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Archives of Sexual Behavior, Vol. 28, No. 6, 1999

In Memoriam: Robert W. Goy

Robert W. Goy, a noted scientist, died January 14, 1999. He would have been 75 years old on January 25th. His death was ascribed to cardiovascular problems and metabolic complications. Referring to Bob Goy as a scientist is like referring to Mozart as a musician. Bob was a psychologist, a teacher, an editor, an administrator, and a dedicated gourmet. He loved Ž ne wines, and cheese and certainly enjoyed a good, down-toearth, Wisconsin beer. He loved Ž ne music, as did his family. And he loved his family greatly and tenderly, each one, to the youngest grandchild. One could write extensively about Goy, the scientist, and describe his contributions to theories of sexual differentiation of behavior and to behavioral neuroendocrinology. One might speak only of Goy the teacher and the very special relationship he maintained with his students. An account of Goy the administrator would certainly be controversial and leave a few irritated souls debating the issues. Bob Goy had many selves, each an interesting character in itself. Bob Goy began his life in Detroit, but he rarely talked about his childhood, although it would seem there was no special reason to avoid the topic. The same applies to his military service during World War II. Bob attended the University of Michigan and received a B.Sc. degree in psychology in 1947 and 6 years later received a Ph.D. in psychology from the University of Chicago. His Ž rst position after getting his Ph.D. was as an animal trainer and the job probably had little impact on the mainstream of his professional development. His account of the problems faced in training chickens to play basketball was a winner and the story was part of a seminar Bob presented to the Psychology Department at Kansas University in 1954. The animals he trained were sold by his employer to various companies as a packaged form for advertizing a product. One particularly difŽ cult assignment involved a stage set up with two large bags of dog chow; one bag of chow was sold by the customer and the second belonged to a competitor. Bob was to train a male dog to sniff both bags of chow and to have the dog treat the competitor’s bag of chow as a he would the proverbial Ž re hydrant. The job certainly presented a challenge but was otherwise unfulŽ lling and Bob left. 471 0004-0002/99/1200-0471$16.00/0 ° C 1999 Plenum Publishing Corporation

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On route from the animal trainer position, he stopped in Lawrence, Kansas, to visit a family friend, Elliot Valenstein. At the time of the visit Bob was introduced to William C. Young, a professor of anatomy at the University of Kansas and head of an active research program in endocrinology and reproduction. Bob, was offered a research position, and being without work, he was happy to sign on. Soon enough he obtained a U.S. Public Health Service postdoctoral fellowship. I happened to attend the seminar alluded to above and it was then that I Ž rst met Bob and we became life-long friends. I began carrying out research in the Endocrine Lab at night while still a member of the Psychology Department at K.U. I too obtained a postdoctoral fellowship such as Bob had held and started full-time research in Young’s laboratory along with Bob Goy. In 1957 Bob published seven articles. One need not wonder what he must have been doing those Ž rst years as a postdoctoral fellow. Incidentally, he published one of those articles with his friend, Elliot Valenstein, who completed his doctoral research in that same Endocrine Lab. Bob’s title was now Instructor in Anatomy. The research group in the Endocrine Lab was then joined by Dr. Arnold (Arnie) Gerall. Bob had met Arnie while at the University of Michigan, but that was not a factor in Arnie’s appointment since the association was not learned of till later. At this juncture, William Young, whose grant from NIH supported the research, suggested we study the effects of prenatal administered testosterone on the sexual behavior of genetic female guinea pigs. Bob Goy, Arnie Gerall and I, working with Will Young, carried out a series of experiments that would prove to have far-reaching consequences for future research in our laboratory and elsewhere and, indeed, for the development of the entire Ž eld of behavioral neuroendocrinology. In 1959 we published a deŽ nitive article in Endocrinology in which we presented evidence that androgen administered prenatally has an organizing action on the tissues mediating mating behavior. The concept became central to much of the future research by Bob and his graduate students. Bob Goy, with Bill Bridson and Will Young, immediately went on to study “the period of maximal susceptibility of the prenatal female guinea pig to masculinizing actions of testosterone,” which happens to be the title of the article they published in the Journal of Comparative and Physiological Psychology. It was soon decided that the concept of the organizing action of hormones, especially testosterone, on the developing fetus should be studied in a species that more closely resembled man. We set about planning for a long-term study in which rhesus monkeys would serve as subjects. To this end Bob went to the laboratory headed by Harry Harlow in Madison WI. Here Bob was to study methods and techniques of behavioral research on nonhuman primates. I went to Christ Hospital Laboratory in Cincinnati to arrange for timed pregnancies in rhesus female monkeys and to treat the pregnant females with testosterone. The treated pregnant females were then transported by van from Cincinnati to Madison and were placed

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under the care of Bob Goy. The young were born in Madison and Bob observed and recorded their behavior in what became a long term systematic study of their behavior. Quite unexpectedly, Will Young was asked if he would consider setting up and leading a program in reproductive biology at the Oregon Regional Primate Research Center. Young asked Bob and me if we would join him if he accepted such a position. We both agreed to go. Three months later we were in Beaverton, Oregon, with our baggage of monkeys and guinea pigs. Bob moved directly to Oregon from Madison and Will Young and I moved from Lawrence, Kansas. Bob had completed the Ž rst phase of research on the behavior of the female pseudohermaphroditic monkeys and their controls. An invited article in Science by Young, Goy, and Phoenix, published in 1964, summarized the research to date. The paper included the results of the Ž rst studies of the pseudo-hermaphroditic monkeys and presented the implications of the research Ž ndings. It was suggested that the action of the prenatal hormones likely involved behaviors other than those that were speciŽ cally sexual in nature. In this same year John Resko joined the group to carry out biochemical investigations that seemed crucial to the hypotheses that had been proposed regarding the masculinization of the nervous system of prenatally treated females. The last 10 years had involved much uncertainty for Bob about his career and the future. They were years of very hard work and Ž nancial rewards were exceedingly modest. Here was a turning point, though he never labeled it as such. There was a feeling of satisfaction—the hard work had paid off—and now there would be more work but with a sense of having reached a goal and a certain degree of security. Within a year, William C. Young died. He was a highly respected mentor, colleague, and friend. Bob became Principal Investigator of the grant from NIH and was appointed Head of the Division of Reproductive Physiology and Behavior, the position previously held by Young. By this time Bob had been appointed professor in the Department of Medical Psychology at the University of Oregon Medical School, which was located not far from the Primate Center. Now there were graduate students eager to carry out research under his leadership. I had been appointed Assistant Director of the Primate Center so that conditions seemed ideal for years of productive research. Under Bob’s leadership, progress in the Division of Physiology and Behavior was remarkable. The Primate Center prospered and all was right with the world. And then it happened. Bob was invited to become Director of the Wisconsin Primate Center. What can a man do? And so after a decade he returned to Madison as Director of the Primate Center and Professor in the Department of Psychology at the University of Wisconsin. Administrative chores were not high on Bob’s “things I want to do list.” Dealing with the bureaucracy of Universities and of Washington, D.C., was a constant and generally unpleasant affair. The satisfaction of seeing the research

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that he was able to encourage and direct had to have been exceedingly gratifying for him to have continued. He turned to his students and colleagues, and there he found reason for going on with administration. Overall, it was largely through his efforts that interest in the effects of prenatal hormones on sexual and sex-related behavior remained in the forefront of so much research for such an extended period of time. However signiŽ cant prenatal hormones may be in determining later sexual behavior, Bob never lost sight of the importance of early social environment on adult behavior. Bob worked for the cause not only as a teacher and research leader but as an editor and editorial consultant. When Frank Beach retired as editor of Hormones and Behavior, Bob Goy took over the position and remained in that post until 1996. He received a number of awards for his outstanding contribution to science. Bob will not soon be forgotten, not by his wife Barbara and his children and their spouses, and his grandchildren and his students, and indeed all who knew him. It is difŽ cult to say good-bye. Charles H. Phoenix Oregon Regional Primate Center

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Gender Constancy Judgments in Children with Gender Identity Disorder: Evidence for a Developmental Lag Kenneth J. Zucker, Ph.D.,1, 2 Susan J. Bradley, M.D.,1 Myra Kuksis, Ph.D.,1 Karen Pecore, M.Ed.,1 Andrea Birkenfeld-Adams, Ph.D.,1 Robert W. Doering, Ph.D.,1 Janet N. Mitchell, Ph.D.,1 and Jennifer Wild, M.Ed.1

Gender constancy judgments in children referred for problems in their gender identity development (N = 206) and controls (N = 95) were compared. On Slaby and Frey’s (1975) gender constancy interview, the gender-referred children performed more poorly than the controls at three stage levels: gender identity, gender stability, and gender consistency. On the Boy-Girl Identity Task, a second measure of gender constancy (Emmerich et al., 1977), the gender-referred children also performed more poorly. Gender-referred children who had not attained gender consistency engaged in signiŽ cantly less same-sex-typed play on a free-play task than the gender-referred children who had, but there were no gender consistency effectsfor the controls. Two other measures of sex-typed behavior were unrelated to gender consistency. In the gender-referred group alone, children who “failed” the gender identity or gender stability stages were more likely to draw an opposite-sex person Ž rst on the Draw-a-Person test and to evince more affective gender confusion on the Gender Identity Interview (Zucker et al., 1993) than children who had “passed.” It is concluded that children referred for problems in their gender identity development have a developmental lag in gender constancy acquisition. Possible reasons for the lag are discussed. KEY WORDS: gender identity disorder; gender constancy; gender identity; gender role; children.

1 Child

and Adolescent Gender Identity Clinic, Child Psychiatry Program, Centre for Addiction and Mental Health—Clarke Division, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto. 2 To whom correspondence should be addressed at Child and Adolescent Gender Identity Clinic, Child Psychiatry Program, Centre for Addiction and Mental Health—Clarke Division, 250 College St., Toronto, Ontario M5T 1R8, Canada. e-mail: ken [email protected] 475 0004-0002/99/1200-0475$16.00/0 ° C 1999 Plenum Publishing Corporation

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INTRODUCTION Children who meet the diagnostic criteria for gender identity disorder (GID) (American Psychiatric Association, 1994) invariably display an array of pervasive and persistent cross-gender behaviors that span domains such as toy interests, dress-up play, roles in fantasy play, and peer preference. These children also show a marked avoidance or rejection of same-sex stereotypical activities. Central to the phenomenology of GID is subjective distress about being a boy or a girl, which is often expressed verbally with repeated remarks about wishing to become a member of the opposite sex. The phenotypic expression and course of GID during childhood have now been well established. It is known, for example, that the Ž rst behavioral signs of GID typically appear during the late toddlerhood to preschool years (Green, 1976), which essentially corresponds to the same time period in which the behavioral signs of more typical gender identity development emerge (Ruble and Martin, 1998). During this time period, if not earlier, children become sensitive to phenotypic social markers that typically discriminate males from females (e.g., hair length) and begin the process of gender self-labeling, i.e., learning that one is a boy or a girl (de Marneffe, 1997; Herzog, 1996; Leinbach and Fagot, 1986; Paluszny et al., 1973; Rabban, 1950; Thompson, 1975). Indeed, correct gender self-labeling is believed by some to be the most basic cognitive underpinning of a young child’s gender identity, i.e., the sense of self as a boy or girl (Kleeman, 1971; Stoller, 1965, 1968a). Moreover, there is some evidence that early gender cognitions organize sex-typed behavioral preferences, in that children who correctly self-label their own gender engage in more sex-typical behavior than children who are unable to categorize themselves as boys or girls and whose behavior patterns tend not to be sex-dimorphic (e.g., Fagot et al., 1986; O’Brien and Huston, 1985). Although toddlers and preschoolers display a rudimentary cognitive understanding of gender, Kohlberg (1966, p. 87) argued that they do not truly appreciate its invariance: “the child age two to four is very uncertain of the constancy of his [gender ] identity, and the label ‘boy’ is for him as arbitrary as the label ‘Johnny.’ ” In Kohlberg’s (1966) now classical cognitive-developmental account of gender constancy 3 development, the child’s eventual understanding that gender is an invariant part of the self—a qualitative or identity constancy (Aboud and Ruble, 1987; DeVries, 1969)—is attained only with the development of concrete-operational thought (Piaget, 1968), which permits the child to appreciate the principle of 3

Contemporary guidelines for the use of the terms sex and gender recommend that the word sex be used to signify biological maleness or femaleness and that the word gender be used to refer to psychological or sociological phenomena stereotypically associated with males or females (American Psychological Association, 1994). By these criteria, both Bem (1989) and Ruble and Martin (1998) noted that the term gender constancy should really be called sex constancy; however, to maintain continuity with the extant literature, we retain the use of the term gender constancy.

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invariance in the face of “superŽ cial” or surface transformations in gender-related behavior, such as activity preferences or clothing style. Given the normative tendency among young children to con ate genderlinked behavioral acts with identity (Kohlberg, 1966), some clinicians and researchers have argued that this cognitive immaturity may contribute to the early signs of gender identity confusion among children with GID (e.g., Coates, 1990; Green, 1974, 1987). To date, however, there has been little systematic research on the cognitive understanding of gender among children with GID. The purpose of the present study, therefore, was to redress this gap in the empirical literature. Before presenting the hypotheses, however, we provide a more detailed review of the gender constancy construct and evaluate its empirical status. The Gender Constancy Construct Since the time of Kohlberg’s (1966) seminal essay, several dozen normative studies have attempted to evaluate the central claims that characterize the gender constancy construct in cognitive-developmental theory. Verbal assessment techniques, such as Slaby and Frey’s (1975) interview schedule, have provided conŽ rmatory evidence for an age-related, stage-like sequence in gender constancy development: children Ž rst self-categorize the gender of self and others (gender identity), then appreciate its invariance over time (gender stability), and, Ž nally, understand its invariance in the face of situational transformations (gender consistency) (e.g., Bhogle and Seethalakshmi, 1992; Eaton and Von Bargen, 1981; Von Bargen, 1979). In another study, McConaghy (1979) suggested that the understanding of genital consistency followed the acquisition of gender consistency across behavioral situations. Other analyses of Slaby and Frey’s (1975) assessment measure have shown that mental age (MA) (derived from IQ tests, where MA = age £ IQ/ 100), as opposed to chronological age, is more strongly associated with stage of gender constancy development (Abelson, 1981a,b; Abelson and Paluszny, 1978; Eaton and Burdz, 1984; Gouze and Nadelman, 1980; Miller et al., 1978; Zucker and Yoannidis, 1983), which provides further support for the in uence of cognitive factors on task performance. In Slaby and Frey’s (1975) original study, which included children 26– 67 months of age, the 40% who achieved the most advanced stage of gender constancy development averaged 4.6 years of age. Critics have suggested that Slaby and Frey’s assessment of gender constancy, particularly gender consistency, may have overestimated the child’s cognitive understanding of gender, since the procedure did not present the child with perceptually inconsistent information. According to these critics, then, the task, at least at this stage level, does not evaluate accurately the in uence of concrete-operational reasoning (see, e.g., Marcus and Overton, 1978).

