminists coun-
tered religious condemnation by promoting masturbation as a legitimate form of wom-
ens self-loving and sexual self-discovery, as well as a component of partner lovemaking
(Chalker, 2002). For example, Betty Dodson, author of Liberating Masturbation, writes:
Masturbation, of course, is our rst natural sexual activity. It’s the way we discover
our eroticism, the way we learn to respond sexually, the way we learn to love our-
selves and build self-esteem. (Dodson, 1974, p. 13)
Purposes of Masturbation
People masturbate for a variety of reasons, not the least of which is the pleasure of arousal
and orgasm. The most commonly reported reason is to relieve sexual tension (Michael et
al., 1994). Masturbation is also valuable as a means of self-exploration. Sex educator Elea-
nor Hamilton recommends masturbation to adolescents as a way to release tension and
to become pleasantly at home with your own sexual organs” (1978, p. 33). Indeed, people
can learn a great deal about their sexual responses from masturbation. Self-stimulation is
often helpful for women learning to experience orgasms and for men experimenting with
their response patterns to increase ejaculatory control. (We discuss masturbation as a tool
for increasing sexual satisfaction in Chapter 14.) Finally, some people find that masturba-
tion helps them get to sleep at night, because the same generalized feelings of relaxation
that often follow a sexual encounter can also accompany self-pleasuring.
At times the satisfaction from an autoerotic session can be more rewarding than an
interpersonal sexual encounter, as the following quotation illustrates:
SEXUALHEALTH
I had always assumed that masturbation was a second-best sexual expression.
One time, after reflecting back on the previous day’s activities of a really enjoy-
able morning masturbatory experience and an unsatisfying experience that
evening with a partner, I realized that first- and second-rate were very relative.
(Authors’ files)
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232 CHAPTER 8
Some people nd that the independent sexual release available through masturba-
tion can help them make better decisions about relating sexually with other people and
can also be a safe-sex alternative (Shelton, 2010). Furthermore, within a relationship
masturbation can help to even out the eects of dissimilar sexual interest. Masturbation
can also be a shared experience:
When I am feeling sexual and my partner is not, he holds me and kisses me
while I masturbate. Also, sometimes after making love I like to touch myself
while he embraces me. It is so much better than sneaking off to the bathroom
alone. (Authors’ files)
e National Survey of Sexual Health and Behavior (NSSHB) found that 48% of
teenage girls and 73% of teenage boys between the ages of 14 and 17 had masturbated
(Robbins et al., 2011). e dierence between the percentages of females and males
who masturbate lessens for people in their 20s. Almost 85% of women and over 94%
of men between ages 25 and 29 had masturbated (Herbenick et al., 2010b).
Table
8.1 shows the range in frequency of masturbation among college students. A current
meta-analysis of research found that although males masturbate more frequently, mens
and womens attitudes toward masturbation are very similar. is same analysis found
that in countries with more equality between the sexes, men and women had smaller
dierences in attitudes and behaviors pertaining to masturbation than in less egalitar-
ian countries. is pattern strongly suggests that there is a sociocultural component to
gender similarities and dierences regarding masturbation (Petersen & Hyde, 2011).
A common concern about masturbation is doing it too much. Even in writings
where masturbation is said to be normal, masturbating to excess is often presented as
unhealthy. A denition of excess rarely follows. If a person were masturbating so much
that it signicantly interfered with any aspect of his or her life, there might be cause for
concern. However, in that case masturbation would be a symptom or manifestation of
some underlying problem rather than the problem itself. For example, someone who
is experiencing intense emotional anxiety might use masturbation as a way to relieve
anxiety or as a form of self-comforting. e problem in this case is the intense emotional
anxiety, not the masturbation.
Masturbation is often considered inappropriate when a person has a sexual part-
ner or is married. Some people believe that they should not engage in a sexual activ-
ity that excludes their partners or that experiencing sexual pleasure by masturbation
deprives their partners of pleasure. Others mistakenly interpret their partner’s desire
to masturbate as a sign that something is wrong with their relationship. But unless
it interferes with mutually enjoyable sexual intimacy in the relationship, masturbation
can be considered a normal part of each partner’s sexual repertoire. It is common for
people to continue masturbation after they marry (Reece et al., 2010a; Herbenick et al.,
2010a). In fact, individuals who masturbate more often also engage in sexual activity
TABLE 8.1 Two Thousand College Students Answer the Question
“How Often Do You Masturbate?”
Men (%) Women (%)
Two or more times a week 50 16
Less than two times a week but more than never 38 44
Never 12 40
SOURCE: Elliott & Brantley (1997).
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexual Behaviors233 233
with their partners more frequently than other individuals who masturbate less often
(Laumann et al., 1994). Moreover, one study found that married women who mastur-
bated to orgasm had greater marital and sexual satisfaction than women who did not
masturbate (Hurlbert & Whittaker, 1991).
Although masturbating is valuable for many people in various situations, not every-
one wants to do it. Sometimes, in our attempts to help people who would like to eradi-
cate their negative feelings about self-stimulation, it may sound as if the message is that
people should masturbate. is is not the case. Masturbation is an option for sexual
expression, not a mandate.
