How Did Erectile Dysfunction Become “Natural”? A Review of the Critical Social Scientific Literature on Medical Treatment for Male Sexual Dysfunction

This article reviews the multidisciplinary social science literature assessing the social consequences of medical treatment for male sexual dysfunction. This literature applies medicalization theory and social constructionist approaches to gender to assert that Euro-American cultural ideals of masculinity and sexuality, as well as ageism and ableism, determine which sexual changes and experiences get defined as “dysfunction” and shape the marketing and use of medical treatments for those changes. These medical responses assuage the suffering of men who become unable to meet cultural ideals for sexuality but in the process make reductive norms for male sexuality seem biologically natural. In addition, the critical social science research suggests that an economic logic underlies the process of redefining diversity and change in men’s sexual function as medical pathology. However, comparative qualitative data on men’s and their sexual partners’ experiences of sexuality and aging across world regions suggest that people do not universally accept the narrow ideals of male sexuality embedded in medical discourse regarding men’s sexual dysfunction. The diversity in people’s sexual desires across the life course and their responses to sexual function change highlight the cultural nature of medical definitions of sexual dysfunction.     

(Not) talking about sex: youth, identity and sexuality

Young people remain inhibited in their exploration of sexuality not only by heterosexual morality and gendered power relations but also by their transitional status, yet the age dimension of youth and sexuality has been relatively neglected in recent research. This paper examines a number of social constraints on young people's opportunities for talk and discussion about sex, with reference to their experiences of sex education and services in sexual health. Based on interviews with 147 young women and young men and a separate survey of 400 clinic users, it emphasises the limited social acceptance of teenage sexuality and the forms of its regulation, which are both normative and relational. Attention to social relations with adults also shows how questions of sexual citizenship are closely connected to wider issues of social equality.     

Gender differences in sexual attitudes and behaviors: a review of meta-analytic results and large datasets

Gender differences in sexual attitudes and behaviors are typically believed to be large, yet recent evidence suggests that some gender differences in sexuality are much smaller than common knowledge would suggest. This article reviews gender differences in sexual attitudes and behaviors as reported by major meta-analyses and large datasets. In particular, this article reviews gender differences in heterosexual intercourse, masturbation, pornography use, attitudes toward premarital sex, and gender differences in same-gender sexuality. Evolutionary psychology, social cognitive learning theory, and social structural theory are explored as possible explanations for gender differences in sexuality.     

Older Lesbian Sexuality: Identity,Sexual Behavior,and the Impact of Aging

In response to the very limited and mostly outdated literature on older lesbian sexuality, this exploratory study examined older lesbian sexual identity, romantic relationships, the impact of aging, and experiences of discrimination within these contexts. Utilizing an online survey that recruited via numerous online lesbian communities and snowball sampling, 456 lesbians over the age of 50 responded to closed, Likert scale, and open-ended questions that provided a preliminary understanding of older lesbian sexuality. The results indicated that older lesbians have experienced fluidity in past romantic and sexual relationships, as well as in erotic fantasies, despite strong identification with being lesbian. The findings also indicate a decreased focus on sexuality in the context of relationships, with more focus on stability and continuity. Future research is needed that provides greater specificity and detail about older lesbian conceptions of sexual behavior and sexual identity labels, as well as specific sexual behaviors.     

How a Divorcee’s Sexual Life Is Socially Constructed and Understood in the Iranian Culture

Sexual well-being is an important factor in postdivorce adjustment and presents various challenges for divorced women in Iran. With an alarming number of marriages ending in divorce in Iran, the postdivorce sexuality adjustment process has become a major concern. Meanings attached to the sexuality of a divorcee necessitate different adjustment and coping strategies among women. How these meanings are generated, negotiated, and modified in Iranian contexts has yet to be explored. We used a grounded theory approach to analyze the extensive, rich data obtained through sustained interaction with the informants as well as through in-depth individual interviews and focus group discussions. “Sociosexual problems” was found to be one of the main domains in our study. Participants experienced a negative impact from divorce on their sexual lives, including sexual interactions. Social isolation and social exclusion resulted from the avoidance of stereotypic interactions and were often a consequence of difficulties with concealment of sexual needs due to stigma. Women discussed a range of negative experiences arising in response to their sexual needs in postdivorce life. The analysis revealed the complexities of gendered postdivorce sexual trajectories. Based on the findings, articulating a sexual health model specific for divorced women seems important.     

Older lesbian sexuality: identity, sexual behavior, and the impact of aging

In response to the very limited and mostly outdated literature on older lesbian sexuality, this exploratory study examined older lesbian sexual identity, romantic relationships, the impact of aging, and experiences of discrimination within these contexts. Utilizing an online survey that recruited via numerous online lesbian communities and snowball sampling, 456 lesbians over the age of 50 responded to closed, Likert scale, and open-ended questions that provided a preliminary understanding of older lesbian sexuality. The results indicated that older lesbians have experienced fluidity in past romantic and sexual relationships, as well as in erotic fantasies, despite strong identification with being lesbian. The findings also indicate a decreased focus on sexuality in the context of relationships, with more focus on stability and continuity. Future research is needed that provides greater specificity and detail about older lesbian conceptions of sexual behavior and sexual identity labels, as well as specific sexual behaviors.     

