Human Sexuality

Caroline Pukall is an associate professor in the Department of Psychology at Queen's University. Caroline is also the director of the sex therapy service at the psychology clinic at Queen's University, through which she trains and supervises clinical psychology graduate students in sex and couple therapy. Among other published works, Caroline has over 30 articles in peer-reviewed journals and has written numerous book chapters. She is the co-editor of a professional book entitled Female Sexual Pain Disorders: Evaluation and Management (Wiley-Blackwell, 2009); a co-author of When Sex Hurts: A Woman's Guide to Overcoming Sexual Pain (Da Capo Press, 2011); an associate editor for The Journal of Sexual Medicine; and a member of several university-based committees and professional organizations.

About the Editor ; Contributor Biographies ; Editor's Preface ; Acknowledgements ; From the Publisher ; Media and Supplements ; 1. Perspectives on Sexuality ; Katherine S. Sutton, Karen L. Blair, and Caroline F. Pukall ; What to Expect from a Sexuality Class? ; Introduction ; Sex and Media ; A History of Sex and Advertising in Western Culture ; Sex in Film and on Television ; Sex and the Internet ; Safer Sex Messages ; LGBTTIQQ Issues ; Cultural Diversity ; Culture and Diversity: Sex and Media in Arabic and Japanese Cultures ; A Brief History of Sex Research ; Ancient Text ; The Middle Ages ; Modern History ; Research vs Real Life: Observing Sexual Response as It Happens in the Lab ; How Have Societal Influences Shaped Views of Sexuality? ; Historical Views on Masturbation ; History of the Vibrator ; History of Sex Education in Canada ; Religious and Cultural Views of Sexuality ; Sexual Diversity in Canada ; Ethical Debate: Should Sexual Orientation Be Considered a Human Right? ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 2. Theoretical Approaches to Studying Human Sexuality ; Elke D. Reissing and Heather L. Armstrong ; What Is the Reproductive Advantage of Same-Sex Orientation? ; Introduction ; Psychological Theories of Sexuality ; Psychodynamic Theory ; Classical Conditioning ; Operant Conditioning ; Research vs Real Life: Should Sex Offenders Avoid Sex? ; Social Learning Theory ; Social Exchange Theory ; Cognitive Theories ; Biological Theories of Sexuality ; Genetic Theory ; Sociobiological Theory ; The Dual Control Model of Sexuality ; Social Constructionist Theories of Sexuality ; Sociological Theory ; Social Script Theory ; Research vs Real Life: It's Evolution: Casual Sex and Sexual Strategies Theory ; Culture and Diversity: I Do-Do You? ; Feminist Theory ; How Do Theories Inform Clinical Work with Sexual Problems? ; Ethical Debate: To What Extent Can You Use Theory to Justify Your Own Sexual Choices? ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 3. Sex Research Methods ; Melissa A. Farmer ; Participating in a Sex Research Study ; Introduction ; Culture and Diversity: Using Research to Explore Sexuality in Asian Canadians ; Ethical Debate: "Normal" Sexuality and Clinical Definitions of Sexual Dysfunction ; A Historical Overview of Sex Research Methods ; Early Texts ; Modern Texts ; Kinsey's Interview-Based Approach ; Masters and Johnson's Observational Approach ; Qualitative vs Quantitative Approaches to Research ; Sex Research Methods and Designs ; Descriptive Designs ; Correlational Designs ; Experimental and Quasi-experimental Designs ; Psychophysiological Approaches to Research ; Measures of Genital Response ; Quantitative Sensory Testing ; Brain Imaging Methods ; Relevance of Animal Sexuality ; Behavioural Indicators of Sexual Response in Animals ; Rodents as Model Organisms ; Research vs Real Life: Translation of Animal Research to Human Sexual Functioning ; Limitations of Animal Models ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 4. Sexual Anatomy: The Parts, the Pieces, and How They Respond ; Caroline F. Pukall