Ethnicity and Masturbation
Adults who are most likely to masturbate, and most likely to masturbate
more frequently than others, have several characteristics in common—
indicating that even this private sexual behavior is strongly influenced by
a persons social group (Laumann et al., 1994). They have liberal views,
are college educated, and are living with a sexual partner. White men
and women masturbate more than African American men and women.
Among White, African, and Hispanic Americans, Hispanic women have
the lowest rate of masturbation.
Self-Pleasuring Techniques
In this section we offer descriptions of self-pleasuring techniques. Spe-
cific techniques for masturbation vary. Males commonly grasp the penile
shaft with one hand, as shown in
Figure 8.1. Some men prefer to use
lotion; others like the natural friction of a dry hand. Up-and-down
motions of differing pressures and tempos provide stimulation. A man
can also stroke the glans and frenulum or caress or tug the scrotum. Or,
rather than using his hands, a man can rub his penis against a mattress
or pillow.
Women enjoy a variety of stimulation techniques. Typically, the hand
provides circular, back-and-forth, or up-and-down movements against
the mons and clitoral area (see
Figure 8.2). e glans of the clitoris is
rarely stimulated directly, although it can be stimulated indirectly when
covered by the hood. Some women thrust the clitoral area against an
object such as bedding or a pillow. Others masturbate by pressing their
thighs together and tensing the pelvic oor muscles that underlie the
vulva. Some women insert their ngers or sex toys into their vaginas dur-
ing masturbation, especially for G-spot stimulation. Dildos and vibrators
that have a curve at the end are particularly good for G-spot stimulation
(Blue, 2007).
Sex Toys
Some individuals also use vibrators and other sex toys for added enjoy-
ment or variation in self-stimulation. Research has found that about 53%
of women and 45% of men have used vibrators in solo or partnered sexual
activities and that vibrator use among women and men is associated with
positive sexual function (Herbenick et al., 2011a; Reece et al., 2009). Sex
toy use appears to be more common among gay and bisexual men than
among heterosexual men. Almost 79% of gay and bisexual-identified
Figure 8.2 Female masturbation.
Figure 8.1 Male masturbation.
© Cengage Learning© Cengage Learning
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234 CHAPTER 8
men have used at least one sex toy for self-stimulation or with a part-
ner (Rosenberger et al., 2012).
Ninety percent of women who masturbate with a vibrator are com-
fortable talking to their partner about it, and many couples incorpo-
rate vibrators into their sex play (Berman, 2004). Sociologist Pepper
Schwartz encourages men not to feel threatened by including a vibra-
tor with their partners: “Gentlemen, this is not your competition, it’s
your colleague (Schwartz, 2006). Several dierent types of vibrators
are available, and peoples preferences vary.
e vibrator is only one kind of sex toy for self-pleasuring and
enhancing sexual interaction with ones partner. e dildo, or articial
penis, has been used to enhance sexual arousal throughout history,
and dildos have been found at archeological sites dating from 4000
BCE (Chalker, 2002). Dildos are also used for anal stimulation. Men
can use latex or rubber simulations of female genitals for masturba-
tion. More elaborate sex toys that stimulate several genital sites at
once are also available, and new variations are always being developed
(Davies, 2011).
Sexual Expression:
The Importance of Context
Up to this point in the chapter, we have been looking primarily at ways
that people express themselves sexually as individuals. However, many
of the sexual behaviors with which we are concerned take place as interactions between
people. In the sections that follow we discuss some of the more common forms of
shared sexual behavior.
This phallic shape was found at a Stone Age settlement
in Sweden. It is carved from a deer antler and is
believed to be a 6,000 to 8,000 year old dildo.
The ring ts at the base of the
penis, and the ball stimulates
the clitoris.
Courtesy of Vibratex, Inc.; www.vibratex.com
Vibrators come in
many forms. The TV
show Sex and the City
brought the rabbit to
the public’s attention.
Courtesy of Vibratex, Inc.; www.vibratex.com
Ann Summerss sex toy.
Steven Chapple
Europics/Newscom
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Sexual Behaviors235 235
The Context of Sexual Expression
Although the following sections include discussions of sexual techniques, a sexual
interaction cannot stand on its own; it exists within the context of motivation and
meanings of the individuals involved and the relationship as a whole (M. Cooper et al.,
2011). One writer explained:
Sex can be motivated by excitement or boredom, physical need or aection, desire or
duty, loneliness or complacency. It can be a bid for power or an egalitarian exchange, a
purely mechanical release of tension or a highly emotional fusion, a way to wear oneself
out for sleep or a way to revitalize oneself. Sex can be granted as a reward or inducement,
an altruistic oering or a favor; it can also be an act of selshness, insecurity, or narcis-
sism. Sex can express almost anything and mean almost anything. (Fillion, 1996, p. 41)
Table 8.2 shows the top 15 out of 237 reasons college men and women gave for
being sexual with a partner. Notably, 20 of the top 25 reasons were identical for men and
women (Meston & Buss, 2007).