Sex With Chinese Characteristics: Sexuality Research in/on 21st-Century China

This article examines the changing contours of Chinese sexuality studies by locating recent research in historical context. Our aim is to use the literature we review to construct a picture of the sexual landscape in China and the sociocultural and political conditions that have shaped it, enabling readers unfamiliar with China to understand its sexual culture and practices. In particular, we focus on the consequences of recent changes under the Xi regime for individuals’ sexual lives and for research into sexuality. While discussing the social and political regulation of sexuality, we also attend to the emergence of new forms of gendered and sexual subjectivity in postsocialist China. We argue throughout that sexuality in China is interwoven with the political system in a variety of ways, in particular through the tension between neoliberal and authoritarian styles of governance. We explore normative and dissident sexualities as well as forms of sexual conduct that are officially “deviant” but nonetheless tolerated or even tacitly enabled by the party-state. In particular, we highlight the dilemmas and contradictions faced by China’s citizens as they negotiate their sexual lives under “socialism with Chinese characteristics.”     

The sexuality‐assemblage: desire,affect, anti‐humanism

Two theoretical moves are required to resist the ‘humanist enticements’ associated with sexuality. Post‐structuralism supplies the first, showing how the social produces culturally specific sexual knowledgeabilities. A second anti‐humanist move is then needed to overturn anthropocentric privileging of the human body and subject as the locus of sexuality. In this paper we establish a language and landscape for a Deleuze‐inspired anti‐humanist sociology of sexuality that shifts the location of sexuality away from bodies and individuals. Sexuality in this view is an impersonal affective flow within assemblages of bodies, things, ideas and social institutions, which produces sexual (and other) capacities in bodies. Assemblages territorialize bodies' desire, setting limits on what it can do: this process determines the shape of sexuality, which is consequently both infinitely variable and typically highly restricted. We illustrate how this anti‐humanist ontology may be applied to empirical data to explore sexuality‐assemblages, and conclude by exploring the theoretical and methodological advantages and disadvantages of an anti‐humanist assemblage approach to sexuality.     

Bare Bodies: Nudity,Gender, and the Looking Glass Body1

This article examines the role of nude embodiment as it affects sexuality, intimacy, and pleasure when people seek to align their nude body with cultural values. This research, based on open‐ended and closed‐ended data from 184 young heterosexual adults attending a large Midwestern university, finds the experience of nude embodiment and its effects to be strongly gendered. For example, among both men and women, comfort with one’s nude body is associated with a sexually expansive point of view, but it is only found to be associated with sexual behavior and pleasure among the women. For women, too, feelings of objectification in nude embodiment are shown to be mitigated through positive relationships with their male partner. Throughout we emphasize the “lived experience” of the body, especially as experienced in the body techniques used in the pursuit of sexual intimacy and pleasure. Discussion relates these results to objectification theory and how wider social changes may impinge on sexual embodiment in general.     

Medicalizations and demedicalizations of sexuality therapies

This article complicates recent discussions about the expanding zones and influences of medicalization and biomedicalization on sexuality and sex therapy by contextualizing them with competing nonmedicalizing trends. These latter developments include an escalating nonexpert commercial sexuality sector on the Internet, as well as a long history of anarchic and democratizing social politics, such as "the counterculture" and "free love movements." What these nonmedicalizing trends have in common is the view of sexual problems and solutions as far broader than sexual dysfunctions and sex therapies, a belief in the social determinants of individuals' sexual experiences, and a deep concern regarding the socially harmful consequences of medicalization. With the quantity of sexuality information and advice available to the public through the Internet only likely to expand, a long era of clashing claims about relations between sexuality and health and about the role of expertise in sexual life can be foreseen.     

Sexuality and digital Space

Since the Internet's inception, sociologists have sought to understand the role digital spaces play in mediating communication, interaction, and its impact on the broader social world. Sociological literature at the intersection of sexuality and digital space presents a key area of inquiry, charting the generative, and sometimes utopian, aspects of sexuality's insertion into the virtual sphere, as well as the problems and drawbacks of this relationship. By drawing on select empirical studies, this article charts three dominant research strands on sexuality and digital space: (a) the influence of digital platforms in sexual selfhood projects; (b) macro‐level trends and micro‐level practices of desire, attraction, and dating online; and (c) the role of digital platforms in sustaining sexual subcultures. I propose additional approaches and lines of inquiry to further develop research in these areas.     

