Exploring Healthy Sexuality s1

Sexuality Research

Research Methods

I. Our current knowledge about sexuality is based on relatively few studies

II. First task of researcher is to ask an explicit question A. Next is designing a way to gather the relevant information – in sexuality research, most commonly used methods are surveys, case studies & experimental research

B. Good researcher chooses method according to particular problem & population being studied

III. Scientific method – research conducted in an atmosphere free from bias; since it is the most objective way to establish new knowledge in any field A. Must approach research without preconceived agendas to show what sexual behavior should be 1. Scientists should not set out to prove something but instead to discover what is

B. Steps in the scientific method 1. Identifying a research question – based on personal interest/experience, on social concerns or on interests of those funding research (govt. or industry)

2. Reviewing the literature – researchers learn what is already known about topic, think of ways to conduct desired research & come up with new questions

3. Formulating an hypothesis (or 2 or more hypotheses)

4. Operationalizing variables – specifying how they are going to be measured; some are easy, some difficult; must state clearly how measure is to be made

5. Collecting data – survey research, case studies, experimental research, direct observation

6. Analyzing data to test hypotheses – data analyzed to describe situations, to show that one situation causes another or to show relationship between variables C. Various forms of bias can be problematic – bias of researchers, research subjects (if all subjects are college-educated —> probably biased)

D. Can't study all humans so must study relatively small group of people from which results may be generalized to larger population 1. Generalization is ability to conclude that the same results would be obtained outside the study

2. Population – the group being studied in research project; usually only a sample (segment of the larger population) participates; full population too unwieldy, large

3. Random sample represents larger population & is chosen in a way that eliminates bias; if sample selected properly, findings can be generalized to larger population

IV. Survey Research – surveys asking people about sexual attitudes and experiences; done orally in face-to-face interviews or in written form as part of a questionnaire A. Surveys are used when information from a large number of people is needed B. The interview allows the interviewer to explain the purpose & value of the survey, to clarify & explain the questions & to report answers clearly

C. Questionnaires are less expensive than interviews, which require many people to conduct them 1. Questionnaires filled out at convenience make people feel more relaxed & reinforces anonymity; privacy may also ensure more honest answering 2. Questionnaire eliminates subject's being influenced by interviewer's facial or bodily gestures

V. Case studies – in depth studies of individuals or small, select groups of individuals; usually followed over a period of months or years A. Case studies provide a chance to look at specific behaviors or characteristics in great depth B. Since they cover a relatively long period of time, one can investigate cause-and-effect relationships in detail (sex offenders, people with sexual-response difficulties)

VI. Experimental research – behavior studied under controlled conditions; match to groups and compare them; groups are identical except for one important difference A. The experimental group is subjected to a particular event or condition, whereas the control group is not B. Both groups are observed & the results are compared to determine whether the experimental condition had an effect

VII. Direct observation – method in which subjects are watched in lab, class, natural setting or workplace; accurate way to collect sexual info especially if researcher controls setting A. Major drawback is required expenditure of time & money; also people may be reluctant to perform sexual activity in lab where they are being observed B. Some people question ethics of participating in observational research as researcher or as subject

Issues in Sexuality Research

I. Cooperation is a big problem in such studies; tough to get a large group of people who will stay with project until it is over A. With mail questionnaires, response rate is usually <40% of those distributed (often close to 20%) B. Interviews are expensive, but response rate can be high, depending on interviewer expertise & awareness 1. Must establish rapport to avoid embarrassment, intimidation, unresponsiveness

II. Additional problems with sexuality research A. Many conditions affect sexuality like broad cultural & social definitions of sexuality roles & proper sexual behavior & characteristics such as:

B. Cooperative subjects may be hard to find due to anxiety, self-consciousness & reluctance to share private thoughts, experiences & memories about sexuality

C. Hard to gather accurate information is influence of researcher's own values & biases 1. May unintentionally phrase questions in favor of his views due to strong opinions 2. May emphasize certain words in interview &/or have racial, ethnic, cultural views that affect rapport with subjects

III. Ethical issues in sexuality research – must protect people participating in study due to intimate nature of research A. Informed consent of participants – subjects must agree to participate after purposes, risks & benefits of study have been explained to them 1. Ensures subjects understand project nature & agree to the described experience; protects them against physical & psychological abuse by irresponsible researchers

B. Human-research review committees often exist in government agencies & universities 1. They review & approve any research designs & procedures that will use human subjects 2. They consider value of research & compare it to any potential risks to participants

C. Studies of sexual behaviors & attitudes of various racial groups – some feel it is important to better understanding of diverse feelings & practices