TABLE 8.2 Top 15 Reasons College Women and Men Give for Having Sex
Women Men
1. I was attracted to the person. I was attracted to the person.
2. I wanted to experience the physical pleasure. It feels good.
3. It feels good. I wanted to experience the physical pleasure.
4. I wanted to show my affection to the person. It’s fun.
5. I wanted to express my love for the person. I wanted to show my affection to the person.
6. I was sexually aroused and wanted the release. I was sexually aroused and wanted the release.
7. I was horny. I was horny.
8. It’s fun. I wanted to express my love for the person.
9. I realized I was in love. I wanted to achieve an orgasm.
10. I was “in the heat of the moment. I wanted to please my partner.
11. I wanted to please my partner. The person’s physical appearance turned me on.
12. I desired emotional closeness (i.e., intimacy). I wanted the pure pleasure.
13. I wanted the pure pleasure. I was “in the heat of the moment.
14. I wanted to achieve an orgasm. I desired emotional closeness (i.e., intimacy).
15. It’s exciting, adventurous. It’s exciting, adventurous.
The Maltz Hierarchy
The context within which sexual experiences occur is critically important in deter-
mining whether they are positive for individuals and relationships. Author and sex
therapist Wendy Maltz developed a model of sexual expression that describes levels
of constructive and destructive sexual experiences (Maltz, 2001). Maltz sees sexual
energy as a neutral force; however, the intent and consequences of sexual behavior
can lead in negative or positive directions. For example, marital intercourse may be
intensely passionate; alternatively, it may be spousal rape.
e three positive levels of sexual interaction are built on mutual choice, caring,
respect, and safety. As shown in
Figure 8.3, Level +1 (Positive Role Fulllment)
reects well-dened gender roles, established by social or religious custom, in which
(in heterosexual relationships) the man is the initiator and the woman is the receiver.
Sexual interactions at this level are characterized by mutual respect, a lack of coercion
and resentment, and a strong sense of safety and predictability. Pregnancy and reduc-
tion of sexual tension are common goals for sex.
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236 CHAPTER 8
Level +2 (Making Love) emphasizes mutual pleasure through
individual sexual creativity and experimentation. Traditional gender-
role behavior is set aside, and sex expands to an erotic recreational
experience. Partners reveal themselves more deeply through sexual
self-expression and communication that create greater intimacy.
Level +3 (Authentic Sexual Intimacy) brings a shared sense of deep
connection both to oneself and to ones partner, with reverence toward the
body in the erotic experience. e enjoyment of sensual pleasure includes
a profound expression of love for one another. Emotional honesty and
openness are of paramount importance, and each partner gains a deeper
sense of wholeness. Authentic sexual intimacy can be a momentary peak
experience, or it can characterize an entire lovemaking experience.
Maltz points out that sexual interactions can also be upsetting or
traumatic ordeals, often imposed on one person by another. On the
negative side of her hierarchy, each level becomes increasingly destruc-
tive and abusive.
Level –1 (Impersonal Interaction) is marked by a lack of respect and
responsibility toward oneself and the other person. Here, individuals
disregard possible negative consequences for themselves and their part-
ners, including unwanted pregnancy and exposure to sexually trans-
mitted infections, including HIV. Enduring unpleasant sex and being
dishonest about issues relevant to the partner (health status or meaning
of the sexual experience) occur at this level. ese experiences result in
uncomfortable, uneasy feelings. An example of such a result can be how
a person feels about himself or herself after hooking up. One study
found that college women were more likely than college men to have
negative reactions after a one-time sexual encounter (Owen & Fincham,
2011). Alcohol and drug use is often an element in sexual experiences
that individuals later regret (Kaiser Family Foundation, 2003).
Level –2 (Abusive Interaction) involves one persons conscious
domination of another by psychological coercion. is can include
coercion for a particular sexual activity. For example, one study found
that about 50% of young women had felt pressured to engage in oral sex on one or more
occasions (Hammond et al., 2011). Other examples include nonviolent acquaintance
rape and incest, and degrading coercive communication. Distorted thinking allows the
exploitative person to rationalize or deny the harm he or she is inicting on the other
person. e experience usually damages the exploited persons self-esteem.
Level –3 (Violent Interaction) occurs when sexual energy is used purposefully to
express hostility. Sex organs are weapons and targets. Rape is the most extreme example.
Frequency of Partner Sexual Activity
The 2005 Global Sex Survey of 317,000 people in 41 countries found that, on aver-
age, individuals have sex 103 times a year.
Table 8.3 shows the range of frequency in
several countries.
e following discussions of shared sexual behaviors, except for coitus and gay and
lesbian sexual expression, are directed toward all individuals, regardless of their sexual
orientation. In fact, because sex between same-sex partners does not duplicate the per-
vasive heterosexual model’s emphasis on penile–vaginal intercourse, gays and lesbians
sexual repertoire is often more expansive and creative than heterosexuals (Nichols,
2000; Sanders, 2000). In lesbian sexual relationships the mutual desire for an apprecia-
tion of touching can result in increased sexual arousal and orgasm compared to women
in heterosexual relationships (Laumann et al., 1994). When a heterosexual sexual
Level +3 Authentic Sexual Intimacy
Emotional openness and closeness;
feelings of ecstasy
Level +2 Making Love
Pleasure focused;
mutuality;
experimentation
Level +1 Positive Role Fulfillment
Social-role behavior;
religious or cultural duty;
sex for reproduction
Level –1 Impersonal Interaction
Lack of responsibility for birth control,
sexually transmitted infections,
or well-being of self and other
Level –2 Abusive Interaction
Sexual dominance and coercion
Level –3 Violent Interaction
Sex used to express hostility;
rape
Sexual Energy (Ground Zero)
Figure 8.3 The Maltz hierarchy of sexual interactions.