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Emmerich et al.’s (1977) Boy-Girl Identity Task (BGIT) has been viewed as providing a more rigorous assessment of children’s understanding of gender invariance (see also Emmerich et al., 1976). In this task, the child is Ž rst shown a two-dimensional drawing of a girl and then asked Ž ve questions pertaining to gender invariance. The Ž rst two questions are purely verbal, akin to Slaby and Frey’s assessment of gender consistency; however, the three subsequent questions are each preceded by a perceptual transformation in the stimulus child’s appearance (hair style, clothing style, and both hair and clothing style, respectively). The procedure is then repeated with a two-dimensional drawing of a boy. Emmerich et al. administered the BGIT on four occasions to several hundred economically disadvantaged children between 4 and 7 years of age. Emmerich et al. found that the majority of children answered the questions incorrectly, indicating lack of gender constancy. In fact, Emmerich et al. (1976) noted that performance levels were, on average, worse than chance (see also Gelman et al., 1986). Emmerich et al. (1976) also reported a U-shaped function in their data, with 5 year olds performing worse than their 4- and 6- to 7-year-old counterparts (see also Szkrybalo and Ruble, 1999; Wehren and De Lisi, 1983). Based on qualitative analyses of children’s verbal justiŽ cations of gender invariant responses, Emmerich et al. (1976, 1977) argued that the 4 year olds tended to offer “pseudo-constant” or preoperational justiŽ cations; that is, their responses were based on affective or superŽ cial justiŽ cations rather than on principles of invariance that characterize concrete operational reasoning (see also Emmerich, 1982; Szkrybalo and Ruble, 1999). Emmerich et al. (1976, 1977) also showed that an understanding of gender invariance on the BGIT was signiŽ cantly correlated with a general measure of cognitive functioning (see also Abelson, 1979), and other studies have shown a relation with measures of physical conservation, thus demonstrating a form of structural parallelism (De Lisi and Gallagher, 1991; Kohlberg, 1966, pp. 97–98; LaVoie and Andrews, 1975; Marcus and Overton, 1978; for no effect, attributed to restricted variance, see Coker, 1984). Martin and Halverson (1983) administered both the Slaby and Frey measure and the BGIT to children ages 4–6 years and found that 64% exhibited gender consistency on the former but only 23% on the latter, thus providing direct comparative support for the greater task demands imposed by the perceptual transformations on the BGIT. However, the two measures are not comparable in another respect: the Slaby and Frey questions are directed to the self, and the BGIT questions refer to a pictured other child, and there is some evidence that children provide gender constant responses for the self before they provide similar responses for others (e.g., Eaton and Von Bargen, 1981). Since the introduction of these two measures to the gender constancy literature over 20 years ago, there has been continued debate regarding the most valid method by which to assess the construct. The introduction of several additional assessment

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methods, often without any comparisons to the original measures, has made it difŽ cult to draw Ž rm conclusions (see, e.g., Bem, 1989; Bhana, 1984; Carter and Levy, 1988; De Lisi and Johns, 1984; Frey and Ruble, 1992; Johnson and Ames, 1994; Kuhn et al., 1978; Leonard and Archer, 1989; Levy and Carter, 1989; Miller, 1984; Taylor and Carter, 1987). One of the most contentious aspects of the normative gender constancy literature concerns the approximate age at which gender consistency is attained (Ruble and Martin, 1998). Providing gender-consistent responses has been affected by variations in question wording (Intons-Peterson, 1988; Johnson and Ames, 1994; Miller, 1984), question order (Siegal and Robinson, 1987; for no effect, see Eaton and Burdz, 1984), the use of proper names instead of pronouns (Beal and Lockhart, 1989), whether the referent is the self or peers (Eaton and Von Bargen, 1981; Gouze and Nadelman, 1980; Leonard and Archer, 1989; Marcus and Overton, 1978), the use of putatively more “realistic” stimuli (MacKain, 1987a,b; but see Marcus and Overton, 1978), and whether the child indicates that his or her responses were “for real” rather than “pretend” (Leonard and Archer, 1989; Martin and Halverson, 1983; Martin and Little, 1990; Trautner, 1985). Unfortunately, it is difŽ cult to draw Ž rm conclusions about “developmental norms” for gender constancy development from many of these studies, since the assessment modiŽ cations rarely have been formally compared to Slaby and Frey’s (1975) original assessment method or to the BGIT and often differ in important additional respects apart from the speciŽ c modiŽ cation itself. The normative literature also remains sharply divided regarding the evidence for the central assumption of cognitive-developmental theory, namely, that gender constancy development should affect, if not determine, other aspects of psychosexual differentiation, such as a child’s preference for same-sex-typed toys, activities, and peers, identiŽ cation with same-sex adults or models, and so on (Kohlberg, 1966). On this matter, the empirical literature is decidedly mixed—some studies Ž nd relations for some measures; others do not, or Ž nd relations for one sex, but not the other (for review, see Ruble and Martin, 1998). As noted by Ruble and Martin (1998), several methodological issues have clouded the matter. For example, in Kohlberg’s (1966) original formulation, it was held that the motivation to behave in a sex-typical matter should occur primarily after the child has achieved the most advanced stage of gender constancy, since it is only at this point that the child truly appreciates gender invariance. Many empirical studies show that this is inaccurate, given that most preschoolers show clear sex differences in sex-typed play, roles, activities, peer preferences, etc. One revised version of the original Kohlbergian claim is that the mere acquisition of gender identity, that is, the knowledge that one is a male or a female, is probably sufŽ cient to exert an in uence on sex-typed behavior in other domains (Le ManerIdrissi, 1996; Lewis and Weinraub, 1979; Martin and Halverson, 1981). A number of empirical studies provide support for this idea (e.g., Bussey and Bandura, 1992;

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Emmerich and Shepard, 1984; Fagot et al., 1986; O’Brien and Huston, 1985; Weinraub et al., 1984). In evaluating Kohlberg’s hypothesis about the central role of gender consistency in organizing other aspects of psychosexual differentiation, Ruble and Martin (1998) have noted that researchers have varied in deŽ ning the cut-point for this stage. Slaby and Frey (1975), for example, included children who passed only the gender stability stage in their deŽ nition of high gender-constant children (see also Bussey and Bandura, 1984; Downs and Langlois, 1988). Other researchers have deŽ ned high gender constancy more rigorously, including only those children who passed at least some, if not all, of the gender consistency questions (e.g., Frey and Ruble, 1992; Lobel and Menashri, 1993; Luecke-Aleksa et al., 1995; Newman et al., 1995; Ruble et al., 1981; Stangor and Ruble, 1989; Urberg, 1982). But some researchers have been quite vague in demarcating gender constancy subgroups [e.g., by treating the measure as a continuous variable (e.g., Marcus and Overton, 1978) ], while others have included all stages of gender constancy in the analyses (e.g., Serbin and Spraf kin, 1986; Smetana and Letourneau, 1984) and, in two studies, did not even assess or include the gender consistency stage in the analyses (Eaton et al., 1981; O’Keefe and Hyde, 1983). Another methodological issue concerns the importance of controlling for age and intelligence. Most of the normative studies Ž nd age correlations for gender constancy and some age correlations for measures of sex-typed behavioral preferences. Indeed, some studies have shown that, with age controlled, the relation between gender constancy and other measures of sex-typed behavior washes out (e.g., Bussey and Bandura, 1984), although this is not a universal Ž nding (e.g., Ruble et al., 1981). Studies that fail to control for age are probably uninterpretable (e.g., Eaton et al., 1981; Perloff, 1982). The bulk of the normative studies has not, however, controlled for possible differences in general intelligence between highand low-gender constant children, which may be of even more importance than controlling for age (Emmerich et al., 1977; Kohlberg and Zigler, 1967). Taken together, the variations in deŽ ning high- vs. low-gender constant children, the variations in measurement instruments, and the failure to control for general intelligence probably contribute to the equivocal empirical database linking gender constancy development with other aspects of psychosexual differentiation (Lutz and Ruble, 1995; Ruble, 1994; Ruble and Martin, 1998; Ruble and Stangor, 1986; Stangor and Ruble, 1987). Study Hypotheses The primary hypothesis was that children with GID would show a developmental lag in gender constancy development compared to control children. There were several reasons for making this prediction. First, clinicians have observed that at least some children with GID misclassify their own gender, even at ages

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beyond that in which correct self-labeling might be normatively unstable (e.g., Stoller, 1968b). Second, in a previous study (Zucker et al., 1993), we found some empirical support for this clinical observation. In that study, we reported the results of a factor analytically derived gender identity interview schedule, which included the gender identity question (and counterquestion) and one of the gender stability questions (and counterquestion) from the Slaby and Frey (1975) interview. These two questions and their counterquestions formed a factor that was labeled Cognitive Gender Confusion. Compared to controls ( N = 98), children with GID (N = 85) provided signiŽ cantly more deviant responses on this factor. Thus, in this early phase of gender constancy development, children with GID appeared to have trouble mastering this basic cognitive component of gender identity. Accordingly, it is conceivable that such early gender identity confusion might cause subsequent developmental lags in the more advanced components of gender constancy acquisition. Indeed, some clinicians (e.g., Coates and Wolfe, 1997; Green, 1974; Schultz, 1979) have noted that when young children with GID engage in extensive cross-gender behaviors, such as cross-dressing, they often voice the opinion that they have become transformed to the opposite sex, suggesting that they have not acquired an invariant understanding of gender constancy. Thus, the present study aimed at evaluating these observations in a more systematic and extensive manner. The second hypothesis tested the prediction that stage of gender constancy development would be associated with other aspects of sex-typed behavior. Thus, we examined whether children who had not attained complete gender constancy would be more likely to manifest cross-gender behavior on several measures of sex-typed behavior than children who had. METHOD Probands Between 1978 and 1995, 236 probands (207 boys, 29 girls) were referred to, and then assessed in, a clinic specializing in gender identity problems in children and adolescents, which was housed in a children’s department within a psychiatric research institute in Toronto, Ontario, Canada. Referrals were initiated either by parents or at the suggestion of professionals (e.g., mental health specialists, family physician, teacher). Of the 236 probands, 206 had the necessary data to be included in the present study (reasons for the exclusion of the remaining 30 children are noted below). For the participating children, parent interview information was used to determine whether the proband met the complete DSM-III or DSM-III-R diagnostic criteria for gender identity disorder of childhood (American Psychiatric Association, 1980, 1987) (for details of the diagnostic procedure, see Zucker and Bradley, 1995). Of the 206 children, 132 (64.1%) met the complete criteria and 74 (35.9%) did

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not. Among the latter, all manifested at least some characteristics of cross-gender identiŽ cation and thus can be considered subthreshold for the diagnosis of GID. One gender-referred boy was excluded from the current study because he did not show any characteristics of cross-gender identiŽ cation and thus was considered a false positive referral. Two children were not seen for psychological testing by parental request, one child was not administered the tasks because of difŽ culty in comprehending English, one child could not be tested due to distress at being separated from his mother, and one child was not administered the tasks by mistake. Four other children were not tested because their parents chose to withdraw from the assessment after the initial clinical interview. The remaining 20 children were between 11 and 12 years of age and were not administered the tasks in order to keep the age range of the probands and the controls comparable. Controls The controls (N = 95) consisted of 36 siblings (23 boys, 13 girls) of the gender-referred children, 36 clinical controls (32 boys, 4 girls), and 23 normal control boys. Of the 36 siblings, 28 came from the Ž rst 36 families that were assessed in the clinic; the remaining 8 siblings were either monozygotic or dizygotic twins of the probands. One purpose in testing the siblings from the Ž rst 36 families was to assess the discriminant validity of a variety of sex-typed behavioral and parent-report questionnaire measures, including the measures of gender constancy in the present study (see below). The results from the other measures have been summarized elsewhere (Zucker and Bradley, 1995). Of the 36 clinical controls, 24 were tested for similar reasons. The remaining 12 clinical controls (all boys) and the normal control boys participated in a study by Mitchell (1991), in which the primary focus was the assessment of mothers of boys with GID (and the control mothers), but in which the children were also administered a variety of sex-typed measures. Data from one other clinical control boy were not available as his mother chose not to have him tested, although she participated in Mitchell’s (1991) study; data from one additional normal control boy were also not available as he refused to be tested. The clinical control boys had been referred to our department for a variety of reasons (other than concerns about gender identity development) and thus were heterogeneous with regard to psychiatric diagnosis. The normal controls were recruited by means of advertisement. Potential participants were excluded if the boy had ever been evaluated or treated by a mental health professional, or was in a special class at school, or at least one of his parents had ever contemplated bringing him for a psychiatric or psychological assessment. Both the clinical and the normal controls were paid for their participation. All clinical and normal controls were pair-matched to a gender-referred proband with regard to sex, age (§ 1 year), social class, and parent’s marital status

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Table I. Demographic Characteristics Gender-referred (N = 206) Variable Age (yr) IQa Social class b Sex (N ) Boys Girls Marital status ( N ) Both parents Mother only/ Reconstituted a

Controls (N = 95)

M

SD

M

SD

p

6.6 107.7 43.0

2.1 16.4 15.1

6.7 109.7 39.0

2.3 15.2 14.5

ns ns .032

184 22

78 17

ns

143 63

61 34

ns

Based on the WISC-R, WISC-III, WPPSI, or WPPSI-R. (1975) Four-Factor Index of Social Status (absolute range, 8–66).

b Hollingshead’s

(two parents vs. mother only or reconstituted). The clinical controls were also pair-matched with regard to IQ (§ 15 points), but this was not possible to do in advance for the normal controls. Demographics Preliminary analyses showed that the three groups of controls were comparable with regard to demographics, so their data were combined (see also below). Table I shows the demographic characteristics of the gender-referred probands and the controls. The two groups did not differ signiŽ cantly in sex composition, age, IQ, and parent’s marital status. The gender-referred probands did, however, come from a somewhat higher social class background than the controls. Because social class did not correlate with the dependent measures used in the present study, this difference did not pose a threat to the validity of the between-groups comparisons. Because the data were collected over a long period of time, preliminary analyses were also conducted on the demographic measures by comparing the Ž rst half of the sample with the second. There were no signiŽ cant differences on any of the measures. Measures Gender Constancy Slaby and Frey’s (1975) gender constancy interview schedule and the BoyGirl Identity Task (Emmerich et al., 1977) were administered. At the time we

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began the study, these were the two best-studied measures of gender constancy available, and subsequent normative research on their psychometric properties has been better established than any other measures available. The tasks were given as part of a battery of psychological testing, which included intellectual, projective, and sex-typed measures. In terms of sequence, the gender constancy measures were administered after the child had completed several other tasks, most typically an IQ test, the Rorschach, the Draw-a-Person test, and a sex-typed free-play task. Slaby and Frey’s (1975) gender constancy interview consists of 13 questions and counterquestions. Questions 1–8 assess the child’s ability to identify the gender of four dolls (a boy, a girl, a man, and a woman) and the gender of four chromatic photographs of adults (two men, two women). Question 9 assesses the child’s ability to identify his or her own gender. Questions 10 and 11 assess the child’s ability to conserve his or her own gender over time (e.g., “When you were a little baby, were you a little boy or a little girl?”). Questions 12 and 13 assess the child’s ability to conserve his or her own gender in the face of situational changes in gender-related behavioral activities or clothing style (e.g., “If you wore [opposite sex of child] clothes, would you be a girl or a boy?”). In Slaby and Frey’s (1975) study, Questions 1–9 were conceptualized as assessing gender identity, Questions 10 and 11 as assessing gender stability (over time), and Questions 12 and 13 as assessing gender consistency (over situations). In the present study, this system was retained, except that Questions 1–8 were conceptualized as assessing gender discrimination, whereas Question 9 was conceptualized as assessing gender identity, since only this question (of the Ž rst nine) actually pertained to the child. For the gender discrimination stage, the child was judged to have “passed” if at least 12 of 16 questions and counterquestions were answered correctly. For each of the remaining three stages, the child was judged to have “passed” only if all of the questions and counterquestions were answered correctly. For the Boy-Girl Identity task (BGIT) (Emmerich et al., 1977), each child was shown a drawing of a same-sex child. The child was told that the drawing was of a same-sex child and then asked to provide the child with a gender appropriate name; if the child could not provide one, the examiner suggested one. Questions 1 and 2 were purely verbal (e.g., “If [name of boy ] really wants to be a girl, can he be?”). For Questions 3–5, the stimulus child’s appearance was perceptually transformed by lifting part of the drawing to reveal, in the case of the boy stimulus, a conŽ guration of the torso accompanied by a dress (Question 3), a conŽ guration of the face accompanied by long hair (Question 4), or a conŽ guration of the face and torso accompanied by a dress and long hair, respectively (Question 5). For the girl stimulus, the transformed clothing was a shirt and pants and the transformed hair was short. Following each perceptual transformation, the child was asked about the gender of the stimulus child (e.g., “If [name of boy] puts on girl clothes like this, what would he be? Would he be a boy or would he be a girl?”). For

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all Ž ve questions, a response was scored as correct if the stimulus child’s gender was conserved; when this occurred, verbal justiŽ cations were then elicited and recorded verbatim. JustiŽ cations were scored according to the guidelines in Emmerich et al. (1976). There were three categories: (1) operational constancy, which included any justiŽ cation in which the concept of gender invariance was explicit or clearly implied (e.g., “He was born a boy”); (2) stimulus description, which included justiŽ cations that referred to an attribute of the transformed stimulus (e.g., “He’s still wearing pants”); and (3) other, which included all remaining response categories, including an inability to provide a response or affectively based justiŽ cations (e.g., “I don’t want him to be a girl”). One coder classiŽ ed all responses ( N = 214); a second coder, masked to group status, classiŽ ed the responses from 25% ( N = 64) of the protocols in which at least one question was answered as gender constant. Of these, 95.8% were classiŽ ed similarly. Sex-Typed Behavior Three measures of sex-typed behavior were used: (1) the sex of the Ž rst person drawn on the Draw-a-Person (DAP) test (Zucker et al., 1983), (2) the difference between the proportions of same-sex play and cross-sex play averaged across a three-trial free-play task (Zucker et al., 1982), and (3) the Affective Gender Confusion factor score on the Gender Identity Interview (Zucker et al., 1993). For the DAP test, each child was asked to “draw a person” and then to identify its sex. On the free play task, the child was exposed to stereotypical masculine and feminine toys (Trial 1), masculine and feminine dress-up apparel (Trial 2), and both the toys and the dress-up apparel simultaneously (Trial 3). Trials 1 and 2 were 5 min in duration and Trial 3 was 10 min in duration. Each child remained alone in a room while an observer, stationed behind a one-way mirror, recorded either on an event recorder or on videotape the child’s sex-typed play behavior, deŽ ned as manual or physical contact with the stimuli. The child was told that he or she could play with whatever they liked while the examiner was out of the room. Free-play data were available for 199 of the gender-referred probands and 90 controls (the task was not administered to some of the older children in the sample, between 10 and 11 years of age). Further procedural details and information on interscorer reliability may be found elsewhere (Zucker et al., 1982). The Gender Identity Interview consisted of 12 structured questions pertaining to the presence of both cognitive and affective gender identity confusion. For the present study, only the seven questions pertaining to Factor 1 (Affective Gender Confusion) were scored. Examples of these questions include “Do you think it is better to be a boy or a girl?” and “In your mind, do you ever think that you would like to be a girl (boy)?” Responses were coded as 2 (explicitly “deviant”), 1 (ambiguous; for example, “both” or “sometimes”), and 0 (explicitly “nondeviant”) (for details,

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see Zucker et al., 1993). It should be noted that all of these questions pertain to “desire,” not gender constancy, and thus are not redundant with the measures of gender constancy used in the present study. At the time we began the study, we had not yet developed this interview schedule; it was administered to the last 138 gender-referred children who were tested and 41 controls.