and Richard J. Wassersug ; Why Would Anyone Want to Become a Eunuch? ; Introduction ; Female Genitals ; External Genitals ; Culture and Diversity: Female Genital Mutilation ; Internal Organs ; Ethical Debate: The Anatomical Problem with Backroom Abortions ; Male Genitals ; External Genitals ; Research vs Real Life: Circumcision ; Internal Organs ; Other Areas of Interest: Erogenous Zones ; Female Breasts ; The Mechanics of Coital Sex ; Sexual Response Cycles ; Masters and Johnson's Sexual Response Cycle ; Other Sexual Response Cycle Models ; Comparing the Models: Sexual Function and Dysfunction ; Age-Related Decreases in Sexual Response ; Sex Differences in Sexual Response ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 5. Sex Hormones and Human Sexuality ; Gillian Einstein and Jennifer Blake ; The Role of Hormones in Sexuality ; Introduction ; What Are Hormones? ; Hormone Synthesis ; What Are Sex Hormones? ; Ethical Debate: Is It a Boy or a Girl? ; The Sexual Brain ; Sex Hormones and Sexuality in the Reproductive Years ; How Hormones Affect Sexuality ; Culture and Diversity: Are Females and Males Born or Made? ; How Sexual Activity and Other Life Factors Affect Hormone Levels ; Oxytocin and Vasopressin: Pleasure, Bonding, and Affiliation ; Prolactin ; Does the Act of Smelling Sex Hormones Lead to Sexual Behaviour? ; Pheromones ; Research vs Real Life: Passing the Sniff Test, or What Your T-Shirt Might Be Saying about You ; Sex Hormones, Sexuality, and Aging ; Menopause ; Andropause ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 6. Pregnancy and Childbirth ; Samantha Waxman and Beverley Chalmers ; Facebook "Unlikes" Breastfeeding ; Introduction ; Conception ; Pregnancy Detection ; Fetal Development ; First Trimester ; Second Trimester ; Third Trimester ; Sexuality during Pregnancy ; Choice of Caregiver for Normal Births ; Culture and Diversity: The Traditional View of Pregnancy in India ; Delivery Options ; Vaginal Birth ; C-Section ; Research vs Real Life: C-Section-Modern-Day Miracle? ; Immediately after the Baby Is Born ; The Postpartum Period ; Postpartum Emotional Issues ; Sexuality during the Postpartum Period ; Breastfeeding ; Complicated Pregnancies ; Ectopic Pregnancy ; Miscarriage (Spontaneous Abortion) ; Rh Incompatibility ; Pregnancy-Induced Hypertension ; Congenital Anomalies ; Preterm Birth/Low Birth Weight ; Anoxia ; Stillbirth ; Infertility and Reproductive Technologies ; Psychological Impact of Infertility ; Treatment of Infertility ; Assisted Human Reproduction (AHR) ; Ethical Debate: Cloning: How Far Is Too Far? ; ART-Related Multiple Births ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 7. Contraception and Pregnancy Options ; Katherine S. Sutton and Beverly Chalmers ; Uh-Oh ... ; Introduction ; Ancient Forms of Birth Control ; A Brief History of Birth Control in Canada ; Ethical Debate: China's One-Child Policy ; Modern Methods of Birth Control ; Hormonal Contraceptives ; Non-hormonal Intra-uterine Devices and Barrier Methods ; Surgical Methods ; Natural Methods ; Abstinence ; Birth Control Use around the World ; Research vs Real Life: Male Contraceptive Pill/Injection ; Birth Control Use in Canada Today ; The Psychology of Birth Control ; Why Use Birth Control? The Bigger Picture ; Choosing Not to Use Birth Control: Sexual Risk-Taking in Canada ; Talking to Your Partner about Contraception ; Emergency Contraception ; The Emergency Contraceptive Pill ; Post-coital IUD Insertion ; Unwanted Pregnancies ; Who Gets Abortions? ; A Brief History of Abortion in Canada ; Types of Abortions ; Culture and Diversity: Abortion around the World ; The Psychological Effects of Abortion ; The Pro-choice-Pro-life Debate ; Adoption ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 8. Sexually Transmitted Infections: At the Junction of Biology and Behaviour ; William A. Fisher and Marc Steben ; Judy and Chris ; Introduction ; Back