SOURCE: Maltz (2001).
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Sexual Behaviors237 237
experience has a greater variety of sexual behaviors, research nds that it is more likely
for the woman to experience orgasm (Herbenick et al., 2010a).
Table 8.4 compares
sexual behaviors and responses of lesbians and heterosexual women.
TABLE 8.4 Comparison of Lesbians’ and Heterosexual Women’s Last
Sexual Experience
Experience During Last Sexual Contact Lesbians (%) Heterosexual Women (%)
Had more than one orgasm 32 19
Received oral sex 48 20
Lasted 15 minutes or less 4 14
Lasted more than 1 hour 39 15
SOURCES: Lesbian statistics from Advocate magazine survey (Lever, 1994); heterosexual statistics from
the National Health and Social Life Survey (Laumann et al., 1994).
TABLE 8.3 Frequency of Sex in Selected Countries
Country Frequency of Sex per Year
Greece 138
Croatia 134
Bulgaria 127
United States 113
South Africa 109
Canada 108
Germany 104
China 96
India 75
Japan 45
SOURCE: Global Sex Survey, 2005.
e sequence in which the following sexual behaviors are presented does not mean
that such a progression is best in a particular sexual relationship or encounter; for exam-
ple, a heterosexual couple may desire oral–genital stimulation after coitus rather than
before. Nor is any one of these activities necessary in a given relationship or encounter:
Complete sexual experience can consist of any or all of them, with or without orgasm.
A sex therapist explained: “Once you’ve begun to think of sex as creating mutual erotic
pleasure rather than as manufacturing orgasms, sex is a continuum of possibilities. You
may nd, for example, that low-key genital—or even non-genital—stimulation can be
surprisingly erotic and relaxing (Ellison, 2000, p. 317). In addition, because sexuality is
inuenced by the relationship as a whole, it may be best to think of foreplay as how part-
ners have treated each other since their last sexual experience together (Joannides, 1996).
Kissing and Touching
i like my body when it is with your
body. It is so quite new a thing.
Muscles better and nerves more.
i like your body. i like what it does,
i like its hows. i like to feel the spine
of your body and its bones, and the trembling
-firm-smoothness and which i will
again and again and again
kiss, i like kissing this and that of you,
i like, slowly stroking the, shocking fuzz
of your electric fur, and what-is-it comes
over parting flesh. . . . And eyes big love crumbs,
and possibly i like the thrill
of under me you so quite new
e. e. cummings*
*”i like my body when it is with your . . . Copyright 1923, 1925, 1951, 1953 © 1991 by the Trustees for the
E. E. Cummings Trust. Copyright © 1976 by George James Firmage, from Complete Poems: 1904–1962 by
E. E. Cummings, edited by George J. Firmage. Used by permission of Liveright Publishing Corporation.
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
238 CHAPTER 8
Kissing
Many of us can remember our first romantic kiss; most likely it was combined
with feelings of awkwardness. Kissing can be an intense, erotic, profound experi-
ence. The lips and mouth are generously endowed with sensitive, pleasure-pro-
ducing nerve endings that make it feel good to kiss and to be kissed in infinite
variations. The classical Indian text on eroticism, the Kama Sutra, describes 17
kinds of kisses (Ards, 2000). Kissing with closed mouths tends to be more tender
and affectionate, whereas open-mouth or deep or French kissing is usually more
sexually intense. Kissing can also run the gamut of oral activities, such as licking,
sucking, and mild biting. All places on the body are possibilities for kissing.
Western practices and attitudes about kissing are by no means universal.
Mouth-to-mouth kissing is completely absent in the highly explicit erotic art
of ancient Chinese and Japanese civilizations. In Japan in the 1920s mouth
kissing was viewed so negatively that Rodins famous sculpture e Kiss was
concealed from public view when it was displayed there as part of an exhibit of
European art. Other cultures—the Lepcha of Eurasia, the Chewa and onga
of Africa, and the Siriono of South America—consider kissing unhealthy and
disgusting (Tiefer, 1995).
Touching
Touch is one of the first and most important senses that we experience when we
emerge in this world. Infants who have been fed but deprived of this basic stimula-
tion have died for lack of it. A classic animal study showed that when baby monkeys
and other primates physical needs were met but they were denied their mothers
touch, they grew up to be extremely maladjusted (Harlow & Harlow, 1962).
Touch forms the cornerstone of human sexuality shared with another (Kluger,
2004). In Masters and Johnsons evaluation:
Touch is an end in itself. It is a primary form of communication, a silent voice that
avoids the pitfall of words while expressing the feelings of the moment. It bridges
the physical separateness from which no human being is spared, literally establishing
a sense of solidarity between two individuals. Touching is sensual pleasure, explor-
ing the textures of skin, the suppleness of muscle, the contours of the body, with no
further goal than enjoyment of tactile perceptions. (1976, p. 253)
e body’s erogenous zones are especially responsive to touch. For example, about
81% of women and 51% of men reported that stimulation of their breasts and nipples
caused and/or enhanced their arousal (Levin & Meston, 2006). However, touch does
not need to be directed to an erogenous area to be sexual. e entire body surface is
a sensory organ, and touching—almost anywherecan enhance intimacy and sexual
arousal. Dierent people like dierent types and intensities of touch, and the same per-
son can nd a certain touch highly arousing one time and unpleasant the next. It is help-
ful for couples to communicate openly about touching.