RESULTS Preliminary analyses showed that, among the gender-referred probands, there were no differences on the two gender constancy measures between those children who met the complete diagnostic criteria for GID and those who did not; thus, the data were collapsed across the two subgroups. 4 Preliminary analyses also showed that the three subgroups of control children (siblings, clinical, and normals) did not differ signiŽ cantly on the two gender constancy measures, which further justiŽ ed collapsing the controls into one group. Additional analyses on both the genderreferred children and the controls showed no sex or time effects (Ž rst half of the sample vs. the second half) on the gender constancy measures. Thus, all subsequent analyses were collapsed across sex and time. All of the signiŽ cance tests reported below are two-tailed. Slaby and Frey’s Gender Constancy Interview As noted earlier, a central assumption underlying the gender constancy construct is that the putative stages emerge sequentially, which has been documented in several previous empirical studies (see Introduction). Table II shows the Guttman scale results for the present sample, based on classifying the subjects’ responses as either “passed” or “failed” to the gender discrimination, gender identity, gender stability, and gender consistency questions, respectively. A scalogram analysis (Green, 1956) showed that these four sets of questions formed a reproducible Guttman scale (coefŽ cient of reproducibility = .99, index of consistency = .77). Of the 301 children, 292 (97.1%) showed one of the Ž ve stage-type patterns (Table II). Of the nine (2.9%) children who did not show a stage-type pattern, eight were from the gender-referred group and one was from the controls [v 2 (1) = 0.95, ns]. Since the number of children who did not show a stage-type pattern was small, their data were retained for all subsequent analyses. Table III shows the percentage of children in the two groups who passed each of the four stages of gender constancy development. All but six of the children in the two groups passed the gender discrimination stage and the percentage who passed 4 With age covaried

because the children who met the complete DSM criteria for GID were signiŽ cantly younger than those who did not meet the complete diagnostic criteria.

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Table II. Number and Percentage of Children at Each Level of Gender Constancy Gender discrimination

Stage

¡

1 2 3 4 5 a

+ + + +

Gender identity

Gender stability

Gender consistency

¡

¡

¡

+ + +

¡

¡

¡

¡

Number (%) of childrena 3 (0.9) 11 (3.6) 30 (9.9) 132 (43.9) 116 (38.5)

¡ ¡

+ +

+

Percentage based on total N of 301. Nine (2.9%) other children showed nonstage patterns.

Table III. Task Performance on the Slaby and Frey (1975) Gender Constancy Interview Gender-referred (N = 206) Gender constancy stage Gender discrimination Passed Failed Gender identity Passed Failed Gender stability Passed Failed Gender consistency Passed Failed a

p< < cp < bp

Controls (N = 95) 2

N

%

N

%

201 5

97.6 2.4

94 1

98.9 1.1

.12

192 14

93.2 6.8

94 1

98.9 1.1

3.40 c

164 42

79.6 20.4

87 8

91.6 8.4

5.88 b

71 135

34.5 65.5

52 43

54.7 45.3

10.23 a

v

.001. . 05. .10.

did not differ between groups. For the gender identity stage, the gender-referred children tended to do less well than the controls ( p = . 065), and for the remaining two stages (gender consistency and gender stability), they did signiŽ cantly less well (respective p’s = .015 and .001). Effect sizes (d) for the gender identity, gender stability, and gender consisp tency stages were calculated using the formula 4 £ v 2 / N ¡ v 2 (Cohen, 1988). The values for d were .21, .28, and .38, respectively. Boy-Girl Identity Task Table IV shows the percentage of children in the two groups who passed each of the Ž ve questions on the BGIT. Questions 1 and 2 were evaluated separately from Questions 3–5, since only on the latter questions were there actual

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Table IV. Task Performance on the Verbal and Perceptual Gender Constancy Questions on the Boy-Girl Identity Task Gender-referred (N = 206)

Verbal questions Question 1 Passed Failed Question 2 Passed Failed Perceptual questions Questions 3–5 Passed Failed Questions 3–5 0 passed 1 passed 2 passed 3 passed ap bp

Controls (N = 95) 2

N

%

N

%

141 65

68.4 31.6

75 20

78.9 21.1

3.03 b

97 109

47.1 52.9

58 37

61.1 38.9

4.53 a

60 146

29.1 70.9

35 60

36.8 63.2

1.45

101 31 14 60

49.0 15.0 6.8 29.1

38 9 13 35

40.0 9.5 13.7 36.8

7.33 b

v

< .05. < .10.

perceptual transformations of the stimulus. On Question 1, the gender-referred children tended to do less well than the controls ( p = . 081), and on Question 2, they did signiŽ cantly less well ( p = .033). For Questions 3–5, two analyses were performed. The Ž rst analysis classiŽ ed children as having passed if all questions were answered correctly. Although the percentage of gender-referred children who passed was smaller than the percentage of controls, the difference was not signiŽ cant. However, Table IV also shows that when children were classiŽ ed as having answered zero, one, two, or three questions correctly, the gender-referred children tended to do signiŽ cantly less well than the controls ( p = .061). For Questions 1 and 2, the effects sizes were .20 and .25, respectively. For Questions 3–5, the effect size was calculated after converting the data to means and SDs, with the formula M1 ¡ M2 / SD of the control group (Cohen, 1988). The effect size was .23. For each BGIT question that was answered as gender constant, verbal justiŽ cations were obtained. Table V shows the percentage of responses in each category as a function of question and group. Chi-square analyses showed that the two groups did not differ signiŽ cantly in their types of justiŽ cations for Question 1 and each of the three perceptual transformation questions. On Question 2, however, there was a trend for the gender-referred group to provide more justiŽ cations re ecting concrete-operational reasoning than the controls.

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Table V. Types of Verbal JustiŽ cations for Gender-Constant Responses on the Boy-Girl Identity Task Gender-referred

Verbal questions Question 1 Operational constancy Stimulus description Other Question 2 Operational constancy Stimulus description Other Perceptual questions Question 3 Operational constancy Stimulus description Other Question 4 Operational constancy Stimulus description Other Question 5 Operational constancy Stimulus description Other

Controls 2

N

%

N

% v

67 51 20

48.6 37.0 14.5

37 23 14

50.0 31.1 18.9

1.09

58 28 7

62.4 30.1 7.5

31 14 12

54.4 24.6 21.1

5.87 a

48 28 8

57.1 33.3 9.5

28 15 7

56.0 30.0 14.0

.68

58 19 6

69.9 22.9 7.2

28 14 7

57.1 28.6 14.3

2.72

45 15 6

68.2 22.7 9.1

29 3 6

76.3 7.9 15.8

4.23

Note. Across both groups, there was a total of 750 gender-constant responses. Due to examiner error, justiŽ cations were not obtained for 18 responses. ap < .10.

Demographic Correlates Table VI shows the demographic correlates of the two gender constancy measures. With the exception of the gender discrimination stage on the Slaby and Frey measure and Question 1 on the BGIT (for age), age, MA, and, to a lesser extent, IQ, were signiŽ cantly correlated with higher scores (passed vs. failed) on the gender constancy variables, whereas social class and marital status were largely unrelated. To examine further the in uence of these demographic variables on task performance, multiple regression analyses were conducted. For all measures, the predictor variables were age and MA (and for four measures, IQ was a third predictor variable; see Table VI). For the gender identity and gender stability stages on the Slaby and Frey measure, only MA signiŽ cantly predicted task performance. For gender consistency, MA was most strongly related to task performance (multiple r = .39), but IQ also contributed unique variance (r 2 D = .03, p < .01). On the situational question and the sum of the perceptual questions on the BGIT, MA was most strongly related to task performance (respective multiple r’s = .34 and .50);

Zucker et al.

490 Table VI. Demographic Correlates of the Gender Constancy Measures Measure Age Slaby and Frey Gender discrimination Gender identity Gender stability Gender consistency Boy-Girl Identity Task Question 1 Question 2 Questions 3–5

IQ

MA

SC

MS

.01 .19a .24a .24 a

.10 .02 .15b .22a

.06 .21a .34a .39a

.12c .00 .01 ¡ .05

¡ .05 .03 .00 .06

.06 ¡ .01 .37 a

.10 .21a .17b

.13c .18b .51a

.11 .34a .00

.04 .08 .11c

Note. MA, mental age (age £ IQ/ 100); SC, social class; MS, marital status, where 1 = two parents and 2 = mother only or reconstituted. ap < .001. bp < .01. cp < .05.

in each case, age also contributed unique variance (respective r 2 D = . 021 and .015, both p’s < . 01). Preliminary analyses showed that, for all Ž ve questions on the BGIT, justiŽ cations based on operational reasoning were positively and signiŽ cantly associated with age and MA and, for Question 5, with IQ. Multiple regression analyses with age and MA as predictor variables (and for Question 5, IQ) showed that MA was the only predictor of response type for Questions 1–4 (r 2 ranged from .06 to .21; all p’s < .01). MA was the strongest predictor of response type for Question 5 (r 2 = . 21, p < . 0001), but IQ and age also contributed unique variance (respective r 2 D = .08 and .13, both p’s < .01). The simple correlation between performance on the gender consistency questions on the Slaby and Frey measure and Questions 3–5 on the BGIT was .60; with age, IQ, and MA partialed out, the correlation was .50 ( p < .001). When analyzed separately by group, the partial correlations were similar for the gender-referred children and the controls (respective r’s = . 53 and .43, both p’s < . 001). Relation Between Gender Consistency and Sex-Typed Behavior As noted earlier, the normative studies have varied in deŽ ning low- and highgender constant subgroups when using the Slaby and Frey (1975) interview measure or variants of it. If one relies on Kohlberg’s (1966) conceptual notion that only gender consistency responses re ect operational reasoning, then the high-gender constant group should include only children who passed this stage. Table VII and Fig. 1 show the data on the relation between gender consistency and three measures of sex-typed behavior. In all analyses, age was covaried because it was signiŽ cantly correlated with the dependent measures.

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Table VII. Relation Between Gender Consistency and Sex-Typed Behavior Gender consistency Gender-referred Passed

Controls

Failed

Passed

Failed

Variable

N

M

SD

N

M

SD

N

M

SD

N

M

SD

Draw-a-Person (sex of Ž rst-drawn person) a Gender identity interview (affective gender confusion) b

71

1.48

.50

135

1.65

.48

52

1.27

.45

43

1.26

.44

49

0.57

.57

89

0.86

.65

20

0.34

.45

21

0.39

.45

a Dummy

variables where 1 = same-sex and 2 = cross-sex. range, 0–2.

b Absolute

Fig. 1. Mean percentage of same-sex play ¡ cross-sex play as a function of group and gender consistency (passed, failed). For the gender-referred group, N = 68 who passed gender consistency and 131 who failed; for the control group, N = 47 who passed gender consistency and 43 who failed.

Table VII shows the data on the DAP for the sex of the Ž rst drawn person as a function of group and gender consistency (passed, failed) on the Slaby and Frey task. For the percentage of same-sex and opposite-sex persons drawn Ž rst, a 2 (group) £ 2 (gender consistency) analysis of covariance yielded a signiŽ cant

492

Zucker et al.

main effect for group [F(1,296) = 27.4, p < . 001 ], which showed that the genderreferred group was more likely to draw an opposite-sex person Ž rst than the controls. The group £ gender consistency interaction was not signiŽ cant [ F(1,296) = 2.0]. The same analysis was also performed using the perceptual questions on the BGIT, which also failed to Ž nd a signiŽ cant group £ gender consistency interaction. Table VII also shows the mean Affective Gender Confusion factor score from the Gender Identity Interview as a function of group and gender consistency. A 2 (group) £ 2 (gender consistency) analysis of covariance yielded a signiŽ cant main effect for group [F(1,174) = 15.6, p < .001], which showed that the genderreferred group had more deviant responses than the controls. The group £ gender consistency interaction was not signiŽ cant [ F(1,174) = 1.5]. The same analysis was also performed using the perceptual questions on the BGIT, which also failed to Ž nd a signiŽ cant group £ gender consistency interaction. Figure 1 shows the mean difference score between same-sex play and crosssex play on the free-play task as a function of group and gender consistency (passed, failed) on the Slaby and Frey task. A 2 (group) £ 2 (gender consistency) analysis of covariance showed a signiŽ cant group £ gender consistency interaction [ F(1,284) = 8.7, p = . 003 ]. Simple effects analyses were conducted to decompose the interaction. At both levels of gender consistency, the controls engaged in signiŽ cantly more same-sex play than the gender-referred probands (respective F’s = 107.5 and 31.0, both p’s < . 001). The controls did not differ signiŽ cantly in amount of same-sex play as a function of gender consistency ( F < 1); however, the genderreferred probands who had not attained gender consistency engaged in signiŽ cantly less same-sex play than the gender-referred probands who had [ F(1,284) = 17.7, p = .001 ]. The same analysis was performed using the perceptual questions on the BGIT, which also showed a signiŽ cant group £ gender consistency interaction [ F(1,284) = 6.8, p = . 010 ]. The simple effects analysis revealed the same pattern that was found for the Slaby and Frey measure. Relation Between Gender Identity and Gender Stability and Sex-Typed Behavior As noted in the Introduction, the ability simply to self-label oneself correctly as a boy or a girl has been associated with other aspects of sex-typed behavior. Accordingly, we examined the relations between both gender identity and gender stability on the Slaby and Frey task with our measures of sex-typed behavior.Because there was virtually no variance on these two components of gender constancy in the controls, these analyses were delimited to the gender-referred probands.

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Table VIII. Relation Between Gender Identity and Gender Stability and Sex-Typed Behavior Passed Variable

Draw-a-Person (sex of Ž rst-drawn person) a Gender identity interview (affective gender confusion) b Free-play task (same-sex ¡ cross-sex play) c

Failed

N

M

SD

192

1.6

.50

127

0.7

.61

13

1.5

185

¡ 0.1

.64

14

¡ 0.4

164

1.5

.50

42

1.8

.43

2.5

.115

105

0.6

.58

33

1.2

.61

14.4

.001

158

¡ 0.04

.47

41

¡ 0.4

.50

2.7

.101

N

M

SD

F

p

3.7

.056

.48

11.3

.001

.40

<1

n.s.

Gender identity 14 1.9 .27

Gender stability Draw-a-Person (sex of Ž rst-drawn person) a Gender identity interview (affective gender confusion) b Free-play task (same-sex ¡ cross-sex play) c

Note. Age was covaried in these analyses. a Dummy variables where 1 = same-sex and 2 = cross-sex. b Absolute range, 0–2. c Absolute range, ¡ 1.00 to 1.00.