to the Future: STIs Past and Present ; A Brief History of Syphilis and Herpes ; A Brief History of HIV/AIDS ; Research vs Real Life: Do Good Values Make Bad Science? ; The STI Hit Parade ; Bacterial STIs ; Viral STIs ; Research vs Real Life: HPV Prevention: A Revolution in Women's Health? ; Ethical Debate: Which Side Are You On? Stimulating Sexual Interest and Sexual Activity among HIV-Positive Persons ; Strange Bedfellows: Other Genital Concerns ; STI Screening and STI Testing: How to Approach the Topic with a (Potential) Sexual Partner ; Is There a Reasonable Way to Be Sexual in the New Millennium? ; Think about Sex ; Use Condoms ; Culture and Diversity: HIV/AIDS-Prevention Interventions in the United States and South Africa ; Get Vaccinated ; Take Secondary Prevention Measures ; Check Out-but Don't Rely On-Your Partner's Sexual and Injection Drug Use History ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 9. Sexuality over the Life span ; Elke D. Reissing and Heather L. Armstrong ; Life Stages ; Introduction ; Sexuality in Infancy and Early Childhood ; Sexuality Education during Childhood ; Sexuality in Preadolescence ; Sexuality in Adolescence ; Sexual Activity during Adolescence ; Sexuality among LGBTTIQQ Adolescents ; Sexuality in Adulthood ; Being Single ; Dating ; Ethical Debate: Sexuality and Disability ; Culture and Diversity: Attitudes toward Premarital Sex across Different Cultures ; Living Together ; Getting Married ; Research vs Real Life: Long-Distance Relationships Are Doomed ... Right? ; Extradyadic Sex ; Divorce ; Sexuality and Older Adults ; Physical Effects of Aging and Their Association with Changes in Sexuality ; Sexual Activity in Older Adults ; Safer Sex among Sexually Active Older Adults ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 10. Gender ; Meredith L. Chivers ; In What Gender Do We Raise Our Child? ; Introduction ; Gender or Sex? ; Nature and Nurture: Theoretical Perspectives on Gender and Sexuality ; Gender Differences or Similarities in Sexuality? ; Masturbation, Numbers of Sexual Partners, Attitudes toward Casual Sex, and Erotica Use ; Sexual Orientation ; Patterns of Sexual Response ; Reporting Biases ; Disorders of Sexual Development ; Sex Chromosome Variations ; Sex Hormone Variations ; Physical Traumas and Congenital Variations ; Gender Development in Childhood ; What Factors Shape a Child's Sense of Gender Identity and Gender Roles? ; Ethical Debate: Is It Possible to Raise a Child Genderless? ; Gender Variation in Childhood and Adolescence ; Trans Identities ; Life Experiences and Sexual Orientations of Transmen and Transwomen ; Transitioning to the Felt Gender and Sex ; Research vs Real Life: Autogynephilia ; The Choice Not to Transition ; Culture and Diversity: A Third (or More) Gender(s)? ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 11. Sexual/Affectional Orientations and Diversity ; Kevin Alderson ; Charlie's Struggle with Same-Sex Attraction ; Introduction ; Sexual/Affectional Orientations and Identities ; Sexual vs Affectional Orientations ; Attempts to Measure Sexual/Affectional Orientations ; Identity Labels ; Asexuality ; Prejudice against Same-Sex Oriented Individuals ; Conversion Therapy ; Research vs Real Life: The Negative Effects of Hate Speech ; Theories of Affectional Orientation and Sexual Identity Development ; Affectional Orientation Development ; Sexual Identity Development ; Self-Identification and Identity Disclosure ; Self-Identification as Lesbian, Gay, or Bisexual ; Identity Disclosure ; Culture and Diversity: Global and Cross-Cultural Findings Regarding Sexual Diversity ; Ethical Debate: Should You Help a Child Become Gender Conforming? ; Relationships and Sex ; Intimate Relationships ; Bisexuality and Relationships ; Same-Sex Sexual Behaviour ; LGB Parenting and Adoption ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 12. Attraction, Intimacy, and Love ; Kelly