Contrary to the stereotype that sexual experiences of gay men are completely geni-
tally focused, extragenital eroticism and aection are important aspects of sexual con-
tact for many male couples. “Compared to other men, gay men are often able to have
more diversity, self-expression, and personal enjoyment in their sexual contact” (Sand-
ers, 2000, p. 253). Hugging, kissing, snuggling, and total-body caressing are important.
A survey of gay men found that 85% liked such interactions more than any other cat-
egory of sexual behavior (Lever, 1994).
Auguste Seysses, “Le Retour”. Toulouse, Musée des Augustins, Photo: Daniel Martin
The marble sculpture Le Retour by Auguste
Seysses, 1898, in The Musee des
Augustins,
Toulouse, France.
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Sexual Behaviors239 239
Rubbing genitals together or against other parts
of a partner’s body can be included in any couples
sexual interaction and is common in lesbian lovemak-
ing. Rubbing ones genitals against someone elses
body or genital area is called tribadism. Many les-
bians like this form of sexual play because it involves
all-over body contact and a generalized sensuality.
Some women nd the thrusting exciting; others
straddle a partner’s leg and rub gently. Some rub the
clitoris on the partner’s pubic bone (Loulan, 1984).
Manual Stimulation of the Female Genitals
The kinds of genital touches that induce arousal vary
from one woman to another. Even the same woman
might vary in her preference from one moment to the
next. Women can prefer gentle or firm movements on
different areas of the vulva. Direct stimulation of the
clitoris is uncomfortable for some women; touches
above or along the sides are sometimes preferable. Insertion of one or more fingers into
the vagina can enhance arousal. One technique for G-spot stimulation is for the partner
to insert two fingers and firmly stroke the urethral sponge with a come here” motion
(Taormino, 2011). Most women approaching orgasm commonly need steady, consis-
tent rhythm and pressure of touch through orgasm (Ellison, 2000).
e vulval tissues are delicate and sensitive. If not enough lubrication exists to make
the vulva slippery, it can easily become irritated. A lubricant such as Astroglide, a lotion
without alcohol or perfume, or saliva can be used to moisten the ngers and vulva to
make the touch more pleasurable.
Manual Stimulation of the Male Genitals
Men also have individual preferences for manual stimulation, and, like women, they
might desire a firmer or softer touch—and faster or slower strokes—as their arousal
increases. Gentle or firm stroking of the penile shaft and glans and light touches or
tugging on the scrotum may be desired, as shown in
Figure 8.4. Some men find that
lubrication with an oil, lotion, or saliva increases pleasure. (For heterosexual couples, if
intercourse might follow, lotion should be nonirritating to the womans genital tissues.)
Immediately following orgasm the glans of the penis may be too sensitive to stimulate.
OralGenital Stimulation
Both the mouth and the genitals are primary biological erogenous zones, areas of the
body generously endowed with sensory nerve endings. Thus couples that are psycho-
logically comfortable with oral–genital stimulation often find both giving and receiv-
ing it to be highly pleasurable. Oral–genital contact can produce pleasure, arousal, or
orgasm. As one woman stated:
I think that men put too much emphasis on a woman coming from “regular
sex.A lot of women I know, including myself, have only experienced orgasm
(aside from masturbation) through oral sex. I thoroughly enjoy getting and giv-
ing oral sex. I love the sounds, sights, smells, and tastes. (Authors’ files)
Figure 8.4 Manual stimulation can be a highly pleasurable way for
partners to explore each others sensations.
tribadism
Rubbing ones genitals against
anothers body or genitals.
© Cengage Learning
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240 CHAPTER 8
Oral–genital stimulation can be done individually (by one partner
to the other) or simultaneously. Some people prefer oral sex individu-
ally, because they can focus on either giving or receiving, as in
Figure
8.5. Others especially enjoy the mutuality of simultaneous oral–genital
sex. Simultaneous stimulation is sometimes referred to as 69 because
of the body positions suggested by that number (
Figure 8.6). Besides
the position illustrated in the gure, a variety of other positions can be
used, such as lying side by side and using a thigh for a pillow. Because
arousal becomes intense during mutual oral–genital stimulation, part-
ners need to be careful not to suck or bite too hard.
Dierent terminology is used to describe oral–genital stimulation
of women and oral–genital stimulation of men. Cunnilingus (kuh-
ni-LIN-gus) is oral stimulation of the vulva: the clitoris, labia minora,
vestibule, and vaginal opening. Many women nd the warmth, soft-
ness, and moistness of the partner’s lips and tongue highly pleasurable
and eective in producing sexual arousal or orgasm. In fact, there is
research evidence that women are most likely to experience orgasm
in sexual encounters that include cunnilingus (Richters et al., 2006).