How Sexual Identities Change: Pragmatism,Habit, and Creativity in the ‘Situation’ of the Lascivious Costume Ball

How do individuals’ sexual identities, in the sense of who they are as sexual beings, change? Research addressing this question in the modern U.S. setting points to several factors, including macrolevel societal transformations, vernacular culture, interpersonal interactions, psychodynamics, and life course transitions. Yet it is less clear how these diverse factors are configured in broader social processes. This article draws on and extends the pragmatist mechanism-based approach to social theory to illuminate a key causal pathway whereby individuals’ sexual identities may change. I argue that habits, specifically taken-for-granted ways of doing and thinking about sexuality, are a crucial constituent of sexual identities. But when individuals encounter problem situations to which existing habits are inadequate responses, they are more likely to do and think about sexuality creatively. Incorporation of these creative responses into stocks of habits can readily encompass shifts in sexual identities. The argument is illustrated using people’s dramatic reflections on the first three iterations of the Lascivious Costume Ball, a sexuality-themed party that occurred at the University of Chicago. The Ball dramatized the radical historical moment of the Sixties and functioned as an exceptional problem situation for all but three of my respondents. The utility of the theory centers on its capacity to (1) generate more precise explanations of how individuals’ sexual identities change; (2) integrate distinct literatures on sexual identity into a carefully generalizable theory of individual change; and (3) highlight a crucial relational dimension of certain problem situations.     

Hormones and history: the evolution and development of primate female sexuality

Sexual behavior is required for reproduction in internally fertilizing species but poses significant social and physical risks. Females in many nonprimate species have evolved physical and behavioral mechanisms restricting sexual behavior to when females are fertile. The same hormones producing female fertility also control these mechanisms, assuring that sex only occurs when reproduction is possible. In contrast to nonprimate mammals, hormones do not regulate the capacity to engage in sex in female anthropoid primates, uncoupling fertility and the physical capacity to mate. Instead, in primates, sexual motivation has become the primary coordinator between sexual behavior and fertility. This dependence upon psychological mechanisms to coordinate physiology with behavior is possibly unique to primates, including humans, and allows a variety of nonphysiological influences, particularly social context, to regulate sexual behavior. The independence between hormonal state and sexual behavior allows sex to be used for social purposes. This complex regulation of primate sexuality develops during adolescence, where female monkeys show both hormonally influenced sexual motivation and socially modulated sexual behavior. We present findings from rhesus monkeys illustrating how social context and hormonal state interact to modulate adolescent and adult sexuality. It is argued that this flexibility in sexual behavior, combined with a tight regulation of sexual motivational systems by reproductive hormones, allows sexual behavior to be used for nonreproductive purposes while still assuring its occurrence during periods of female fertility. The evolutionary pressures that produced such flexibility in sexual behavior remain puzzling, but may reflect the importance of sexuality to primate social attraction and cohesion.     

Sexuality in Marriage,Dating, and Other Relationships: A Decade Review

In this article, we review the major research advances made during the 1990s in the study of sexuality in marriage and other close relationships. More specifically, we provide a critical review of the empirical findings from the last decade on such sexual phenomena as sexual behavior, sexual satisfaction, and sexual attitudes within the context of marriage, dating, and other committed relationships. After highlighting the major theoretical and methodological advances of the 1990s, we focus on the research literatures of: (1) frequency and correlates of sexual activity in marriage; (2) sexual satisfaction, including its association with general relationship satisfaction; (3) sexuality in gay and lesbian committed relationships; (4) trends in sexual behavior and attitudes in dating relationships; and (5) the role of sexuality in dating relationships. We also incorporate brief reviews of the past decade's research on sexual assault and coercion in marriage and dating and on extramarital sex. We end our decade review with recommendations for the study of sexuality into the next decade.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Masculine Status,Sexual Performance,and the Sexual Stigmatization of Women

Collegiate hookup culture advances ideas of masculinity but contradicts notions of appropriate feminine sexuality. Drawing on focus group and interview data with college students, I examine how a group of class‐ and race‐privileged fraternity men face dilemmas as they enact a group constructed masculinity focused on sexual performance and the objectification of women. I employ a symbolic interactionist framework to illustrate how men, attentive to peer status yet anxious about the sexual stigmatization of women, draw on cultural ideas about appropriate feminine sexuality as they account for their approaches to sex and women (both with whom they interact sexually and how) along a range of intimacy—from hookups to committed relationships. I demonstrate that heterosexual interaction does not unequivocally link to masculine status and that men sometimes strive to limit the impact of casual sex or avoid it altogether.     

Effects of sexually transmitted infection status, relationship status, and disclosure status on sexual self-concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.     

Vaginal reconstruction in gynecologic cancer: A feminist perspective

Vaginal reconstruction is a frequent accompaniment of or sequel to radical surgery for recurrent gynecologic cancers. After reviewing research on vaginal reconstruction, undertaken from a perspective which gives prominence to women's power over decisions concerning the use of their bodies and over the definition of their sexuality, we note that the psychosocial and sexual impact of such surgery for the patient and her partner has often been underestimated, ignored, or misunderstood. We discuss the need for vaginal reconstruction and the definition of its success in terms of researchers' Stereotypic attitudes and assumptions about female sexuality as these are exemplified in their research methodologies. This analysis raises serious concerns about what constitutes informed consent for reconstructive surgery, the medical professionals' biases about female sexuality concerning power over their own bodies, and how best to meet the sexual rehabilitation needs of women with gynecologic cancer.