D. The methods that have been developed to measure physiological changes in vagina or penis due to sexual stimulation – its use can be debated 1. Vaginal plethysmography – involves inserting probe into vagina to measure elevated blood volume, as indicator of sexual arousal; chart blood volume changes over time 2. Penile strain guage – wire or cuff placed around penis & attached to plethysmograph, a lab measuring device that charts physiological changes over time

3. Plethysmography used to determine a person's sexual interests, like sexual interest in children; could provide info that would lead to referral for possible treatment

E. Crucial to be sure test has validity that it tests what it's supposed to – sexual knowledge test must be good representation of overall sexual knowledge compare to others F. Many believe sexuality research is useless & meaningless since subjects can lie about sexual behavior, exaggerate experiences or be too embarrassed to discuss honestly Early Sexuality Researchers

I. Attempts to study human sexual behavior systematically date back at least to ancient Greeks A. Physicians like Hippocrates & philosophers like Plato & Aristotle are forefathers of sexuality research

B. Rome – Greek physicians (Soranus, Galen) further advanced sexual knowledge

C. 19th century – new concerns about overpopulation & sexual psychology intensified efforts to study sexuality D. At turn of 20th century, sexuality investigations became legitimate endeavor in own right

II. Richard von Kraft-Ebbing (1840 – 1902) – wrote during time when Victorian standards strongly suppressed thinking about sexuality A. Since he was product of the time & a physician who worked mostly with sexually disturbed people, writings (1902) indicated that sexual activity is something to fear B. Supported double standard whereby men have sexual freedom s that women do not

C. Had a great influence on physicians as well as the public 1. Seemed to be biased & made some false assumptions, but his writings convinced some physicians & researchers that the study of sexuality was legitimate

III. Henry Havelock Ellis (1859 – 1939), English psychologist & physician who studied sexuality; grew up in fear of what he had been told about danger of nocturnal emissions A. From 1896 – 1910, he published a 6 volume series (Studies in the Psychology of Sex), which included the following beliefs:

B. Wrote about sexual behavior from anthropological, cultural, psychological & medical viewpoints; findings mostly from case studies & life histories C. Two aspects made his writing significant

D. He influenced many of attitudes about sexuality held in society today; his ideas were controversial & ahead of their time, particularly sexuality education support

IV. Sigmund Freud (1856 – 1939) – psychological researcher; developed theories about human development, personality & psychopathology that have influenced our thinking A. According to Freud, to develop into well –adjusted person, he said one had to progress successfully through a number of psychosexual stages B. Viewed sexuality & sexual pleasure as central part of human life & felt that people naturally sought to have as much pleasure & as little pain as possible C. Indicated that sexual activity was natural & that procreation was secondary to pleasure; cautioned against severe restrictions on sexual instincts

D. Important contribution – suggested that early childhood experiences had strong consequences for adult functioning

20th Century Sexuality Researchers: Background

I. 19th century model of sexuality & sexual behavior was a medical one A. Individuals who differed from accepted norms considered ill or, in scientific terms, deviant or pathological; little known about sexual attitudes, behaviors & activities

B. 1930s – a number of things led to greater acceptance of human sexuality as legitimate field for research

20th Century Sexuality Researchers: Scientific Literature - Kinsey

I. Alfred C. Kinsey: Establishing Scientific Sex Research – biologist & zoologist; joined Indiana U. faculty in 1920; gained recognition early in career through writings in biology A. 1937 – became teacher of newly introduced course in marriage & sexuality education 1. As interest grew, began to amass info concerning sexual activities & beliefs about sexuality; his scientific background led him to gather facts & statistical data

2. Realized need to standardize data-collecting methods & developed detailed list of 521 interview questions

B. Interviews covered 6 ways in which males & females achieve orgasm in our culture:

C. Focused on 9 major areas

D. Collected data from only white males/females; represented rural & urban areas in each state & range of ages, marital statuses, educational levels, occupations & religions 1. Sample contained disproportionately high number of better-educated people living in cities; all subjects were volunteers

2. Not first researcher to do sex survey by questionnaire or interview, but revolutionary

E. Americans had little knowledge about sex behavior in our culture before him & his conclusions generated much public reaction 1. Concluded that there was relationship between sexual behaviors/attitudes on one hand & education & socioeconomic factors on the other

2. Concluded from data that people are sexual from early childhood through adulthood F. Since sample disproportionately large number of educated, urban, Protestant young people with fewer less-educated, rural, older persons, did not represent pop. in general G. Despite limitations, work hailed as first large-scale study of sexual behavior; books had large effect on subsequent research & society in general by opening up subject 1. Despite criticism it evoked (some justified), generally acknowledged at time for its objectivity, scholarly approach & scope