Table VIII presents these data. At both the gender identity and the gender stability stages, it can be seen that the children who failed showed more cross-gender behavior on the three measures than the children who passed. These differences were at a trend level of signiŽ cance for the DAP test (both stages) and the free-play task (gender stability stage) and at p < .001 for the Affective Gender Confusion factor. DISCUSSION Psychometrics of Gender Constancy The results of the present study provide several new pieces of information about the gender constancy construct. On Slaby and Frey’s (1975) gender constancy interview, both the gender-referred probands and the controls showed the same type of sequential pattern of stage development that has been found in normative samples. Indeed, only 2.9% of the sample did not show a response pattern consistent with the putative gender constancy stages originally identiŽ ed by Slaby and Frey (1975). Thus, there was no evidence for any qualitative difference in gender constancy development in this predominantly clinical sample. To our knowledge, the correlational analyses are the Ž rst in the literature to examine formally the amount of shared variance between the gender consistency components of the two measures, which we found was 25% (cf. Martin and Halverson, 1983). Although the correlation was highly signiŽ cant, it is also

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apparent that a large part of the variance is left unexplained, which suggests that one will lose important information if only one measure is used. The correlational data and regression analyses showed that MA was the best predictor of task performance on both measures, which is consistent with one of the basic tenets of cognitive-developmental theory (Kohlberg, 1966) and with previous empirical studies that have included general measures of intelligence or cognitive functioning (e.g., Emmerich et al., 1977; Gouze and Nadelman, 1980; Miller et al., 1978; Zucker and Yoannidis, 1983). Proband–Control Comparisons On both measures of gender constancy, the gender-referred probands performed less well than the controls. On the Slaby and Frey measure, we found differences between the probands and the controls at three stage levels: gender identity, gender stability, and gender consistency. The largest difference was at this last stage, which is not surprising given the mean age of the sample. Using Cohen’s (1988) criteria for gauging the magnitude of effect sizes, the effect was “small” for gender identity and “medium” for gender stability and gender consistency. To date, only several studies have attempted to assess differences between groups of children on measures of gender constancy development. For example, there have been comparisons between mentally retarded and normal children, but no substantial differences were found once MA was taken into account (e.g., Abelson, 1979, 1981b). Katz and Rank (1981) found no differences among children who varied in sibling status. Munroe et al. (1984) compared gender constancy development in four countries (Belize, Kenya, Nepal, and American Samoa), using children ages 3, 5, 7, and 9 years. They reported an age £ sex £ culture interaction, with subsequent analyses indicating only minor effects of cultural group. Unfortunately, Munroe et al. did not assess general cognitive functioning or intelligence, which might have accounted for the modest cultural effects. The present study, therefore, probably provides the strongest evidence to date for a between-groups effect in gender constancy among children who were demographically and intellectually comparable. In our view, the poorer performance of the gender-referred group can best be interpreted as evidence for a developmental lag in gender constancy acquisition. That is, although gender-referred children showed the same sequence of gender constancy development as the controls (Table II), their rate in its attainment appears to be slower. Explanations of the Developmental Lag How might this developmental lag come about? It is clear from our demographic data that certain organismic factors, such as intelligence, did not account for the lag, since there was no between groups difference in IQ. In addition, two

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family background variables—parent’s social class and marital status—were unrelated to task performance. Given that the gender-referred probands performed more poorly than the controls even at the gender identity stage on the Slaby and Frey measure, it is plausible that the lag has its developmental origins quite early in the life of at least some of the gender-referred probands. This would be consistent with the clinical observations noted earlier that some children with GID misclassify their own gender (Stoller, 1968b), which, in turn, induces subsequent lags in gender constancy acquisition. Of course, longitudinal data would be required to test this notion directly, which is likely to prove difŽ cult in a clinic-referred sample, since one typically does not have control over the age at referral. We suggest that there is some type of causal interface between the child’s extensive cross-gender behavior and delayed gender constancy development. One possibility is that children with GID are not provided with external input (e.g., by parents) that facilitates the development of correct gender self-labeling. For example, Green (1974) reported that a minority of parents of boys with GID contributed in an “active” manner by cross-dressing them in girls’ clothing, such as dresses, when they were toddlers. Given that toddlers and preschoolers place so much reliance on phenotypic cues, such as sex-dimorphic clothing and hair style, in discriminating the sexes (e.g., Intons-Peterson, 1988; Katcher, 1955), promotion of cross-dressing may inadvertently result in initial errors, or at least confusion, in early gender self-labeling. Regarding the phenotypic cue of hair style, one 4-yearold boy (IQ = 111) in the present study remarked that he “sometimes” got “mixed up” about whether he was a boy or a girl when “my mommy lets my hair grow real long and she forgets to get me a hair cut.” In other instances, probably the majority (Green, 1987; Zucker and Bradley, 1995), parents appear to “tolerate” or view as cute various manifestations of early cross-gender behavior, which may contribute to confused cognitive gender identity development in a similar manner. Some normative data on toddlers and preschoolers are consistent with this general interpretation. For example, Weinraub et al. (1984) found that certain parental characteristics(e.g., fathers who engaged more frequently in masculine activities in the home) were associated with “advanced” gender identity self-labeling in 2 and 3 year olds. Along similar lines, Eisenberg et al. (1985) found that maternal reinforcement of same-sex play was positively related to gender constancy acquisition in preschoolers, whereas maternal and paternal reinforcement of cross-sex play was negatively related. A complementary interpretation of the developmental lag is that the child’s extensive cross-gender behavior, regardless of its origin, has a feedback effect on the child’s cognitive understanding of gender constancy, such that it impedes the acquisition of the principle of invariance. In normative samples of children, cross-gender behavior is engaged in relatively infrequently, and when it is enacted, negative feedback is common, especially for boys (e.g., Fagot, 1977, 1985a). To some extent, then, gender constancy questions pertaining to cross-gender behavior, such as cross-dressing, are largely hypothetical for most preschoolers and

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school-age children. This is clearly not the case for children with GID, so it is conceivable that the extensive and chronic engagement in cross-gender behavior impedes the understanding of cognitive gender invariance. So far, we have treated the gender constancy results as bona Ž de evidence for a developmental lag in the gender-referred probands. Are there any grounds for arguing that the difference between the probands and the controls does not truly re ect a “competence” factor, but rather a “performance” one? For example, perhaps it could be argued that, because of their extensive cross-gender behavior, the gender-referred probands were more likely than the controls to interpret gender consistency questions as “pretend” rather than “real.” Thus, the gender-referred probands were not really deŽ cient in their gender constancy development, but simply interpreted the task demands differently. In the normative studies that have addressed the “pretend–real” distinction (e.g., MacKain, 1987; Martin and Halverson, 1983), no one has attempted to validate the potential signiŽ cance of children who claim that their answers were “just pretend” rather than “for real.” Although we cannot address the issue directly, there are at least three reasons for suggesting that the probands and the controls interpreted the questions similarly: (1) the two groups showed similar stage-like sequences in their responses; (2) the correlates with demographics, such as age, were similar; and (3) the qualitative justiŽ cations for gender-constant responses on the BGIT were largely similar for the two groups. 5

Gender Constancy and Sex-Typed Behavior We used three measures of sex-typed behavior and examined their relation to gender constancy. On two of these measures—the DAP and the Affective Gender Confusion factor of the Gender Identity Interview—there were no differences between children who had achieved complete gender constancy and those who had not. However, we did Ž nd an effect of gender constancy on the free-play task. On this measure, gender-referred children who had not achieved complete gender constancy engaged in signiŽ cantly less same-sex play than those who had; among the controls, however, there was no effect of gender constancy. This pattern was found for both the Slaby and Frey measure and the BGIT. We also examined, within the gender-referred group alone, the relation between the gender identity and gender stability stages on the Slaby and Frey measure 5

Gelman et al. (1986) have argued convincingly that the extant gender constancy measures require property to category inferences rather than category to property inferences. In the case of gender, Gelman et al. showed that preschoolers were more likely to make correct inferences on the basis of category information than on the basis of property information. It is conceivable, therefore, that genderreferred children would perform as capably as controls on category-to-property tasks. However, this in no way negates the Ž nding that on property-to-category tasks, such as the ones used in the present study, the gender-referred children performed more poorly than the controls.

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and sex-typed behavior. The data showed that children who “failed” the gender identity stage were more likely to draw an opposite sex person Ž rst on the DAP (at a trend level of signiŽ cance) and showed signiŽ cantly more affective gender confusion on the Gender Identity Interview than children who had “passed.” We found similar effects for the affective gender confusion factor for the gender stability stage. It is apparent that these data do not provide unequivocal support for either side of the debate in the normative literature on the relation between gender constancy and sex-typed behavioral preferences. On the one hand, the sex-typed behavioral preferences of the controls showed no relation to stage of gender constancy development, which is consistent with a number of normative empirical studies (e.g., Bussey and Bandura, 1984; Carter and Levy, 1988). On the other hand, effects of gender constancy development were observed in the gender-referred probands. We detected behavioral effects at the early stages of gender constancy (gender identity and gender stability), which is consistent with a number of normative studies (Fagot et al., 1986; Martin and Little, 1990; Weinraub et al., 1984; Yee and Brown, 1994), and we also found an effect at the gender consistency stage on the free-play task. These Ž ndings support Ruble and Martin’s (1998) conclusion that understanding the relation between gender constancy development and other aspects of sex-typed development should not be abandoned, as some critics have argued (e.g., Bussey, 1983; Carter et al., 1985). Because our study was cross sectional in design, as have virtually all of the normative studies (for exceptions, see Fagot, 1985b; Fagot and Leinbach, 1989), we suggest that the direction of effect between gender constancy development and sex-typed behavior remains to be explicated.6 In the normative literature, however, it is generally argued that early gender cognitions (i.e., the capacity to selflabel) organize sex-typed behavioral preferences, not the other way around (e.g., Fagot et al., 1986), and that advanced gender cognitions (e.g., gender consistency) increase the motivation to engage in sex-typical behavior under certain conditions (e.g., Frey and Ruble, 1992; Luecke-Aleksa et al., 1995). Regarding children with GID, however, it is not clear if this line of reasoning would apply, since these youngsters often show marked cross-gender behavioral preferences quite early in development (Green, 1974). It is possible, therefore, that at least some gender-referred children did not make random errors in early gender self-labeling, but systematic ones in identifying themselves as the opposite sex, which thus serves to organize a cross-sex-typed behavioral preference. Alternatively, it could be argued that it is the early cross-sex-typed behavior that induces 6

An anonymous reviewer of this article pointed out that this issue is analagous to the inquiry in both basic and applied social psychology regarding the relationship between attitudes and behavior (see, e.g., Ajzen and Fishbein, 1977; Bentler and Speckart, 1979; Stacy et al., 1994). In this large area, there appears to be no simple story: in some instances, attitudes strongly predict behavior; in other instances, behavior predicts attitudes; and in further instances, the relations are reciprocal or affected by moderator variables.

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the errors in self-labeling, perhaps because such behavior causes them to “match” themselves to children of the opposite sex. Once children with GID recognize their status as boys or as girls, their core con ict often revolves around trying to reconcile the felt distress associated with this knowledge; however, some clinicians (e.g., Coates, 1990) have suggested that the immature gender cognitions that precede the full attainment of gender constancy are the fuel that permits gender change fantasies to dominate the child’s thinking. The results of the present study appear to support the idea that difŽ culties in mastering the developmental task of gender constancy play a role in understanding the atypical psychosexual differentiation of children with GID. ACKNOWLEDGMENTS This research was supported, in part, by grants from the Laidlaw Foundation, the Sonor Foundation, and the Dean’s Fund (University of Toronto). Cathy Spegg assisted in data analysis and J. Michael Bailey provided statistical consultation. A preliminary version of this article was presented at the meeting of the International Academy of Sex Research, Minneapolis, August 1988. REFERENCES Abelson, A. G. (1979). Development of psychosexual concepts in relation to expressive language performance. Psychiatry 42: 274–279. Abelson, A. G. (1981a). The development of gender identity in the autistic child. Child Care Health Dev. 7: 347–356. Abelson, A. G. (1981b). Assessment of core gender identity and gender constancy: A covariance analysis of the data. J. Psychiatr. Treatment Eval. 3: 429–435. Abelson, G., and Paluszny, M. (1978). Gender identity in a group of retarded children. J. Autism Child. Schizophr. 8: 403–411. Aboud, F. E., and Ruble, D. N. (1987). Identity constancy in children: Developmental processes and implications. In Honess, T. M., and Yardley, K. M. (eds.), Self and Identity, Routledge & Kegan Paul, New York, pp. 95–107. Ajzen, I., and Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychol. Rev. 84: 888–918. American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders , 3rd ed., American Psychiatric Association, Washington, DC. American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders , 3rd ed., rev., American Psychiatric Association, Washington, DC. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders , 4th ed., American Psychiatric Association, Washington, DC. American Psychological Association. (1994). Publication Manual of the American Psychological Association (4th ed.), American Psychological Association, Washington, DC. Beal, C. R., and Lockhart, M. E. (1989). The effect of proper name and appearance changes on children’s reasoning about gender constancy. Int. J. Behav. Dev. 12: 195–205. Bem, S. L. (1989). Genital knowledge and gender constancy in preschool children. Child Dev. 60: 649–662. Bentler, P. M., and Speckart, G. (1979). Models of attitude-behavior relations. Psychol. Rev. 86: 452– 464.

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Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Gendered Sex Work in the San Francisco Tenderloin Martin S. Weinberg, Ph.D.,1, 2 Frances M. Shaver, Ph.D.,3 and Colin J. Williams, Ph.D.4

The variable “gender” rarely appears in prostitution research. Its inclusion raises the same questions brought up with respect to other areas of work: Is there a gendered perspective with respect to the work and are gender inequalities re ected in it? This study examines gender differences in the work of 140 sex workers in the San Francisco Tenderloin. As well as women and men who are workers, we include transgender workers (genetic males who present themselves as women), further accentuating differences by gender. Looking at work-speciŽ c characteristics, we Ž nd that women do not suffer inequities of income. They are, however, more prone to occupational hazards. Transgenders, who suffer the most societal discrimination, are closer to women than men in their work situation. Examining the sexuality of sex workers, the women are the least likely to enjoy sex with clients. Men report more sexual enjoyment with clients and transgenders are closer to the men in this regard. Few differences are, however, found in sexual pleasure in the personal lives of the women, men, and transgenders. A gender difference that stands out is that the men have more noncommercial sex partners than the women. Again, transgenders are more like the men, although various aspects of their condition make for some unique differences. KEY WORDS: female prostitutes; male prostitutes; transgender prostitutes; sex workers; San Francisco.

INTRODUCTION The literature on prostitution is vast and difŽ cult to summarize (for a review see Vanwesenbeeck, 1994). Much of it has been criticized by Pheterson (1990), 1

Department of Sociology, Indiana University, Bloomington, Indiana 47405. whom correspondence should be addressed. 3 Department of Sociology and Anthropology, Concordia University, Montreal, Quebec, Canada H3G 1M8. 4 Department of Sociology, Indiana University–Purdue University at Indianapolis, Indianapolis, Indiana 46202. 2 To

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who argues inter alia that the category “prostitute” is given a self-evident status and that little attempt is made to examine differences in the variety of existing “prostitutions.” Thus, she notes (1990, p. 404), “ . . . Studies of prostitutes are usually focussed [either] exclusively on women or on men. Studies including both are exceptions.” The research reported in this paper helps to Ž ll this gap. A previous study that compared women and men in sex work was conducted in Sydney, Australia, by Perkins and Bennett (1985). They attribute the differences they found to social inequality and the different learning experiences of women and men. Regarding social inequality, they note that women have fewer work opportunities to choose from than do men. Additionally, they suggest that in commercial transactions between a woman and a man, the woman has less social status than in commercial exchanges between two men where there is more equality. Regarding the gendered interpretation of their sex work experiences, Perkins and Bennet claim women see prostitution more as “work” (because they learn to relate to sexuality in ways that emphasize intimacy), whereas more men see it as recreational (because they are more likely to learn that impersonal sexual activity is an accepted part of being a man). Also included in the Perkins and Bennett study were a small number of transgender people—genetic males (usually still retaining a penis) who present themselves as women, aided by the use of estrogen which feminizes the male body (e.g., giving them breasts). Such persons, who may or may not live full-time as women, are often known as “she-males,” “he/she’s,” etc. 5 Since transgender people are an interesting mix of male genes, male genitals, male socialization, female hormones, female secondary sexual characteristics, and feminine appearance and role performance, their inclusion in the Australian sample allowed for some valuable comparisons. Unfortunately, Perkins and Bennett were unable to compare systematically a transgender group with the women and men in their book. This study is organized around the topics covered by Perkins and Bennett. It is dissimilar in method, however. Unlike their collation of material from separate studies of each gender group done by different people with different instruments, we do a unitary study using a single interview schedule. Further, as well as comparing the women and men directly, we also compare them with the transgender workers. In this way we can try to explore certain aspects of gender: for example, does the transgenders’ genetic sex and prior role as men make them similar to men in the sex trade, or does their later adoption of the role and status of women (as well as for some, their use of female hormones) make them more similar to women? 5

For an account of transgender people, see Blanchard and Collins (1993) and Money and Lamacz (1984). The name “transgender” has received widespread publicity in San Francisco, where it has now become an umbrella term for many types of persons who cross gender lines (San Francisco Chronicle , 1993; Tenderloin Times, 1993). For a description of transvestite prostitutes (a segment of which overlaps our transgender group) in Atlanta, Georgia, see Boles and Elifson (1994).