Variations of stimulation include rapid or slow circular or back-and-forth tongue move-
ment on the clitoral area, sucking the clitoris or labia minora, and thrusting the tongue
into the vaginal opening. Some women are especially aroused by simultaneous manual
or dildo stimulation of the vagina and oral stimulation of the clitoral area. According to
the NSSHB study, over half of women ages 18 to 49 had received oral sex from a male
partner in the previous year (Herbenick et al., 2010b).
Fellatio (fuh-LAY-shee-oh) is oral stimulation of the penis and scrotum. Options
for oral stimulation of the male genitals include gently or vigorously licking and sucking
the glans, the frenulum, and the penile shaft, and licking or enclosing a testicle in the
mouth. Some men enjoy combined oral stimulation of the glans and manual stroking of
the penile shaft, testes, or anus. Among homosexual men fellatio is the most common
mode of sexual expression—more so than anal sex (Lever, 1994).
It is usually best for the partner performing fellatio to control the other’s movements
by grasping the penis manually below her or his lips to prevent it from going farther into
the mouth than is comfortable. is helps avoid a gag reex. Also, too vigorous thrust-
ing could result in lacerations of the partner’s lips as he or she attempts to protect the
penis from his or her teeth.
SEXUALHEALTH
Figure 8.5 During oral sex one
partner can devote full attention to the
experience of giving while the other
can enjoy receiving.
Figure 8.6 Simultaneous oral–genital
stimulation in the 69 position.
cunnilingus
Oral stimulation of the vulva.
fellatio
Oral stimulation of the penis.
© Cengage Learning
© Cengage Learning
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Sexual Behaviors241 241
Couples dier in their preference for including ejaculation into the mouth as a part
of male oral–genital stimulation. Many nd it acceptable, and some nd it exciting. For
those who do not want oral sex to include ejaculation into the mouth, a couple can agree
beforehand that the one being stimulated will indicate when he is close to orgasm and
withdraw from his partner’s mouth. For couples who are comfortable with ejaculating
into the mouth, the ejaculate can be swallowed or not, according to ones preference.
e avor of ejaculate varies from person to person and is inuenced by the factors
described in
Table 8.5.
TABLE 8.5 Factors Affecting Taste of Ejaculate
Sources of Unpleasant Bitter or Salty-Tasting Ejaculate Sources of Milder-Tasting Ejaculate
Coffee, alcohol, cigarettes, junk food, and recreational drugs Water—1 to 2 liters a day
Red meats and dairy products Fruit, especially pineapple juice
Garlic, onions, cabbage, broccoli, cauliower, and asparagus Veggies with high chlorophyll content, such as parsley and celery
Cinnamon, cardamom, peppermint, and lemon
SOURCE: Tarkovsky, 2006.
In the United States, dierences in oral sex experience and attitudes exist among
population segments, as shown in the following Sexuality and Diversity discussion.
SEXUALITY and DIVERSITY
Oral Sex Experiences Among American Men and Women
The National Health and Social Life Survey (Laumann et al., 1994) questioned men
and women of different ethnic, educational, and religious backgrounds to compare
their experiences of oral sex. The findings are summarized in
Table 8.6. In general,
White Americans (both men and women) have the highest level of experience with
oral sex, followed by Hispanic Americans; African Americans have the lowest rate of
oral sex. However, socioeconomic level is more important than race. A study com-
paring African American and White American men of matched socioeconomic status
found similar rates of oral sex experience (Samuels, 1997).
TABLE 8.6 Oral Sex Experiences From the National Health
and Social Life Survey
Performed
Men
Oral Sex (%)
Women
Received
Men
Oral Sex (%)
a
Women
Race
White 81 75 81 78
African American 51 34 66 49
Hispanic American 71 60 73 64
Education
Less Than High School 59 41 61 50
High School Graduate 75 60 77 67
Any College 81 78 84 82
Religion
Conservative Protestant 67 56 70 65
Other Protestant 82 74 83 77
Catholic 82 74 82 77
Other or None 79 78 83 83
a
Rounded to nearest percentage point.
SOURCE: Laumann et al. (1994, p. 141).
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242 CHAPTER 8
Some people have qualms about oral–genital stimulation. ey may believe that
their own or the partners genitals are unattractive. Although routine, thorough
washing of the genitals with soap and water is adequate for cleanliness, some people
think the genitals are unsanitary because they are close to the urinary opening and
anus. Despite these negative attitudes, oral–genital contact is quite common and
has become even more so in the last 15 years (Herbenick et al., 2010b). e mean-
ing and role of oral–genital sex have also changed greatly over time. For example,
women born before 1950 almost never experienced oral sex in high school or before
marriage, and oral sex occurred after the couple had been having intercourse for
some time. Currently, most adults believe that oral sex is more intimate than inter-
course, whereas most teens and young adults believe the opposite (Chambers, 2007;
Gelperin, 2005). Furthermore, research indicates that young people who have had
sexual intercourse are as likely to have had oral sex (De Rosa et al., 2010). A study
of 15- to 19-year-olds found that about 55% of teenagers have had oral sex—5%
more than have had sexual intercourse (Duberstein et al., 2008). Some research even
indicates that young people do not consider oral sex to be sex. A survey that asked,
Would you say you had sex’ with someone if you engaged in ____” found that only
20% believed this was true if they had oral sex. However, 98% agreed that they had
sex if they had penile–vaginal intercourse, and 78% agreed they had sex if they had
anal intercourse (Hans et al., 2010). Does this mean that sex” only happens if a
penis is put inside another’s body?