II. Kinsey's findings on masturbation - A. Close to 92% of males in study stated that they had masturbated at some point n their lives; highest incidence reported between 16 & 20 years of age B. ~62% of females report that they had masturbated

III. Nocturnal dreams about sex – dreams about sex experienced by both sexes A. 70% of women had dreams about sex; ~90% of women reporting sexual dreams has heterosexual dreams about sex partners they could not identify B. ~37% of 45-year-old women had experienced dreams that led to orgasm

IV. Heterosexual petting – defined as deliberate attempt to effect erotic arousal through any physical contact that does not involve intercourse A. 88% of all males had engaged in petting or would engage in some form of petting before marriage

B. Highest incidence of heterosexual petting in males occurred between 16 & 20 years of age with tremendous variation in frequency

C. 40% of females in study experienced heterosexual petting by 15 & between 69% and 95% had such experience by age 18 1. Petting to the point of orgasm during late teens reported by 23% of females

V. Premarital intercourse A. 22% of all adolescent males had experienced increase; among college males, 67% had experienced it

B. Nearly 50% of females reported premarital intercourse; ~2/3 of married females reported sexual orgasm before marriage through any one of 5 techniques: C. At all social levels, devoutly religious males & females reported much less premarital intercourse than nondevout subjects

D. Also found that people who married earlier had experienced premarital intercourse at younger age; those who married later began premarital intercourse at later age

VI. Homosexual activity – homosexual incidence highest in high school males A. ~37% of all males had some homosexual experience between adolescence & old age B. 25% of females aged 30 years & over had been erotically aroused by other females; 17% had experienced sexual contact with other females

VII. Kinsey Institute still operating as Kinsey Institute for Research in Sex, Gender & Reproduction; located at Indiana University

20th Century Sexuality Researchers: Scientific Literature – William Masters & Virginia Johnson: The Physiology of Sexual Response

I. Masters & Johnson – probably most widely known & cited of all sex-related data; first to observe people's sex behaviors in lab & identify physiological changes during arousal A. Masters was gynecologist, Johnson a psychologist; directors of what was Reproductive Biology Research Foundation In St. Louis; now Masters & Johnson Institute 1. 1966 – published data in Human Sexual Response & in 1970 Human Sexual Inadequacy

B. They realized prostitutes were not best subjects for study of normal sexual response; informed university contacts & professionals that they needed volunteer study subjects 1. Got social & sexual histories for all, gave info to explain study, introduced them to lab setting II. Human Sexual Response - used direct observation, filming, instrument monitoring; recorded changes in body physiology in general & genitals & reproductive organs in particular A. Most findings related to physiological responses to sexual arousal that had never been measured or documented

B. Whole cycle was called human sexual response occurs in both sexes in 4 phases always in order: excitement, plateau, orgasm & resolution

C. Research serves as basis for modern therapy, education & counseling; cross-disciplinary research & general info about sexual functioning

III. Human Sexual Inadequacy – study of sexual dysfunction; put relationship of physiology & psychology of sexual response in sharper focus A. Dealt with causes of sexual dysfunction, relationship of partners who experienced sexual dysfunction & sexual interaction in general B. Defined sexual dysfunction as inability to respond emotionally & physically to sexual arousal; gave range of dysfunctions defining 6 basic types (3 for women, 3 for men)

IV. The group they studied was not representative of overall American population – they were better educated than average, had all been sexually active & were mainly white

V. 1980 – Bernie Zilbergeld & Michael Evans (psychologists) – wrote critical review of M & J research; examined research methods in order to replicate study using different population A. Replication plays important role in research; methodology should be described clearly & specifically so others can replicate it & verify the findings

B. Questioned M & J's conclusions about efficacy of sexual dysfunction treatments, criteria they used to define low relapse rates in patients & small number of patients followed up

VI. 1979 – M & J published Homosexuality in Perspective, a study of sexual response of homosexuals added much info to human sexuality literature A. Data gathered by studying sexual response cycles of 38 lesbian couples & 42 male homosexual couples between 1957 & 1970 B. Homosexuals who had problems with their homosexuality were studied; some expressed desire to function within lifestyle more effectively & some wanted to become heterosexual