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We also examine whether there are situations wherein the transgenders are unique, that is, behaving or responding in a manner that differentiates them from both women and men. For example, since a large amount of estrogen in males tends to suppress testosterone, reduce sexual appetite, and create difŽ culties in producing erections, could this affect these sex workers in their sexual experience both inside and outside the sex trade? We look at two general topics when considering gender and prostitution. First, we study the three groups of sex workers in their round of work. We consider the advantages and disadvantages of sex work for each group and whether they appear to be related to gender inequities. For example, do we Ž nd gender differences in the perception of alternative sources of income, the level of relational responsibility (e.g., having dependents to support and care for), their earnings and work schedules, years in the work, and plans to get out of the occupation? We also try to determine whether the groups face different degrees and forms of vulnerability (self-imposed such as drug use and those imposed by others such as beatings, rape, and arrest). Finally, we examine gender differences in the work strategies used to maximize rewards (e.g., time spent with customers, conning the customer). The second general subject focuses on the sexual experiences of the three groups of sex workers. We address this by comparing their commercial and noncommercial lives. For example, the involvement of women in prostitution has been criticizedby some writers as “self-estranging” since sex becomes instrumental (see Chapkis, 1997). Others refer to this phenomenon as “disengagement” and argue that it is a survival strategy (Alexander, 1988; Day and Ward, 1996). Still others argue that the commodiŽ cation of sex eventually destroys the ability of the sex worker to positively experience sex in personal sexual relationships (cf. Hoigard and Finstad, 1992). No such claims have been made about the effects of sex work on the personal sexual lives of men who are involved in sex work. This re ects the view that women are more “emotionally vulnerable” than men, that the costs of impersonal sexual acts are greater for women, or that the meaning attached to sexual acts is different for women and men. Thus, for women, sexual acts are seen as more likely to be meaningful only in a context of a personal relationship with a partner (Gagnon and Simon, 1973). In their study of prostitute women, Savitz and Rosen (1988) seem to negate this portrayal. They report that most of their respondents report some form of sex with clients and lovers to be sexually enjoyable, although this was more likely among the latter. However, arguments still surround their Ž ndings (Pheterson, 1990). In the present study we examine whether sexual enjoyment is less likely to be part of a woman’s work experience than a man’s (cf. DeZalduondo, 1991). In addition, we study whether the gap between sexual enjoyment on the job and during the more intimate sexual acts of private life is more apparent among the women workers than the men workers. Finally, whether the transgenders respond like the women or the men will be theoretically informative.

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METHOD This study was conducted in 1990–1991. It grew out of long-time Ž eldwork observations in San Francisco’s Tenderloin, where sex workers from each of the three groups were found to be working. We had come to know a number of them during previous research in San Francisco (Weinberg et al., 1994). Throughout the period of the current study, transgender sex workers congregated around and inside a particular bar: The Green Tulip.6 Women sex workers rarely if ever frequented the bar but did share the same stroll area—the recognized territory of streets for soliciting. The transgenders also worked an adjacent area where there were few women and which was only a block away from the major area for the sex working men. The Ž eldwork—carried out by the three authors (two men and one woman) and two research assistants (a female graduate student and a male undergraduate senior student)—conŽ rmed that each group of sex workers had its own stroll. Observing the street life of the strolls, we became observed ourselves. We came to know the regulars and discussed their work informally with them. We also talked with the police, outreach workers (CAL-PEP), and others who came into contact with the sex workers. Participants Using a structured interview guide with both open- and closed-ended questions, we interviewed 46 women, 46 men, and 48 transgender people working the strolls in the Tenderloin. Interviewers were sent to a particular place at a particular time during a 24-hr period and instructed to interview the sex workers found there. By this time we had observed who was involved in the sex trade and no mistakes were made (e.g., asking non-sex workers). Since we had become well known on the street, there were few refusals. All respondents were given the nominal sum of $10—a token of our appreciation for their participation. The typicality of the three groups cannot be judged any more accurately than to say that in just over a month we were able to interview most of the regulars. We were fortunate to be accepted at The Green Tulip, where an estimated 600 person hours were spent observing the transgender sex workers and their clients (42 clients were interviewed the following year). These observations helped us to interpret the interviews with the transgender group. Although most of the interviews with the sex workers were conducted on the street, some took place in coffee shops or residential hotels. A few of the transgenders were interviewed in The Green Tulip. The average time of the interviews was 30 to 45 min. 6 The

Green Tulip is a pseudonym. This bar was closed in 1995. Transgenders, however, colonized another bar closer to their major stroll area. It functions in the same way for them.

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Table I. Selected Demographics of the Three Groups of Sex Workers W–M

Women (N = 45)

Mean age

**

29.3

Relationship status % cohabitating/married % sharing in the Ž nancial support of a child or adult (excluding pimp)

** **

52 59

W–TG

** **

Transgenders (N = 45)

M–TG

Men (N = 44)

29.7

**

23.8

19 23

11 22

Education % less than high school % high-school degree % at least some college

39 37 24

25 46 29

41 37 22

Ethnicity % visible minority

37

55

30

65 35 0

71 29 0

Sexual preference % reporting sexually turned on by Just men Both men and women Just women

** **

** * **

37 50 13

Note. SigniŽ cance of the difference between indicated pairs: ¤ ¤ p · .01; ¤ p · .05.

Statistical analysis (ANOVAs) indicated that the three groups of sex workers in the study differed signiŽ cantly on several demographic variables (Table I). On average, the transgender and the women workers were older than the men. With respect to relationship status, the women stood out as the group most likely to be married or cohabiting with a partner and sharing in the Ž nancial support of a child or another adult. (Pimps were excluded from the adult category and only two of the women worked for someone who would currently be considered a pimp.) Differences in levels of education are not signiŽ cant. Nonetheless, it is worth noting that over one-third of the sex workers studied completed high school and an additional quarter had received some college education. Differences in ethnicity are apparent: somewhat more of the transgenders (about half ) were members of a visible minority (e.g., African-American, Thai). All three groups of sex workers primarily service men. With regard to the direction of their sexual feelings, however, there are some notable group differences. The women and the transgender workers are similar in that two-thirds of them say they are “sexually turned on” only by men; the remainder have sexual feelings toward both men and women. In contrast, about a third of the men reported that they were sexually turned on only by men, half by both men and women, and the remainder (13%) by just women. Only eight of the transgenders had undergone sex reassignment surgery and had constructed vaginas. The others were evenly divided between saying they wanted surgery and having no interest in it.

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Measures Comparisons were made in terms of two broad sets of dependent variables. The Ž rst is Round of Work. Round of Work issues were grounded in six sets of questions—each relating to a particular theme. The Ties to Sex Work theme included six items designed to assess the extent to which a sex worker was “locked” into the business. Examples of these items are access to other sources of income, level of satisfaction with work, belief in one’s ability to get a job outside sex work, willingness to leave the trade, and number of years on the job. Three of the Round of Work themes were designed to measure the way in which sex work was organized. The Ž rst—Work Schedules and Earnings— included questions about the regularity of the work schedule, the number of working days per week, the number of clients seen, and the average time spent with each client. Respondents were also asked to estimate their average weekly income.7 The second focused on the Types of Sexual Services Provided. On a 5-point scale ranging from “do not provide” (1) to “provide more than three quarters of the time” (5), respondents were asked to indicate what proportion of the six were sexual services they normally performed for their customers. The list includes hand job, oral sex, anal insertive, anal receptive, coitus, and half-and-half (a combination of oral and vaginal or oral and anal).8 The third theme in this set measured Relating with Clients. On a 5-point scale ranging from “never” (1) to “all of the time” (5), respondents were asked to report how often they reneged on an agreement made with a client regarding a sexual service or price. The next Round of Work thematic focus was on Use of Illegal Drugs and Alcohol. To a degree, this can be considered an extension of the Ties to Sex Work theme because of the Ž nancial burden that hard drug use can produce and the repercussions it (as well as heavy alcohol or soft drug use) can have for conventional employment. We queried respondents about the frequency of their use of alcohol, marijuana, and hard drugs (heroin, cocaine, and crack). We also asked them to estimate how many days per week they were stoned or drunk. The Ž nal thematic focus in the Round of Work was a series of Selected Occupational Hazards which were externally imposed. Respondents were asked to indicate how often in the last 12 months they were raped, beaten, or robbed by a client. This was followed with a question about how often they were arrested during the same time period, and for what crimes. 7

Average weekly incomes for each individual were also estimated using a formula sensitive to the type and price of sevices most often provided by each of the groups: they were comparable to the group means based on the individual sex workers’ estimates. 8 Our focus is on the sexual services provided by all three gender categories to male clients. Thus, we do not report on the coital activities of the men or, for anatomical reasons, on the anal insertive activities of the women. In addition, because only eight of the transgenders have surgically constructed vaginas, we do not report on coital activities of transgenders.

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Sexual Enjoyment was the focus of the second set of dependent variables. It was assessed using three questions. On a 5-point scale ranging from “never” (1) to “all of the time” (5), respondents were asked to indicate the extent to which they enjoyed performing up to eight sexual activities with their clients. In addition, an item regarding orgasmic frequency was included: “How often do you cum (have orgasm)?” Using the same scale, respondents were asked how much they enjoyed these same activitieswith their current, or most recent, male partner in their personal life. We limited our focus to male partners in order to simplify matters when comparing levels of sexual enjoyment on and off the job. In a third question, respondents were asked to indicate how many different male and/or female sexual partners they had in their personal life in the last month and the last year. Analysis To determine whether the women, men, and transgenders differed on any of the Round of Work or Sexual Enjoyment measures, a MANOVA was conducted to examine gender differences for all of the dependent variables within each of the thematic packages. In addition, a number of demographic controls were introduced when examining these relationships. The demographic variables included age, relationship status (cohabiting or married; Ž nancially supporting a child or adult), education, ethnicity, and sexual preference (turned on just by men and turned on just by women). Their possible relationship to various dependent variables are exempliŽ ed as follows: with respect to the Round of Work, they could relate to work motivation (age by way of energy level, ethnicity through affecting work attitude, sexual preference through feeling better about engaging in sex work with a male client), they could affect market value (e.g., age and ethnicity having effects on income), or they could affect one’s round of work through Ž nancial need (e.g., having a dependent to support). Several other variables that differentiated the gender groups were also individually tested. These included hard drug use (which could create more Ž nancial need and ties to sex work, affect work schedule regularity, or increase the risk of arrest), other sources of income (which could affect the regularity and number of hours of work), the number of years worked (which could affect one’s work schedule or work hazards by increasing one’s time on the street), and the time ordinarily spent with a client (which could produce patterns of client exploitation). These same controls also can be related to Sexual Enjoyment. For example, the biological correlates of age can affect sexual enjoyment; age cohort, education, ethnicity, and sexual preference can be related through socialization to sexual meanings and the development of sexual responsiveness; relationship status can have an effect through the fatigue associated with child care or the sexual habituation that can occur in a marriage or cohabiting relationship; and length of time in sex work and time spent with a client can affect the degree of sexual enjoyment, as

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can the use of hard drugs. In addition, in considering orgasm, we felt it important to control for some indication of orgasmic frequency outside of the social context under consideration (i.e., work or personal life). This was to control for the possibility that their sexual responsiveness in one of the contexts could be a re ection of their sexual responsiveness in the other. For example, the individual could be nonorgasmic in both contexts, could have a satiation effect from a high frequency of orgasm in one of the contexts, and so on. Therefore we controlled for orgasmic frequency with a personal partner when analyzing the relationship between gender and sexual enjoyment and orgasm with a client and did the reverse when looking at the relationship between gender and sexual enjoyment and orgasm with a personal partner. Because of our relatively small sample size (140 respondents), we were unable to introduce the controls simultaneously. The strategy we adopted was to introduce each of the controls one by one. Only those found to be signiŽ cant for the relationship under examination were retained in the Ž nal models. Using the general linear model (GLM), contrast results were requested for each MANOVA and the signiŽ cance of the differences between the three paired gender combinations (W vs. M, W vs. TG, M vs. TG) is reported in the tables. Our usual practice is to discuss Ž rst the comparison between the women and the men and then the comparison between the transgenders and each of the former groups. SigniŽ cant contrasts are noted in the tables by asterisks. While some of what we conclude may be identiŽ ed as speciŽ c to the point in time and geographic locale of the study (e.g., the nature of the transgender group, the rates of arrest, and the character of the substance use of the different groups), the fundamental Ž ndings regarding differences in the round of work and sexual enjoyment seem quite generalizable. One measure of their reliability and generalizability is that they replicate the basic Ž ndings in the Perkins and Bennett study (1985). One measure of validity is that the general Ž ndings do not diverge from our observational studies of sex workers over a long period prior to the present study. Furthermore, Ž eldwork has continued since the completion of the study and nothing has arisen to call the basic conclusions into question. RESULTS Round of Work The Ž ndings regarding the experiences of the three groups of respondents in their round of work are listed in Table II. Ties to Sex Work. Six items assessed dissatisfaction with or commitment to sex work. Controls sequentially entered into the analysis were age, education, the two items under relationship status, ethnicity, and hard drug use. Results of the

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Table II. Round of Work of the Three Groups of Sex Workersa W–M Women W–TG Transgenders M–TG Ties to sex work b % reporting other sources of income % very dissatisŽ ed with work % believing it easy to get job outside sex work % willing to leave sex work if offered “square” job for same pay % believing they will quit in 1 year or less Mean number of years worked (based on age began to be regularly paid) Work schedules & earnings c % having a regular work schedule Mean no. working days/week Mean no. clients/week Mean no. minutes spent with client Average weekly income in 1990 ($) Types of sexual services provided d % providing hand jobs % providing hand jobs half or more/time % providing oral sex % providing oral sex half or more/time % providing anal (I) % providing anal (R) % providing anal intercourse half or more/time % providing vaginal intercourse % providing half-&-half (oral & vaginal or anal intercourse)

**

Selected occupational hazards i Mean no. violent incidents over 12 months Raped by client Beaten by client Robbed by client

(N = 36) 47 14 58

89 59

*

9.73

** ** **

(N = 37) 70 5.2 26 23.8 1030

* **

(N = 37) 70 11

*

97 49 NAe 19 0

**

Relating with clientsh % reporting they go back on agreedupon sexual services % reporting they raise agreedupon prices Use of illegal drugs & alcohol h % using marijuana at least once/week % using hard drugs at least once/week Mean no. days/week stoned Mean no. days/week drunk (alcohol)

(N = 37) 38 19 57

89 86

** *

** **

**

(N = 46) 54 52

** ** **

(N = 46) 20 59 2.8 1.3 (N = 46)

**

0.41 0.46 0.50

(N = 40) 68 25 68

81

80

28

55

11.53

**

(N = 44) 64 4.8 15 29.2 688 (N = 43) 88 9 100 81 47 70 9 NA f 35

6.83

**

** * * **

*

(N = 48) *

**

Men

71 73 (N = 48) 35 25 3.4 1.3 (N = 48) 0.13 0.23 0.52

(N = 44) 41 4.2 10 45.1 507 (N = 32) 91 44 88 50 50 34 6 NAg 9 (N = 45)

*

** **

47 58 (N = 46) 70 26 5 1.6 (N = 46) 0 0.09 0.57 (Continued )

512

Weinberg, Shaver, and Williams Table II. (Continued ) W–M

Frequency of all arrests over 12 months Prostitution-related Drug-related Personal crime Property crime

Women

W–TG

0.89 ** ** **

0.63 0.07 0 0.11

Transgenders

M–TG

0.48 *

0.38 0.04 0.02 0.04

Men 0.83

** * *

0.20 0.24 0.13 0.20

Note. SigniŽ cance of the difference between indicated pairs: ¤ ¤ p · .01; ¤ p · .05. a The N ’s reported within each set of measures vary since they re ect the number of respondents retained during the analysis. b Controls: age ¤ ¤ ; cohabit ¤ . c Controls: other sources of income ¤ ¤ ; college ¤ . d Controls: years of work ¤ ¤ . e An anatomical impossibility. f Since only eight of the transgenders had surgically constructed vaginas, this was set to NA. g This activity does not apply since the clients are male. h Controls: n.s. i Controls: hard drug use¤ .

MANOVAs indicated that only age and cohabiting had signiŽ cant effects on the original relationship. Thus, both were retained the model. The gender comparisons indicate that societal inequalities often presumed to be re ected in women’s ties to sex work are not evident, at least from the point of view of the participants. Four of the six variables show no signiŽ cant variation whatsoever between the gender groups: women, men, and transgenders are similar in showing some dissatisfaction with their sex work, believing it is easy to get a job outside of sex work, saying they would leave sex work if offered a “square” job for the same pay, and in the number of years they had worked in prostitution. On the other hand, the remaining two items do show some gender variation even with the controls. The women were less likely than the men to report other sources of income and the transgenders were less likely than the women to believe they will quit in a year or less. Work Schedules and Earnings. Five items tapped the sex worker’s work schedule and earnings. Initial controls were age, both items on relationship status, education, ethnicity, years worked, and hard drug use. One—education— signiŽ cantly affected the original relationship so was retained in the MANOVA analysis. Even with this control in place, signiŽ cant gender differences between women and men were evident on all Ž ve items: women were more likely than men to have a regular work schedule, work more days per week, see more clients, spend less time with their clients, and earn more. Recalling that women were signiŽ cantly less likely than men to report other sources of income, we decided to check its effect and added other sources of income to the model. With this control in place,

Gendered Sex Work in the San Francisco Tenderloin

513

the gender difference in the number of working days disappeared. This suggests that women are more dependent on sex work than men because it is likely to be their only source of income. The transgenders were similar to the women on two items: both tended to have regular working schedules (64 and 70%, respectively) and to spend similar amounts of time with their clients (about 25–30 min). This set both groups apart from the men who were less likely to have a regular schedule (only 41% did so) and who spent signiŽ cantly more time with their clients (45 min). On two other items, however, the transgenders more closely matched the men: in the number of clients served and weekly income earned. Types of Sexual Services Provided. Nine items were used to measure the type and proportion of sexual services provided by the sex worker. The individually entered controls included the Ž ve demographic factors (age, the two items on relationship status, education and ethnicity). These were followed by years worked, hard drug use, and the two sexual preference items (turned on just by men, turned on just by women). The only variable to be retained and included in the Ž nal model was number of years worked since it was the only control that was signiŽ cantly related to the original relationship. The results indicate there are signiŽ cant gender differences in the type of services provided to clients. Regardless of the years worked, fewer of the women than the men provided “hand jobs” (70 and 91%) and those who did did so much less frequently (11 vs. 44% at least half of the time). On the other hand, the women were more likely than the men to provide “half-and-half ” (a combination of oral sex and vaginal or anal intercourse). The women, by virtue of their anatomy, were the only ones able to provide vaginal intercourse (and 89% did). On the other hand, they were unable to provide insertive anal intercourse except with a dildo (and none did). The transgenders and the women were similar with respect to two of the service items: “hand jobs” represented a very small part of the service repertoire of both (only 9 and 11%, respectively, provided it more than half of the time) and almost all had provided oral sex (100 and 97%). The transgenders and the men were closer on two items. Both were equally likely to have given “hand jobs” (88 and 91%) and to have provided insertive anal intercourse (47 and 50%). The transgenders were uniquely different with respect to the proportion of their acts of oral sex and the likelihood of ever providing receptive anal intercourse: they provided both these services signiŽ cantly more often than did either the women or the men. Relating with Customers. Two questions asked whether relations with clients involved deception. The control variables entered were age, years worked, work schedule, length of work week, and time spent with the client. None was signiŽ cantly related to the original relationship between gender and relating with customers.