Some individuals may engage in oral sex instead of intercourse because they believe
they cannot contract HIV (the virus that causes AIDS) through oral sex. Although the
risk of transmitting HIV through oral–genital contact is low, only monogamous part-
ners who are both free of the virus are completely safe when engaging in such behavior.
Because oral–genital contact involves an exchange of bodily uids, it does pose the risk
of transmitting or contracting HIV. is virus can enter the bloodstream through small
breaks in the skin of the mouth or genitals. In addition, oral cancers can be caused by the
human papillomavirus (HPV), also a sexually transmitted infection. e risk increases
with the more oral sex partners an individual has (Girshman, 2011). (We discuss HIV
and HPV extensively in Chapter 15).
Anal Stimulation
Anal sex among heterosexuals has become more common in the United States. The
NSSHB study found that 20% of men ages 25 to 49 and women ages 20 to 39 reported
anal sex in the last year. The percentages of people who have had anal sex at least once
in their lifetimes have doubled—40% of men ages 25 to 59 and women ages 20 to 39
(Herbenick et al., 2010a).
e anus has dense groups of nerve endings that can respond erotically. Individu-
als and couples may use anal stimulation for arousal and variety. Manually stroking
the outside of the anal opening, inserting one or more ngers into the anus, or licking
the anus can be pleasurable for some people during masturbation or partner sex. Some
women report orgasmic response from anal intercourse (Masters & Johnson, 1970),
and heterosexual and homosexual men often experience orgasm from stimulation dur-
ing penetration. For others, anal sex is unappealing, uncomfortable, or painful (Carter et
al., 2010). In fact, one study found that almost half of young heterosexual women had
to discontinue their rst anal intercourse because of pain or discomfort. ese ndings
SEXUALHEALTH
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexual Behaviors243 243
highlight the importance of information, education, and partner communication about
anal intercourse (Stulhofer & Ajdukovic, 2011).
Because the anus contains delicate tissues, special care needs to be taken during
anal stimulation. A nonirritating lubricant and gentle penetration are necessary to
avoid discomfort or injury. It is helpful to use lubrication on both the anus and the
penis or whatever object is being inserted. e partner inserting needs to go slowly
and gently, keeping the penis or other object tilted to follow the direction of the colon
(Morin, 1981). It is essential for sex toys or other objects used for anal stimulation
to have a larger base than tip; otherwise an object can slip past the anal opening
and become trapped by the anal sphincter, requiring a trip to the emergency room to
remove the object.
Important health risks are associated with anal intercourse (McBride & Fortenberry,
2010). Heterosexual couples should never have vaginal intercourse directly following
anal intercourse, because bacteria in the anus can cause vaginal infections. Oral stimula-
tion of the anus, known as analingus (or, in slang, rimming”), is extremely risky; various
intestinal infections, hepatitis, and sexually transmitted infections can be contracted or
spread through oral–anal contact, even with precautions of thorough washing. Careful
use of a dental dam helps prevent transmission of bacteria and viruses.
Anal intercourse is one of the riskiest of all sexual behaviors associated with trans-
mission of HIV, particularly for the receptive partner because tissue in the anus is rela-
tively fragile and can tear easily. For women the risk of contracting this virus through
unprotected anal intercourse is greater than the risk of contraction through unprotected
vaginal intercourse (Maynard et al., 2009). Heterosexual and gay male couples who
wish to reduce their risk of transmitting or contracting this deadly virus should use a
condom or refrain from anal intercourse. In Chapter 15 we more fully discuss precau-
tions to avoid transmission of HIV.
Coitus and Coital Positions
A heterosexual couple can choose a wide range of positions for penile–vaginal inter-
course, or coitus.
Table 8.7 shows college students three favorite positions. Many
people have a favorite position yet enjoy others, as shown in
Figures 8.7 through 8.11.
A 30-year-old man stated:
SEXUALHEALTH
analingus
Oral stimulation of the anus.
Different intercourse positions usually express and evoke particular emotions
for me. Being on top, I enjoy feeling aggressive; when on the bottom, I experi-
ence a special kind of receptive sensuality. In the side-by-side position, I easily
feel gentle and intimate. I like sharing all these dimensions of myself with my
lover. (Authors’ files)
TABLE 8.7 College Students Answer the Question “What Is Your Favorite
Intercourse Position?”
Men (%) Women (%)
Man on top 25 48
Woman on top 45 33
Doggie style 25 15
SOURCE: Elliott & Brantley (1997).
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244 CHAPTER 8
Figure 8.7 Man-above, face-to-face
intercourse position.
© Cengage Learning
Figure 8.8 The woman-above inter-
course position.
© Cengage Learning
Each position provides various opportunities for physical and emotional expression.
Changes in health, age, weight, pregnancy, or partners can create dierent preferences. In
some positions, one person has greater freedom to initiate and control the tempo, angle,
and style of movement to create arousing stimulation. In other positions, mutual control
of the rhythm of thrusting works well. Some positions—such as the woman above, sit-
ting upright—lend themselves to manual stimulation of the clitoris during intercourse.