20th Century Sexuality Researchers: Scientific Literature – Other Investigators

I. Robert Sorenson: Adolescent Sexuality in Contemporary America – 1973; reported data gathered from ~400 adolescents 13 – 19 years old; first such study since Kinsey A. Parental permission needed for participation since many of subjects were minors; 40% of adults refused permission & some teenagers refused; highlights difficulty of research B. Showed dramatic rise in premarital coitus among American adolescents; 45% of girls & 60% of boys had participated by age 19

C. Found teenagers were concerned with values, communication & emotional aspects of sexual activity

D. Used good sampling procedures, but concerns raised about differences between teens who did & did not participate (since some [or their parents] refused to participate)

II. Melvin Zelnik & John Kantner: Sexual Behavior of Young Women – 1971, 1976, &1979: studied sexual behavior of white & black American females aged from 15 – 19 years A. Gathered info from several hundred women on sexual activity, contraceptive use, premarital pregnancy & abortion using probability sampling techniques B. In 1976 – 1 in 5 American women had experienced intercourse by 16 & 2/3 by 19; numbers were higher than in 1971 group 1. Also in 1976 – 1 in 10 young women reported at least 1 pregnancy by age 17 & 1 in 4 by age 19

C. 1980 – published combined results of 3 studies; incidence of premarital sex for women - >30% in 1971, 43% in 1976 & 50% in 1979 1. Proportion of coital experienced whites rose from 26% in 1971 to 38% in 1976 to 47% in 1979 2. Proportion of coital experienced blacks rose from 54% in 1971 to 66% in both 1976 & 1979; blacks more likely to initiate coitus 1 yr earlier than whites D. Contraceptive methods used in 1976 & 1979 differed as well 1. Use of pill & IUD declined by 41% in the 3 years; use of withdrawal & rhythm method rose by 86%

III. Alan Bell & Martin Weinberg: Homosexuality – studied sexual lives of homosexual men & women in SF area; published findings in 1978; very comprehensive study of gay lifestyle A. Homosexualities: A Study of Diversities Among Men & Women – 979 men & women in sample were from divergent social, economic & occupational strata

B. Concluded that term homosexual should really be homosexualities since they found that distinct types of relationships exist among homosexuals; relationship categories follow: 1. Closed couples – those living together in committed, stable relationships 2. Open couples – those living together with less emotional involvement & dependency & having intercourse outside relationship 3. Functionals – sexually active people uncommitted to any partner 4. Dysfunctionals – sexually active people with sexual problems who were unhappy about being homosexual 5. Asexuals – those who were not happy about being homosexual & who were less active sexually C. Found that homosexual & heterosexual men were much alike, though homosexuals tended to be lonelier & have less self-esteem

D. Concluded that homosexuals who are adjusted to their lifestyle are "no more distressed psychologically than are heterosexual men & women" 1. Published results in 1981 with S. K. Hammersmith in Sexual Preference: Its Development in Men and Women

IV. Philip Blumstein & Pepper Schwartz: Relationships Among Couples – published American Couples (1983); had info about trends in couples, married & cohabiting, hetero- & homosexual A. Distributed questionnaires to 11,000 couples recruited from ads in media; 55% response rate (4314 heterosexual couples; 1757 homosexual couples [969 gay males, 788 lesbian]) B. Both homosexual & heterosexual cohabiting couples seemed to have fewer difficulties in relationships than married heterosexual couples 1. Hypothesized that this occurred because cohabitation is based more on equal participation by both partners

V. National Health & Social Life Survey (NHSLS) – U. of Chicago; first comprehensive survey of adult sexual behavior since Kinsey; awarded grant in 1988 to study 20,000 people A. Designed to assess incidence & prevalence of broad range of sexual practices & attitudes in US population; initiated in response to lack of knowledge of sex practices after AIDS 1. After 2 years of planning, federal funds withdrawn; in 1991, conservative members of Congress were offended by using government funds to study sexual behavior 2. Passed legislation to eliminate federal funding for such studies

B. Findings – of married persons, 93.7% had had only one sex partner in last year as compared with 38% of those never married & not cohabiting 1. Married people much more likely than singles to report being extremely or very happy

Wellness and Human Sexuality

I. Sexuality contributes to overall health & is affected by it; high-level sexual health can be a positive force in our lives A. High level physical well-being (CV health, muscle tone) can make us feel better about our bodies & provide energy & capability to maximize sexual pleasure & function

B. High-level emotional well-being helps one deal with sexual issues C. High-level intellectual well-being helps us process sexual information, think critically & make sound decisions regarding sexual health D. High-level social well-being enhances sexuality & provides safe forum to explore it & share it with others E. Our sexual health is based in ability to form healthy relationships with others

II. All of the levels of well-being impact our sexuality & we will spend the semester looking at many aspects of these impacts