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The gender comparisons indicate that there are no signiŽ cant differences between the women and the men in “conning” a client. The transgenders, however, stand out in their willingness to renege on agreed upon sexual services and prices (although on the former, the signiŽ cance falls just below the .05 level in the comparison with the women, and on the latter, this was the case in the comparison with the men). The most unique deception transgenders perpetrated was presenting themselves as females—a type of con that was not relevant to the women and the men. About 40% of the transgenders “mostly” or “always” told their customers they were males, 36% told them “sometimes or rarely,” and 23% never told them. Disclosure was less likely to occur on the street than in The Green Tulip, where clients were assumed to be in the know or were reminded (“You know I’m a boy”). Thus, many of the transgender prostitutes restricted themselves to working the bar. They did not work the street because of their fear of the con ict that the deception could cause (see also Boles and Elifson, 1994). Also, since performing oral sex and receiving anal intercourse represent a large proportion of the services provided, the question of their biological sex may not arise. Techniques involved in this deception include tucking or taping the penis back between the legs, restricting services (e.g., the transgenders saying they are having their period and refusing to remove their skirt or panties), and, in some cases, using their hands or anus to fake coitus. In the last 12 months, the transgenders reported on average that 13 customers discovered their deception in trying to pass as female. Only rarely (in about 15% of the cases) was the client said to respond with any violence. The rest were reported to have been equally likely to have left calmly or accepted the deception and stayed. Use of Illegal Drugs and Alcohol. Four items measure the use of illegal drugs and alcohol. Age, relationship status (two items), education, ethnicity, and years worked were each in turn entered as controls. None had signiŽ cant effects on the original relationships and thus were eliminated from the subsequent analysis. SigniŽ cant gender differences indicated that the women were unique in their extensive use of hard drugs. They were much more likely than both the men and the transgenders to be heavily involved in hard drug use (59% used at least once a week, compared to only a quarter of the men and transgenders). Thus the transgenders resembled the men in their limited use of hard drugs, but their lesser use of soft drugs and propensity for being stoned more closely matched those of the women. Selected Occupational Hazards. Eight hazards were examined in this Ž nal round of work category: three involve an experience with violence and Ž ve with arrest. Sequentially controlling for age, years worked, a regular work schedule, length of work week, and time spent with the client, we determined that none had a signiŽ cant impact on the gender relationship under examination. Deception and hard drug use (two items) were also introduced, given the likelihood each had for elevating the risks of violence and arrest for transgenders and women respectively. Hard drug use was the only one found to be signiŽ cant.

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The results indicate that women and transgender sex workers were not signiŽ cantly more likely than men to experience beatings and robbery on the job. With respect to rape, however, the women were much more at risk than were their transgender and male counterparts. Differences in overall arrest rates by gender are not statistically signiŽ cant, but important variations in the reasons behind the arrests are in evidence. The women stand out as more likely to have been arrested for prostitution-related offenses than either the transgenders or the men. The lower rate of prostitutionrelated arrests for men and transgenders seems to be associated with their being able to avoid the attentions of the police because they are on the street less—e.g., the gay bars, where male prostitutes and their clients often assemble, and The Green Tulip, for transgenders and their clients, were less often under surveillance by the police. On the other hand, compared to both the women and the transgenders, the men had a higher frequency of arrests related to drugs. Given that hard drug use remained in the model, the more frequent arrests of the men is interesting. Although we did not obtain information on the nature of the drug arrests, we believe that their greater number among the men is related to their involvement in selling drugs, especially “speed”; this interpretation is supported by Sheigla Murphy, Dan Waldorf, and Toby Marotta’s Ž eldwork on men sex workers in the Tenderloin (personal communication; also for differences between men and women in the opportunity to deal drugs, see Schur, 1984; Colten and Marsh, 1984). The fact that they had signiŽ cantly more arrests for personal crime (than the women and the transgenders) and property crime (than the transgenders) is also most likely related to the typical activities engaged in by young men on the street (cf. Schur, 1984). Sexual Enjoyment The Ž ndings regarding sexual enjoyment with a client are reported in Table III. Eight sexual activities are listed, along with two measures related to orgasmic frequency. The controls introduced were age, relationship status (two items), education, ethnicity, sexual preference (two items), hard drug use, years worked, length of work week, and time spent with client. Of these, none was signiŽ cantly related to the relationship between gender and sexual enjoyment with a client, thus all were dropped from the analysis. As mentioned earlier, we felt it important to control for orgasmic frequency with a personal partner, but it also proved to be nonsigniŽ cant. There are striking gender differences in sexual enjoyment with a client. On four of the sexual activities, the women were much more likely than the men to “never enjoy” their commercial sex. They were also much less likely to experience

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Table III. Sexual Enjoyment of the Three Groups of Sex Workersa W–M Sexual enjoyment of activities with clientsb % reporting never enjoy: Hand jobs Kissing Having breasts fondled Giving oral sex Receiving oral sex Anal intercourse (I) Anal intercourse (R) Vaginal intercourse % reporting orgasm never % reporting orgasm most or all the time Sexual enjoyment of activities with partner f % reporting enjoy most or all the time Hand jobs Kissing Having breasts fondled Giving oral sex Receiving oral sex Anal intercourse (I) Anal intercourse (R) Vaginal intercourse % reporting orgasm most or all the time Mean no. of noncommercial sexual partners i Men in the last month Men in the last year Women in the last month Women in the last year

Women

W–TG

(N = 39) ** ** ** *

** **

**

67 28 67 72 36 NAc 15 56 69 5

** ** **

**

*

M–TG

Men

(N = 43)

(N = 33)

40 26 19 28 21 12 14 NAd 30 7

24 18 12 36 15 6 9 NAe 15 45

**

(N = 39)

(N = 42)

(N = 33)

26 79 67 67 59 NAc 8 74 74

38 83 86 64 43 19 64 NA g 57

31 72 22 59 72 34 16 NAh 91

*

**

(N = 46) ** **

Transgenders

0.43 1.85 0.11 0.20

*

¤ ¤

**

** **

(N = 48)

(N = 46)

1.60 10.96 0.17 0.29

2.43 15.15 0.96 6.93

*

p · .01; ¤ p · .05. (I) Insertive anal sex

Note. SigniŽ cance of the difference between indicated pairs: activity; (R) receptive anal sex activity. a The N ’s reported within each set of measures vary since they re ect the number of respondents retained during the analysis. b Controls: n.s. c An anatomical impossibility for women. d This was set to NA since only eight of the transgenders had surgically constructed vaginas. Of those, however, three reported they never enjoy this activity with their clients. e This activity does not apply since the clients are male. f Controls: orgasmic frequency with client most or all the time¤ ¤ . g Of the Ž ve who reported engaging in this activity with a partner, three enjoy it most or all the time. h Although some of the men have female partners in their personal lives, we focus on activity with male partners in order to simplify matters. i Controls: turned on just by men ¤ ¤ ; turned on just by women ¤ ¤ .

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orgasm. We also found striking differences between the women and the transgenders on three activities: the women were signiŽ cantly more likely to “never enjoy” giving client’s hand jobs, having their breasts fondled, and providing oral sex. These differences in sexual enjoyment were also re ected in the frequency of orgasm with clients: the women were more likely than the transgenders to report that they never experienced it (69 vs. 30%). The extent of this difference in orgasm is noteworthy since the hormones taken by transgenders often suppress sexual response: a third of them took estrogen “regularly” and about another third took it “sometimes.” Over half those who took estrogen said that it affected their ability to have erections and orgasms. With respect to the Savitz and Rosen (1988) Ž ndings that most women sex workers found some form of sex with clients sexually enjoyable “most” or “all of the time,” only a small proportion of the women in the present study found sex with clients sexually enjoyable, and then usually “sometimes” or “rarely.” Differences in sexual enjoyment with clients are much less in evidence when comparing the transgenders and the men. In fact, what we see are similar responses between the transgenders and the men on all but one of the items that differentiated the transgenders and the women. The item for which there is signiŽ cant variation between these two groups is with respect to having orgasm “most” or “all” of the time with clients: only 7% of the transgenders reported this, compared with 45% of the men. (Again, we attribute this to the effect of hormones.) On this item the transgenders were more like the women. At the same time, overall it was the men and the transgenders who experienced sexual enjoyment with their clients. In analyzing the relationship between gender and sexual enjoyment with male partners in their personal lives, the only control that proved to be signiŽ cant and was thus used was orgasmic frequency with clients. The gender comparisons indicate that the relationship between gender and sexual enjoyment is much different when examined in the context of their personal lives than it was in their commercial lives. The Ž nal results of the MANOVA indicate fewer differences between the women and the men concerning sexual enjoyment of comparable activities with a noncommercial male partner. Here differences are apparent with respect to only one activity: breast fondling. The women were more likely than the men to say they enjoyed it most or all of the time. When examining sexual enjoyment with males in their personal life, differences appear with respect to two activities: enjoyment of breast fondling and receptive anal intercourse. The transgenders were more likely than the men to say they enjoyed them most or all of the time. The higher propensity for men to report orgasm most or all of the time remained the same as with male clients. The transgenders stand out as unique (i.e., signiŽ cantly different from both the women and the men) in their enjoyment of breast fondling and receptive anal intercourse. They are also less orgasmic than the other two groups, but only signiŽ cantly so in comparison to men.

518

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With regard to the Ž nal theme—the number of noncommercial sexual partners—a sexual preference for only men and for only women were both found to be signiŽ cantly related and thus were retained in the model. Regardless of these preferences, however, the women reported fewer noncommercial sexual partners (male and female) than the men. The transgenders’ resemblance to the men was with respect to the greater number of male partners they had in the last year compared to the women. Their resemblance to the women was with respect to the small number of female partners in the last year. DISCUSSION This study, conducted in San Francisco in 1990, replicates the basic differences between women and men in prostitution found by Perkins and Bennett in their 1983 Sydney, Australia, study. This replication increases the reliability and validity of claims regarding gender differences in prostitution and provides them with generalizability beyond the time and place of each study. In addition, through adding transgenders to the comparison, we are able to supplement their Ž ndings and continue the discussion of the relationship between gender and sex work. For example, although we too Ž nd sex work to be extremely gendered, our data indicate that it is not solely or necessarily because social inequalities bear most heavily on women. It is clear that of all three groups, the women spend the most time doing sex work and serve the most clients. Since the women also have the greatest need to support dependents and are the most likely to be maintaining a hard drug habit, one might expect prostitution to be experienced as less of a choice for them. In terms of their own perceptions, however, the women do not appear to be more likely to see themselves as being “trapped” in prostitution than are the other two groups. Women sex workers’ lack of other sources of income, however, did seem to increase their ties to sex work—and in this way made it less of a choice for them—since it served to explain their longer work week. Overall, one could argue that in the sexual market place, gender operates to the advantage of women in that there are simply a greater number of men seeking women than there are men seeking men for commercial sex (Overs and Longo, 1997); this advantage seems to be maintained even though there are more women sex workers with whom to compete. On the other hand, the greater costs a woman sex worker bears vis-`a-vis the work are that she loses more social status because she is a prostitute, is arrested for prostitution more, and faces a higher risk of being raped by a client. Thus one’s gender can produce both advantages and disadvantages. The transgenders are more like the women than the men with respect to some aspects of their round of work. Like the women, they are tied to their work with

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regard to the number of years in the sex trade (although this difference from men is nonsigniŽ cant when age is controlled), the regularity of their work schedule, and the time spent with the client. The reason for this appears to be tied to the stigma of a male presenting himself as a woman. This likely restricts employment possibilities and goes beyond being a woman. In this case it applies to being a transgender and being discriminated against even more. The way in which gender works to the advantage of the transgenders is that they are able to attract men who are drawn to their mix of sexual characteristics or who “deny” or believe they are having sex with a female, not a genetic male. Another advantage found in our study—one they share with the men sex workers—was a low incidence of prostitution-related arrests. We also found that gender is related to both the sexual activities offered and the gratiŽ cations that sex provides on the job. The activities differ not just because of anatomical differences, but also in the gendered meaning attached to them. For example, women were the least likely to provide or enjoy anal sex. Receptive anal sex was provided and enjoyed most often by the transgenders, who were also much more likely than the women to enjoy breast fondling. They often said that these activities made them feel more feminine and thus can be seen as identity conŽ rming (for a similar observation see Boles and Elifson, 1994). Another gender difference concerns overall sexual enjoyment with clients. While some people believe that the sex involved is a reward for the women in sex work (e.g., Savitz and Rosen, 1988), most of the literature emphasizes that women sex workers try to handle their clients as expeditiously as possible without regard to their own sexual satisfaction [cf. the sex workers’ handbook (Overs and Longo, 1997) ]. Our Ž ndings fall in line with the latter description, even though sexual enjoyment with a client does sometimes occur. Regardless of the sexual activity, compared with men, women spend less time with clients and are much less likely to report sexual enjoyment or orgasm. There are fewer such gender differences in sexual enjoyment and orgasm when the partner is a not a client. This supports Perkins and Bennet’s (1985) notion that a recreational element is less likely to be part of the prostitution of women. It also supports other research which shows that in general men Ž nd it easier to enjoy sex outside of a personal relationship than do women (cf. Schwartz and Rutter, 1998). Following Chapkis’s arguments (1997), these results suggest that women sex workers are adept at building boundaries between sexual activities inside and outside of work in order to preserve emotional distance from prostitution. This is no different from similar survival strategies found in other types of women’s service work (cf. Hochschild, 1983). Those who maintain that prostitution is “selfestranging” or that “disengagement strategies” are alienating may be giving special meaning to occupational sex in a way the prostitute does not. Emotional damage, if it occurs, is much more likely to come from negative social attitudes, loss of

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control over the work situation, or harassment from clients and the police than the sex itself. On balance, the transgenders are more like the men than the women with regard to their sexual behavior and responses. Their service repertoire is similar because most share the same genital anatomies as the men. Their sexual enjoyment with clients is even more striking in its similarity to the men, suggesting a gender effect through a subculture that supports male sexual values. Off the job, transgenders and men had more sex partners than did the women, re ecting general differences between males and females. Transgenders are uniquely different, however, in their relative lack of orgasm, which we view as attributable to the effects of estrogen in males (see also Baldwin and Baldwin, 1997). Thus Pheterson’s (1990) argument, quoted in the Introduction, is supported: there is something to be gained by studying the prostitution of different genders in juxtaposition to one another. Having the transgender group in the study helps to increase our understanding of gender because they show how and suggest why they are more likely to be similar to the men or women. REFERENCES Alexander, P. (1988). Prostitution: A difŽ cult issue for feminists. In Delacoste, F., and Alexander, P. (eds.), Sex Work: Writing by Women in the Sex Industry, Virago Press, London. Baldwin, J. D., and Baldwin, J. I. (1997). Gender differences in sexual interest. Arch. Sex Behav. 26: 181–210. Blanchard, R., and Collins, P. (1993). Men with sexual interest in transvestites, transsexuals, and she-males. J. Nerv. Ment. Dis. 181: 570–75. Boles, J., and Elifson, K. W. (1994). The social organization of transvestite prostitution and AIDS. Soc. Sci. Med. 39: 85–93. Chapkis, W. (1997). Live Sex Acts: Women Performing Erotic Labor, Routledge, New York. Colten, M., and Marsh, J. (1984). A sex-roles perspective on drug and alcohol use by women. In Widom, C. (ed.), Sex Roles and Psychopathology , Plenum Press, New York. Day, S., and Ward, H. (1996). The Praed Street project: A cohort of prostitute women in London. In Javkson, S., and Scott, S. (eds.), Feminism and Sexuality, Edinburgh University Press, Edinburgh. DeZalduondo, B. (1991). Prostitution viewed cross culturally: Toward recontextualizing sex work in AIDS intervention research. J. Sex Res. 28: 223–248. Gagnon, J., and Simon, W. (1973). Sexual Conduct: The Social Sources of Human Sexuality , Aldine, Chicago. Hochschild, A. (1983). The Managed Heart: The Commercialization of Human Feeling , University of California Press, Berkeley. Hoigard, C., and Finstad, L. (1992). Backstreets: Prostitution, Money, and Love, Pennsylvania University Press, University Park. Money, J., and Lamacz, M. (1984). Gynemimesis and gynemimetophilia: Individual and crosscultural manifestations of a gender-coping strategy hitherto unnamed. Comp. Psychiatry 25: 392– 403. Overs, C., and Longo, P. (1997). Making Sex Work Safe, Network of Sex Work Projects, London. Perkins, R., and Bennett, G. (1985). Being a Prostitute: Prostitute Women and Prostitute Men, Allen & Unwin, Boston. Pheterson, G. (1990). The category “prostitute” in scientiŽ c inquiry. J. Sex Res. 27: 397–407. San Francisco Chronicle (1993). Transgender people coming out, May 28.