B. Smith ; Keeping the Magic Alive ; Introduction ; Attraction ; Proximity ; Physical Attractiveness ; Reciprocity and Uncertainty ; Similarity ; Menstrual-Cycle Effects ; Do Opposites Attract? ; Pick-Up Strategies: What Works for Men, and What Works for Women? ; Intimacy ; What is Intimacy? ; Attachment Theory ; Hooking Up and Casual Sex ; Love ; What Is Love? ; Culture and Diversity: Cross-cultural Views on Love ; Different Types of Love: Passionate and Companionate ; Theories of Love ; Research vs Real Life: Attraction, Intimacy, and Love over Time ; Love for Objects ; Optimal Sexuality ; Jealousy ; Different Types of Jealousy: Sexual and Emotional ; Social Networking Sites and Jealousy ; The Role of Online Technologies in Love, Attraction, and Intimacy ; Ethical Debate: Infidelity ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 13. Sexual Communication ; Uzma S. Rehman and Erin E. Fallis ; Let's Talk about Sex ; Introduction ; Communication in Intimate Relationships ; Couples' Communication Behaviours ; Patterns of Couples' Communication ; How Do Researchers Study Couples' Communication? ; Gender Differences in Heterosexual Couples' Communication ; Sexual Communication ; Importance of Sexual Communication ; Culture and Diversity: Differences in Couples' Communication Styles across Cultures ; Why Do Couples Find It Challenging to Talk about Their Sexual Relationship? ; Should We Ask Couples to Discuss Sexual Topics for Research Purposes? ; Do Same-Sex Couples Have Different Patterns of Sexual Communication than Mixed-Sex Couples Have? ; How to Communicate Effectively with One's Partner about Sexuality ; Ethical Debate: What Responsibility Do Psychologists Have to Break or Protect Confidentiality If an Individual Discloses Information about Risky Sexual Behaviours? ; Research vs Real Life: Who Should Give Children "the Talk," and When Should It Happen? ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 14. Sexual Behaviours and Relationships ; Natalie O. Rosen and Sheila MacNeil ; A "Friends-With-Benefits" Relationship ; Introduction: What Does It Mean to "Have Sex"? ; First Sexual Experiences ; Expectations of and Reactions to First Sexual Experiences ; Virginity ; Ethical Debate: Should Doctors Perform "Revirgination" Surgery for Cultural and Social Reasons? ; Sexual Consent ; Varieties of Sexual Behaviours ; Solitary Sexual Behaviours ; Partnered Sexual Behaviours ; Research vs Real Life: Prevalence of Oral Sex among Adolescents ; Orgasm ; Sexual Satisfaction and Sexual Preferences ; Sexual Satisfaction ; Sexual Preferences ; Culture and Diversity: Acculturation and Sexuality in East Asian Canadians ; Use of Sex Toys to Increase Sexual Pleasure ; Diversity in Sexual Relationships ; Monogamous Relationships ; Non-monogamous Relationships ; Media ; Theoretical Perspectives on How Media Influences Sexuality ; Positive and Negative Influences of Media on Sexuality ; The Internet ; Sexually Explicit Material ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 15. Variations in Sexual Behaviour ; Katherine S. Sutton and Caroline F. Pukall ; Lord Morpheous Speaks, and You'd Better Listen! ; Introduction: What Is "Normal" Sexual Behaviour? ; How Are Atypical Sexual Behaviours Defined? ; Diagnosing Paraphilic Disorders ; What Are the Commonly Identified Atypical Sexual Behaviours? ; Paraphilias and Paraphilic Disorders that Involve Consenting Partners ; Ethical Debate: Voluntary Amputation ; Paraphilic Disorders that Involve Non-consenting People: The Courtship Disorders ; Pedophilic Disorder ; Other Specified Paraphilic Disorders ; Culture and Diversity: The Child Sex Trade in Southeast Asia ; What Factors Play a Role in the Development and Maintenance of Paraphilias/Paraphilic Disorders? ; Psychoanalytic Theory ; Behavioural Theory ; Neurological Findings ; Theories of Development and Maintenance of Pedophilic Disorder ; Sex Differences in Paraphilias ; Assessment of Paraphilic Disorders ; Treatment of Paraphilic Disorders ; CBT and Relapse-Prevention Techniques ; Self-Esteem and Social-Skills Training ; Satiation Therapy ; Research vs Real Life: Sex Offender Registries ; Orgasmic Reconditioning ; Aversion Therapy ; Community-Based Support Programs ; Medical Treatments ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 16. Sexual Dysfunctions ; Peggy J. Kleinplatz ; A New Baby ; Introduction ; Causes of Sexual Problems ; Intrapsychic Factors in the Development of Sexual Problems ; Interpersonal/Relational Factors in the Development of Sexual Problems ; Cultural/Psychosocial Factors in the Development of Sexual Problems ; Culture and Diversity: BDSM and the DSM ; Organic Factors in the Development of Sexual Problems ; Sexual Difficulties in Men and Women ; Sexual Difficulties in Men ; Sexual Difficulties in Women ; Sexual Desire Disorders in Men and Women ; Research vs Real Life: Botox Injections for Vaginismus ; Therapy for Sexual Difficulties ; Sex Therapy in the New Millennium ; Ethical Debate: Pink Viagra for Women? ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 17. The Dark Side of Sex: Assault and Harassment ; Scott T. Ronis ; Trying to Move On: A Rape Survivor's Story ; Introduction: Why Is It Important to Understand the Dark Side of Sex? ; Sexual Assault and Rape ; Prevalence and Incidence of Sexual Assault ; Human Sex Trafficking ; Effects of Sexual Assault ; Reasons for Sexual Assault ; Culture and Diversity: Marital Rape Lost in Translation ; Practical Advice Following a Sexual Assault ; Legal Sanctions for Sexual Assault ; Sexual Victimization of Men ; Ethical Debate: Ethical Issues in Rounding Up the Usual "Sex-spects" ; Childhood Sexual Abuse ; Sexual Harassment ; Research vs Real Life: Should We Treat Juvenile Sexual Offenders Like Adult Sexual Offenders? ; Sexual Harassment as an Employee ; Sexual Harassment as a Student ; Effects of Sexual Harassment ; Reasons for Sexual Harassment ; Legal Sanctions for Sexual Harassment ; Stalking ; Effects of Stalking ; Characteristics of Stalkers ; Reasons for Stalking ; Legal Sanctions for Stalking ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 18. Selling and Buying Sex ; Kevin Alderson ; What Do You Do With Tracy? ; Introduction ; Growth of the Sex Industry ; Selling and Buying Sex ; Sex Trade Work ; A Snapshot of the History of STW in Canada ; Legal Aspects of STW ; Types of STW ; Culture and Diversity: The Decriminalization of STW in New Zealand and Australia ; Who Works in the Sex Trade, and Why? ; If You Sell Sex, Do You Enjoy Sex? ; Underage STWs ; The Impact of STW on Physical and Psychological Health ; Male STWs ; Exotic Dancing ; Ethical Debate: What Approach Should We Take to Exotic Dancing in Canada? ; Pornography, Erotica, and Sexually Explicit Material ; Effects of Consuming SEM ; Research vs Real Life: How about Erotica Instead of Violence on Television? ; Internet SEM ; Addiction to SEM ; Being a "Porn Star" ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; 19. Sex Education in Canada ; Stephanie C. Boyer & Shannon M. Coyle ; Abracadabra: Vagina! ; Introduction ; Sex Education in Canada ; Goals and Principles ; Theory ; Curriculum and Delivery ; Effectiveness of Sex Education: How Is Canada Doing? ; Knowledge ; Motivation ; Behaviour ; Alternative Forms of Sex Education ; Parents and Peers ; Research vs Real Life: Does Talking about Sex Lead to Sex? ; Media ; Barriers to Sex Education ; Institutional Barriers ; Socio-demographic Factors ; Culture and Diversity: Sex Education in Canadian Aboriginal Populations ; Sex Education for Older Adults ; Sex Education for Individuals with Disabilities ; Ethical Debate: Sexuality in Individuals with Intellectual Disabilities ; Chapter Summary ; Debate Questions ; Review Questions ; Suggestions for Further Reading and Viewing ; Glossary ; References ; Index ; Photo Credits