Many couples like a position that allows partners to make eye contact and see each
other’s bodies. e face-to-face, side-lying position can provide a particularly relaxed
connection, with each partner having one hand free to caress the other’s body. Rear entry
can be a good position during pregnancy, when pressure against the womans abdomen is
uncomfortable. e tailgate position is a rear-entry position where the woman is lying
at on her stomach, and the man enters from behind (Taormino, 2011). is position is
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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexual Behaviors245 245
particularly good for G-spot stimulation. Beyond options for position, cooperation and
consideration are important, particularly at intromission (entry of the penis into the
vagina). Often the woman can best guide her partner’s penis into her vagina by moving
her body or using her hand. If the penis slips out of the vagina, which can occur fairly
easily in some positions, it is usually easiest for the woman to lend a helping hand to
guide the penis back into the vagina.
Intercourse the Tantric Way
The concept of male orgasm as the ultimate point of heterosexual intercourse is alien
to the concepts and practices of Tantric sex (Yarian & Anders, 2006). Margo Anand,
in her book The Art of Sexual Ecstasy (1991), explains that Tantra was an ancient
Eastern path of spiritual enlightenment, begun in India around 5000 BCE. Tantric
thought holds that an erotic act of love between a god and a goddess created the
world. According to this viewpoint, sexual expression can become a form of spiritual
meditation and a path of deep connection (Kuriansky & Simonson, 2005).
Figure 8.10 Face-to-face, side-lying
intercourse position.
© Cengage Learning
Figure 8.9 Tailgate position.
© Cengage Learning
intromission
Insertion of the penis into the vagina.
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246 CHAPTER 8
In Tantric sex the male learns to control
and delay his own orgasm and to redirect the
sexual energy throughout his and his part-
ner’s body. Before intercourse, lovers usually
slowly and erotically stimulate each other.
When both partners are ready for intercourse,
the woman guides gentle, relaxed penetra-
tion. e couple initially keeps thrusting to a
minimum, generating energy by subtle inner
movements, such as contractions of the mus-
cles surrounding the opening of the vagina.
e couple harmonizes their breathing, nd-
ing a common rhythm of inhaling and exhal-
ing, while visualizing the warmth, arousal,
and energy in the genitals moving upward in
their bodies. Movements can become active
and playful, always slowing or stopping to
relax before the man experiences orgasm.
e partners welcome feelings of profound
intimacy and ecstasy, often looking into each
other’s eyes, creating a deep relaxation of the heart” (Anand, 1991). Research indicates
that studying Tantra Yoga improves the physical and psychological aspects of sexual
experience (Yekenkurul, 2007).
© Werner Forman/Art Resource, New York
Figure 8.11 The rear-entry intercourse position
can be a comfortable option during pregnancy.
© Cengage Learning
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Sexual Behaviors247 247
Celibacy
Celibacy means not engaging in sexual activities. Celibacy
can be complete (avoiding masturbation and interpersonal
sexual contact) or partial (including masturbation). In many
circumstances celibacy is a positive way of expressing ones
sexuality.
Erotic Dreams and Fantasy
Erotic dreams often accompany sexual arousal and orgasm
during sleep. Erotic fantasies serve many functions: ey
can enhance sexual arousal, help overcome anxiety or
compensate for a negative situation, allow rehearsal of new
sexual experiences, permit tolerable expression of forbidden
wishes, and provide relief from gender-role expectations.
Masturbation
Masturbation is self-stimulation of the genitals, intended to
produce sexual pleasure.
Past attitudes toward masturbation have been highly con-
demnatory. However, the meaning and purposes of mastur-
bation are currently being more positively reevaluated.
Masturbation is a behavior that tends to continue
throughout adulthood, although its frequency varies
with age and sex.
Sexual Expression: The Importance
of Context
e meaning of sexual expression can vary from a profound
sense of love for self and other to exploitation and abuse.
e Maltz hierarchy delineates six levels.
Kissing and Touching
e body’s entire surface is a sensory organ, and kissing
and touching are basic forms of communication and shared
intimacy.
Preferences as to the tempo, pressure, and location of
manual genital stimulation vary from person to person. A
lubricant, a nonirritating lotion, or saliva on the genitals can
enhance pleasure.
Summary
Oral–Genital Stimulation
Oral–genital contact has become more common in recent
years. Qualms about oral–genital stimulation usually stem
from false ideas that it is unsanitary or solely a homosexual
act or from religious beliefs that it is immoral.
Cunnilingus is oral stimulation of the vulva; fellatio is oral
stimulation of the male genitals.
Anal Stimulation
Couples engage in anal stimulation for arousal, orgasm,
and variety. Careful hygiene is necessary to avoid introduc-
ing anal bacteria into the vagina. To reduce the chances of
transmitting the AIDS virus, couples should avoid anal
intercourse or use a condom and practice withdrawal before
ejaculation.
Coitus and Coital Positions
e diversity of coital positions oers potential variety dur-
ing intercourse. e man-above, woman-above, side-by-side,
and rear-entry positions are common.
Tantric sex emphasizes intense, prolonged sexual intimacy.
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