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Savitz, L., and Rosen, L. (1988). The sexuality of prostitutes: Sexual enjoyment reported by streetwalkers. J. Sex Res. 24: 200–208. Schur, E. (1984). Labeling Women Deviant, Random House, New York. Schwartz, P., and Rutter, V. (1998). The Gender of Sexuality, Pine Forge Press, Thousand Oaks, CA. Tenderloin Times (1993). Transgenders unite to Ž ght for justice and recognition, August. Weinberg, M., Williams, C., and Pryor, D. (1994). Dual Attraction: Understanding Bisexuality, Oxford University Press, New York. Vanwesenbeeck, I. (1994). Prostitute’s Well-Being and Risk, Vu Uitgeverij, Amsterdam.

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Sexual Coercion in India: An Exploratory Analysis Using Demographic Variables Lisa K. Waldner, Ph.D.,1, 2 Linda Vaden-Goad, Ph.D.,1 and Anjoo Sikka, Ph.D.1

A 14-item Sexual Coercion Inventory (SCI) was administered to an urban university sample in Western India. Twenty-six percent of the sample reported a total of 160 incidents of sexual coercion ranging in severity from unwanted kissing to sexual intercourse. The most common outcome was intercourse and was followed by kissing and fondling. No gender differences were discovered regarding victim status or types of coercion tactics experienced. A MANOVA analysis found no overall gender effect, but marital status and protected class membership did have a signiŽ cant effect with people who are married and protected class members reporting more sexual coercion. Reasons for the lack of an overall gender effect and limitations of this research are discussed. KEY WORDS: sexual coercion; sexual victimization; cross-cultural; marital relations; sexual behavior.

INTRODUCTION Social scientists have used a continuum to conceptualize sexual coercion, or pressure from a partner to engage in sexual behavior. This continuum is comprised of both coercion tacticsand outcomes. Tacticsrange in severity from psychological/ verbal pressure to the use of physical force. Outcomes can also be conceptualized along a continuum of severity, beginning with milder infractions such as unwanted kissing and proceeding to more extreme violations including unwanted intercourse (Christopher, 1988; Christopher and Frandsen, 1990). While research has documented rates of premarital sexual victimization occurring among 1 University

of Houston–Downtown. whom correspondence should be addressed at Department of Social Sciences, University of Houston–Downtown, 1 Main Street, Houston, Texas 77002. Fax: (713) 221-8144. e-mail: [email protected].

2 To

523 0004-0002/99/1200-0523$16.00/0 ° C 1999 Plenum Publishing Corporation

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heterosexual females (Koss et al., 1987; Koss and Dinero, 1989), heterosexual males (McKinney, 1986; Smith et al., 1987; Muehlenhard and Cook, 1988; Struckman-Johnson, 1988; Struckman-Johnson and Struckman-Johnson, 1994; Waldner-Haugrud and Magruder, 1995), and gays and lesbians (Brand and Kidd, 1986; Waterman et al., 1989; Duncan, 1990; Waldner-Haugrud and Gratch, 1997), very little cross-cultural research has documented sexual coercion rates among intimates living in non-Western societies. An exception is the work of Tang et al. (1995), who investigated the prevalence of sexual coercion perpetrated by partners among a sample of Chinese students in Hong Kong. Reported rates of sexual coercion are somewhat comparable to American samples, probably because the status of Hong Kong as a former British colony ensures a pronounced Western cultural in uence. Tang et al. (1995) found that rates for milder forms of sexual coercion were similar to American rates. However, rates for more severe coercion such as rape were lower for the Hong Kong sample than what has been found among American college students. With the exception of the Tang et al. study, how sexual coercion rates for a non-Western society might compare to an American sample is largely unknown. India presents an interesting contrast because, despite decades of modernization, India has persisted in remaining largely agrarian and rural (Nathawat and Mathur, 1992). While India is in a state of transition, with an ever-increasing proportion of women involved in higher education, business, and industry, it still remains largely traditional in terms of values and gender-role expectations (Nathawat and Mathur, 1992). Besides a lack of information on non-Western societies, a further limitation of sexual coercion research is the nearly exclusive focus on singles. With the exception of marital rape, sexual coercion reported by married respondents has been largely ignored. An initial investigation is needed to ascertain whether sexual coercion, as deŽ ned by American social scientists, is applicable to Indian society. Sexual coercion is a complex topic that has cultural, structural, relational, and psychological components. We propose to describe the frequency of sexual coercion and explore the use of some possible independent variables. These variables include gender, marital status, and protected class membership. By American standards, India is a patriarchal society. It can be characterized as a male-privileged society with signiŽ cant power differences based on economic dependence and minimal social advocacy on behalf of women. For example, under the Hindu Succession Act of 1956, males are the sole inheritors in a Hindu United Family. The Muslim Personal Law allows polygyny and gives men unilateral divorce rights. In some cases, members belonging to tribes may be exempt from these laws. With an acknowledgment that most crimes against women go unreported, Pathak (1996) reports that crimes against women within a marriage in Gujarat (the state in India where data collection took place) account for 6.33% of the total number of such crimes in India. Gujarat accounts for 4.88% of the nations’ population (Pathak, 1996). In this India state, the difference in the literacy rate of women (48.6%) and men (73.1%) was high (Mukherjee, 1996). Similar

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differences in levels of education were observed among rural as well as urban population. In a male-privileged society, we would expect higher female victimization in the form of rape, incest, sexual harassment, and milder forms of sexual coercion. Therefore, we propose that gender is an important predictor of sexual coercion. When compared to men, we expect that Indian women may experience higher levels of sexual coercion. Because most marriages in India are arranged (Nanda, 1992), couples do not date. As a consequence, opposite-sex interaction is limited. Furthermore, honor and shame are associated with unmarried women’s sexuality, where the burden of preserving the family’s reputation lies on their shoulders. Therefore, any sexual coercion that occurs between intimate partners probably takes place within a marriage. We hypothesize that married respondents will report higher levels of coercion than singles. Finally, we believe that protected class membership is a possible predictor of sexual coercion. The caste system is comprised of four major castes (in order of prestige: Brahmans, Kshatriyas, Vaishyas, and the Shudras), which can also be broken down into various subcastes (Hurst, 1992). Protected class refer to persons who belong to the Shudras, which also includes a subgroup known as the Harijans (untouchables) and persons belonging to some tribal groups and those who are economically disadvantaged. There is some evidence that supports the existence of social ostracism of members belonging to the lower caste. According to the National Crime Records Bureau (1995), crimes against members of scheduled castes and tribes are fairly high. In spite of government sponsored afŽ rmative action programs, the hierarchical caste system ensures economic and social privileges to those who are born into the upper castes and a less than desirable existence to those who are unlucky enough to be born into the lower caste. Like other stratiŽ cation systems, an ideological component justiŽ es differential treatment. In the case of India, Hindu religious ideology suggests that those born into the lower caste deserve poor treatment as punishment for transgressions committed in a previous life. Americans make a distinction between ascribed statuses (born into) and those that are achieved and would deŽ ne India’s caste system as an example of ascription. Conversely, for Indians, placement in a caste is achieved, albeit through actions in a past life. Castes are ranked according to pollution and purity with the upper caste, being the most pure. In the past, persons occupying positions in the lower caste are closer to pollution and contamination by having occupations that require working with bodily wastes, dead organisms, and so forth (Hurst, 1992). Upper caste members avoid contact with those from the lower caste for fear of contamination. While reforms have taken place that allow the lower caste to interact with the upper caste in public (e.g., the lower caste are allowed in the temples), evidence exists that the upper caste still tries to avoid interaction with the lower caste, especially in private interactions (Sharma, 1994). The government has also tried to compensate for caste-based inequity by making some educational and economic opportunities

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available to the lower caste. For example, a quota system is used at the universities which reserves a portion of the entering freshman class and postbaccalaureate programs for persons who are protected class members. Despite these reforms, the social power of protected class members, particularly lower-caste members, is weak. We believe that sexual coercion, like other aggressive behaviors, may persist in the protected classes because these behaviors may compensate for lack of power in other spheres of life. We hypothesize, then, that protected class members will report higher levels of sexual coercion than nonprotected class members. In summary, we hypothesize that gender, marital status, and protected class membership are related to rates of sexual coercion. METHOD Participants A study was conducted in Western India with an urban university sample (N = 137) of both males (n = 54) and females (n = 83). Potential participants were asked to complete a survey in English containing items on relationships and communication within intimate relationships. Since respondents were afŽ liated with the university, English proŽ ciency was not a concern. Participants were assured that their responses would remain anonymous. Although an exact response rate was not calculated, very few refused to participate. Because gender is an important variable in this analysis, gender differences were explored prior to the principal analysis. For marital status, there were no gender differences [v 2 (3, N = 127) = 3.09, ns]. Approximately 31% were married, 65% were single, 2% were divorced, and 2% were widowed. An analysis also was conducted to test for gender differences in social stratiŽ cation. There were no gender differences in this sample relative to their mothers’ [v 2 (8, N = 129) = 4.14, ns] or fathers’ [v 2 (8, N = 129) = 12. 70, ns] education or respective occupations [v 2 (4, N = 129) = 1.36, ns; v 2 (8, N = 129) = 11. 33, ns]. After eliminating cases with missing data on the analysis items, as well as divorced and widowed respondents, the sample consisted of 44 males and 54 females ( N = 98). Divorced and widowed respondents were excluded from the analysis because there were too few cases in those cells when dividing the sample by marital status. Procedures and Measurement Participants completed a survey containing a demographic form, the SCI (Sexual Coercion Inventory), the BDI (Beck Depression Inventory) (Beck and Steer, 1987), the RSES [Rosenberg (1965) Self-Esteem Scale], the SMAT (Short Marital Adjustment Scale) (Locke and Wallace, 1959), and the STSS (Silencing the Self Scale) (Jack, 1991). The SCI, which is the focus of this paper, is a 14-item sexual coercion inventory designed to measure degree of victimization by focusing

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on a continuum of both tactics and outcomes. This inventory was developed using both items from other studies (Christopher, 1988; Muehlenhard and Cook, 1988; Struckman-Johnson, 1988; Waldner-Haugrud and Magruder, 1995) as well as items developed by the authors. For each coercion tactic, respondents were asked to indicate the most extreme sexual behavior that had occurred with an intimate partner, despite their wish not to participate. Outcomes included on the survey were kissing, fondling, intercourse, and not applicable if a coercion tactic was not experienced. For example, someone who was coerced into kissing, fondling, and intercourse because their partner would not stop touching them would select intercourse as the most extreme outcome for the persistent touching item. Coercion items included encouraging excessive drinking, threatening to end the relationship, making a partner feel guilty, begging, threatening to tell lies, threatening to disclose secrets (blackmail), refusing to leave or let partner leave, persistent touching, making false promises (e.g., “We’ll get married”), saying things that were untrue (e.g., “I love you”), holding partner down, threatening to use force, using physical force, and using a weapon. See the appendix for the exact wording of coercion items. RESULTS Results indicate that sexual coercion does occur in intimate relationships in India, albeit at a lower rate than American samples. There was a total of 160 incidents of coercion ranging in severity from kissing to intercourse. However, respondents who reported any coercion were conŽ ned to a very small proportion of the sample (26%; n = 25). For the combined sample, the most common outcome experienced was intercourse comprising 44% (70) of all coercion experiences, followed by kissing (30%; 48) and fondling (26%; 22). This pattern was also found when the sample was split by gender. For both men and women, intercourse was the most common outcome, followed by kissing and fondling. Table I reports frequencies and percentages for kissing, fondling, and intercourse when results for all coercion tactics were combined. Figure 1 allows comparisons of coercion outcomes for the combined sample and male/female subsamples. Table I. Coercion Outcomes by Gender Combined Outcome Kissing Fondling Intercourse Totals N

Male

Female

F

%

F

%

F

%

48 42 70 160 98

30 26 44 100

21 22 35 78 44

27 28 45 100

27 20 35 82 54

33 24 43 100

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Fig. 1. Total coercion experiences by types of outcomes and gender.

For men, the most common coercion tactics experienced were both begging and being held down. These items were followed by (in order of frequency) made to feel guilty, persistent touching, making threats to tell lies, partner not leaving or letting them leave, use of a weapon, use of blackmail, partner telling lies, partner using physical force, making false promises, partner threatening to use force, partner encouraging intoxication, and making threats to end the relationship. For women, the most common tactic reported was being made to feel guilty followed by encouraging intoxication, begging, partner not leaving or letting them leave, telling lies, making threats to end the relationship, persistent touching, using a weapon, using blackmail, being held down, making false promises, using physical force, making threats to use force, and making threats to tell lies. Table II reports all frequencies and percentages by gender for all coercion tactics and outcomes. To test for gender differences in victim status, respondents were split into two groups, victims and nonvictims. In order to be classiŽ ed as a nonvictim, a respondent must have chosen “not applicable” for all coercion items. A 2 £ 2 contingency table was created and chi-square was calculated suggesting that no signiŽ cant association exists between gender and victim status [ v 2 (1, N = 98) = .13, ns]. In order to test for overall effects of gender, marital status, and protected class membership on sexual coercion, coercion items were dummy coded into occurrence and nonoccurrence categories, with kissing, fondling, and intercourse collapsed into the coercion category. Gender (male/female), marital status (single/ married), and protected class (nonmember/member) were dichotomized to create two levels per variable. While a factorial (2 £ 2 £ 2) MANOVA design is preferable to test all dependent variables simultaneously because it reduces the risk of in ating type I error, cell sizes were too small for the procedure. Therefore, three one-way MANOVAs were used to test for overall effects of the categorical

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Table II. Frequencies of Sexual Behaviors by Coercion Tactics for the Combined Sample and by Gender Combined

Males

Females

Tactic

F

%

F

%

F

%

Physical force Not applicable Kissing Fondling Intercourse Total

89 0 2 7 9

90.8 0.0 2.0 7.1 9.2

39 0 2 3 5

88.6 0.0 4.5 6.8 11.3

50 0 0 4 4

92.6 0.0 0.0 7.4 7.4

Threat of force Not applicable Kissing Fondling Intercourse Total

91 1 1 5 7

92.9 1.0 1.0 5.1 7.1

40 1 1 2 4

90.9 2.3 2.3 4.5 9.1

51 0 0 3 3

94.4 0.0 0.0 5.6 5.6

Weapon Not applicable Kissing Fondling Intercourse Total

86 5 2 5 12

87.8 5.1 2.0 5.1 12.2

38 2 1 3 6

86.4 4.5 2.3 6.8 13.6

48 3 1 2 6

88.9 5.6 1.9 3.7 11.2

83 2 3 8 13

86.5 2.1 3.1 8.3 13.5

36 1 3 4 8

81.8 2.3 6.8 9.1 18.2

47 1 0 4 5

90.4 1.9 0.0 7.7 9.6

84 3 3 6 12

87.5 3.1 3.1 6.3 12.5

37 1 1 3 5

88.1 2.4 2.4 7.1 11.9

47 2 2 3 7

87.0 3.7 3.7 5.6 13.0

False promises Not applicable Kissing Fondling Intercourse Total

90 5 0 3 8

91.8 5.1 0 3.1 8.2

40 3 0 1 4

90.9 6.8 0.0 2.3 9.1

50 2 0 2 4

92.6 3.7 0.0 3.7 7.4

Touching Not applicable Kissing Fondling Intercourse Total

83 6 5 2 13

86.5 6.3 5.2 2.1 13.6

37 4 2 1 7

84.1 9.1 4.5 2.3 15.9

46 2 3 1 6

88.5 3.8 5.8 1.9 11.5

Not leave Not applicable Kissing Fondling Intercourse Total

84 9 4 1 14

85.7 9.2 4.0 1.0 14.2

38 5 1 0 6

86.4 11.4 2.3 0.0 13.7

46 4 3 1 8

Held down Not applicable Kissing Fondling Intercourse Total Told lies Not applicable Kissing Fondling Intercourse Total

85.2 7.4 5.6 1.9 14.9 (Continued )

530

Waldner, Vaden-Goad, and Sikka Table II. (Continued ) Combined

Males

Females

Tactic

F

%

F

%

F

%

Blackmail Not applicable Kissing Fondling Intercourse Total

86 0 2 8 10

89.6 0 2.1 8.3 10.4

38 0 0 5 5

88.4 0.0 0.0 11.6 11.6

48 0 2 3 5

90.6 0.0 3.8 5.7 9.5

Threat of lies Not applicable Kissing Fondling Intercourse Total

88 1 4 3 8

91.7 1.0 4.2 3.1 8.3

38 0 4 2 6

86.4 0.0 9.0 4.5 13.5

50 1 0 1 2

96.2 1.9 0.0 1.9 3.8

82 5 6 5 16

83.7 5.1 6.1 5.1 16.3

36 1 3 4 8

81.8 2.3 6.8 9.1 18.2

46 4 3 1 8

85.2 7.4 5.6 1.9 14.9

82 5 6 5 16

83.7 5.1 6.1 5.1 16.3

37 0 3 4 7

84.1 0.0 6.8 9.1 15.9

45 5 3 1 9

83.3 9.3 5.6 1.9 16.8

Stop seeing Not applicable Kissing Fondling Intercourse Total

88 2 2 6 10

89.8 2.0 2.0 6.1 10.1

41 1 0 2 3

93.2 2.3 0.0 4.5 6.8

47 1 2 4 7

87.0 1.9 3.7 7.4 13.0

Intoxication Not applicable Kissing Fondling Intercourse Total

86 4 2 6 12

87.8 4.1 1.0 1.0 6.1

40 2 1 1 4

90.9 4.5 2.3 2.3 9.1

46 2 1 5 8

85.2 3.7 1.9 9.3 14.9

Begging Not applicable Kissing Fondling Intercourse Total Guilt Not applicable Kissing Fondling Intercourse Total

independent variables. For gender, multivariate F tests (Pillai’s trace) indicate no signiŽ cant overall effect. Both marital status ( p < . 001) and class ( p < . 001) had signiŽ cant overall effects, suggesting that marrieds and members of protected class report higher levels of coercion. The univariate F tests for marital status suggest that the overall effect is concentrated in the following items: intoxication ( p < .001), threats to stop seeing the respondent ( p < . 001), guilt ( p < . 001), blackmail ( p < .001) refusing to leave ( p < .001), persistent touching ( p < .001), making false promises ( p < . 001), telling lies ( p < . 001), being held down ( p < . 001), and using a weapon ( p < .001). Table III reports all means and univariate F statistics for all coercion items.

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531

Table III. Comparison of Coercive Tactics to Obtain Sexual Behavior Ranging from Kissing to Intercourse, by Marital Status Tactic Physical force Threat of force Weapon Held down Told lies False promises Touching Not leave Blackmail Threat of lies Begging Guilt Stop seeing Intoxication

Married (mean)

Unmarried (mean)

.142 .114 .257 .257 .285 .200 .314 .285 .257 .142 .257 .342 .285 .285

.063 .047 .047 .063 .031 .015 .031 .063 .015 .047 .111 .063 .000 .031

Univariate F (df = 97) 1.69 1.50 9.84 ¤ 7.76¤ 15.34¤ 11.12 ¤ 18.19¤ 9.80 ¤ 16.39 ¤ 2.74 3.57 14.49¤ 24.69 ¤ 15.34¤ ¤ ¤ ¤ ¤ ¤ ¤ ¤

¤ ¤ ¤

Note. Pillai’s trace = .336; F(14,83) = 3.01; p < .001. ¤ ¤ p < .001. Table IV. Comparison of Coercive Tactics to Obtain Sexual Behavior Ranging from Kissing to Intercourse, by Protected Class Status Tactic Physical force Threat of force Weapon Held down Told lies False promises Touching Not leave Blackmail Threat of lies Begging Guilt Stop seeing Intoxication

Protected class (mean)

Nonprotected (mean)

Univariate F (df = 88)

.045 .045 .272 .318 .318 .272 .363 .363 .318 .227 .272 .363 .272 .272

.089 .059 .074 .074 .074 .014 .074 .074 .044 .029 .119 .104 .059 .074

.51 .80 6.29 ¤ 9.09 ¤ ¤ 9.09¤ ¤ 17.90 ¤ ¤ 12.38¤ ¤ 12.38 ¤ ¤ 14.10 ¤ ¤ 9.68¤ ¤ 2.97 8.52¤ ¤ 8.05 ¤ ¤ 6.29¤

Note. Pillai’s trace = .393; F(14,74) = 3.42; p < .001. ¤ p < .01. ¤ ¤ p < .001.

The univariate F tests for membership in a protected class suggest the overall effect is concentrated in the following dependent variables: intoxication ( p < . 01), threats to stop seeing the respondent ( p < .001), guilt (p < .001), threatening to tell lies ( p < . 001), blackmail ( p < . 001), not leaving ( p < . 001), persistent touching ( p < . 001), making false promises ( p < .001), telling lies ( p < . 001), being held down ( p < .001), and using a weapon ( p < .01). Table IV reports all means and univariate F statistics by protected class membership.

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DISCUSSION The purpose of this study was to document the extent to which sexual coercion occurs in India and to explore the relationship of demographic variables to incidence rates. These data suggest that the frequency of sexual coercion occurring within an intimate relationship is much lower than results from American university samples. Past research using American female college students reports rates ranging from 54% (Koss et al., 1987) to 74% (Garrett-Gooding and Senter, 1987; Poppen and Segal, 1988). Twenty-six percent of this sample reported at least one sexual coercion incident. The lack of signiŽ cant gender differences in sexual coercion rates con ict with the Western notion of India as a patriarchal and traditional society where one would expect to Ž nd women at greater risk. Past research in India on rape, dowry, and wife beating, as well as sexual harassment, suggests a strong gender bias against women (Menon and Kanekar, 1992). This is especially true for acquaintance rape, after which women are often held responsible for the rape. As in the United States, conviction rates in India are higher in cases of stranger rape, especially when the woman suffers physical injuries, which implies resistance (Kanekar et al., 1991). Besides traditional attitudes, other factors which might encourage sexual victimization of women are divergent gender roles, which dictate that “men are expected to take the initiative and be aggressive in sexual matters and women are expected to be bashful, coy, and submissive” (Menon and Kanekar, 1992, p. 1941). While traditional attitudes and a strict sexual division of labor are often thought to be a “recipe” for extreme sexual coercion, other work suggests that Indians with traditional ideologies do not necessarily engage in traditional practices (Rayaprol, 1996). In other words, attitudes do not always translate into behavior. What factors, then, might account for the lack of gender differences? First, a small sample size might suggest nonsigniŽ cant statistical Ž ndings when actual effects are present. Only 25 persons of the initial sample of 137 reported any incident of sexual coercion. We believe that the small sample size is the single, most important reason for failing to Ž nd a gender difference. However, there are other potential possibilities and methodological issues that deserve discussion. First, one reason that the lack of a gender difference is surprising is that it infers that women as well as men are perpetrators of sexual coercion. If both male and female victims reported male perpetrators, these Ž ndings would not be so surprising. A reading of the directions given to respondents for the sexual coercion items (see the appendix) reveals that we did not ask respondents to differentiate between same-sex or opposite-sex intimate partners. Therefore, it is possible, though not highly probable, that same-sex partners coerced some respondents. Most American male victims of relationship-based sexual coercion report a female perpetrator (Sorenson et al., 1987; Struckman-Johnson, 1988; Struckman-Johnson and Struckman-Johnson, 1994). Since Indian society is even less tolerant toward homosexuality than their American counterparts, there is no reason to believe that a large proportion of the male victims had a same-sex coercion experience. Second,

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it is important to note that the directions for the sexual coercion items asked respondents about their experiences in an intimate relationship. This wording excludes stranger assaults. A second methodological issue is the nature of the sample. We used an urban, university-afŽ liated sample where differentials between men and women in power-giving resources such as education and literacy may be less of an issue. For example, the literacy differences between the general population of men and women in Gujarat do not exist in a university sample. A gender effect may exist in rural areas that are more isolated from Western in uence. Gujarat, the site of this study, has a higher number than other states of nongovernment organizations (NGOs) involved in initiatives that promote social and economic equality (Pathak, 1996). We recognize the limited utility of our sample and are not trying to generalize to all of India. However, we believe that this initial investigation can serve as a starting point for other studies. While the issue just highlighted suggests fundamental differences between the general and the university populations, another methodological issue that might be raised is English language proŽ ciency. Due to prior British rule, English is the instructional language used in educational settings and several national publications, including newspapers and magazines, are published in English. By the time an individual reaches the university level, he or she has spent years in and out of classrooms developing English reading and writing proŽ ciency. With this sample, there was no need to use a language other than English. Future studies using a nonuniversity sample where English competency cannot be presumed will have difŽ culty translating the items for at least two reasons. First, there is no one native language even in Gujarat State. While many assume that Hindi is the common language in India, not everyone has Hindi proŽ ciency. There are many languages spoken, making English the most universal language for those with education. Second, it will be difŽ cult, if not impossible, to convey the intent of the items with a Hindi translation. Another explanation for the Ž nding of no gender difference is a systematic bias in reporting, where women are underreporting and men are overreporting. However, there is no evidence that this has occurred. In fact, in Western cultures this bias is presumed to be in the opposite direction, with women overreporting and men underreporting. A Ž nal area of speculation is another cultural difference between Americans and Indians. India differs from the United States “because cultural views emphasize social duties rather than individual rights as the starting point of society, and the self is experienced in contextual and relational terms” (Luther and Quinlan, 1993). Milder forms of sexual coercion, then, may be ways of encouraging partners to perform their social duties (sex for procreation, marital stability) and may not be thought of as a violation of individual rights. Even in American society the line between “friendly persuasion” and coercion is a blurry one. The majority of coercion experiences reported by this sample falls on the milder end of the continuum because the tactics used were nonviolent. Both men and women may

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take a role in encouraging their partners to engage in sex, which could account for the lack of a gender difference. Obviously, this social pressure is most acceptable within a marriage. This reasoning Ž ts with the Ž nding that married respondents reported the majority of coercion experienced by this sample. Differences in sexual coercion between singles and marrieds is not surprising since married respondents are in a committed relationship in which sex is a social duty. This increases the possibility of experiencing behaviors that are deŽ ned by American researchers as sexual coercion. In fact, unwanted intercourse that is due to some cultural expectation also occurs in American society. Both Poppen and Segal (1988) and Muehlenhard and Linton (1987) found that men experienced unwanted intercourse at higher rates than women did because of cultural reasons such as sex-role concerns and perceptions of peer pressure. Unlike the Ž ndings reported here, engaging in unwanted sexual behavior because of sex-role concerns or presumed peer pressure does not indicate a coercive partner. An individual’s perceptions of culture may motivate behavior that would preferably be avoided. While unfortunate, this is not sexual coercion. Sexual coercion requires a perpetrator who pressures a victim using tactics that can range in severity from milder forms such as persistent touching to more severe forms such as the use of physical force. While persons living in cultures that emphasize social duty may not view this behavior as negatively as individualistic Americans, the behavior is still sexual coercion. The outcomes for Americans and Indians are the same; both experience sexual coercion. What is potentially different for Americans and Indians is the meaning of sexual coercion that includes any stigmatization. Because of the continued practice of arranged marriages, dating occurs less frequently in India than in the West. In short, single respondents have a low probability of experiencing sexual coercion since there is limited opportunity for opposite-sex interaction outside of marriage. This difference may become less pronounced if Indian culture becomes more Westernized in itsmate selection practices. The overall effect of membership in protected classes is interesting. Because mate selection in India follows an endogamous pattern, we would expect that the partners of protected class members are also members of protected classes. A possible explanation for the higher rates of sexual coercion reported by members of protected classes is that feelings of powerlessness, which may accompany protected class membership, motivate aggression in interpersonal relationships. In other words, aggression and the use of coercion toward a spouse or child are motivated by a need to feel powerful in perhaps the only aspect of life that is controllable. Interpersonal power is used, then, to compensate for a lack of social power. It is also possible that the protected classes, particularly members of tribes, have different views about sexual coercion which contribute to its occurrence. While protected class membership seems to increase the risk of experiencing sexual coercion, the reasons for this difference are only speculative. Obviously, more information is needed. Future research possibilities include examining the rates of sexual coercion speciŽ c to a marital relationship and comparing marriages that were arranged

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to those that were not. Larger sample sizes would also allow testing for gender differences regarding the severity of sexual coercion outcomes. One study using American university students found that women were more likely to report unwanted intercourse than men. When men reported sexual coercion, outcomes (kissing, fondling) were on the milder end of the continuum (Waldner-Haugrud and Magruder, 1995). While it would have been interesting to test for gender differences in the severity of outcomes experienced (kissing, fondling, or intercourse), small cell sizes precluded the use of the chi-square test. Finally, cultural factors speciŽ c to India should be explored to explain further the purpose and meaning of sexual coercion in Indian society. A question that needs to be asked is whether Indians view these behaviors as problematic. In other words, no data exist to ascertain the meaning of sexual coercion for Indian respondents. American social scientists consider sexual coercion problematic because it is a violation of individual rights and choice. Indians tend to stress social duty over individual rights. In fact, appealing to a partner’s sense of social duty may be a type of coercion strategy used with some success in India. While we know that “saying things” is a coercion strategy, it would be interesting to know the variety of themes that are used, whether social duty is one of those themes, and how themes may differ by gender. By using a behavioral checklist, we were able to document that some Indian respondents had unwanted sex (ranging from kissing to intercourse) because of something their partner did or said. While these behaviors may be deŽ ned as unwanted and, hence, coercive, Indians may not feel as violated as their American counterparts, who tend to value and stress individual rights and personal choice. APPENDIX Table AI. Sexual Coercion Inventory Sometimes in a relationship, one partner wants to become more physically or sexually involved than the other. For the following list, indicate whether or not you were pressured by your partner to engage in certain behaviors despite your wish NOT to participate. Only indicate the most extreme outcome, with kissing being less extreme and sexual intercourse being the most extreme. If your partner did not pressure you using the listed technique, circle “did not happen.”

No.

Item

1

My partner encouraged me to drink or use drugs, then took advantage of me.

2

My partner threatened to stop seeing me.

Kissing (1)

Touching breasts (2)

Touching genitals (3)

Vaginal /oral / anal intercourse (4)

Did not happen 0

(Continued )

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Waldner, Vaden-Goad, and Sikka Table AI. (Continued )

Kissing (1)

No.

Item

3

My partner said things to make me feel guilty (It’s your duty).

4

My partner begged me and would not stop until I agreed.

5

My partner threatened to tell lies about me.

6

My partners threatened to tell private things about me.

7

My partner would not let me leave although I wanted to go.

8

My partner tried to interest me by touching but I was uninterested.

9

My partner made false promises (We’ll get married).

10

My partner said things that later proved to be untrue (I love you).

11

My partner physically held me down.

12

My partner threatened to use or did use a weapon.

13

My partner threatened to use physical force (for example, slapping, hitting).

14

My partner did use physical force.

Touching breasts (2)

Touching genitals (3)

Vaginal /oral / anal intercourse (4)

Did not happen 0

ACKNOWLEDGMENTS This Research was supported by a grant to Linda Vaden-Goad, Anjoo Sikka, and Lisa Waldner from the University of Houston–Downtown, College of Humanities and Social Sciences. William Murff, Judith Hudgens, and Christopher Benites helped with coding and data entry. Joy Wolenski provided valuable comments on early drafts. The authors also thank C. N. Daftuar, Mario Xavier, and Sangeeta Menon at M.S. University, Baroda, India. An earlier version of this paper was presented at the 1996 National Council of Family Relations Annual Meeting, Kansas City, MO.

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REFERENCES Beck, A. T., and Steer, R. (1987). The Beck Depression Inventory , The Psychological Corporation, San Antonio, TX. Brand, P., and Kidd, A. H. (1986). Frequency of physical aggression in heterosexual and homosexual dyads. Psychol. Rep. 59: 1307–1313. Christopher, F. S. (1988). An initial investigation into a continuum of premarital sexual pressure. J. Sex Res. 25: 255–266. Christopher, F. S., and Frandsen, M. M. (1990). Strategies of in uence in sex and dating. J. Soc. Interpers. Relation. 7: 89–106. Duncan, D. (1990). Prevalence of sexual assault victimization among heterosexual and gay/lesbian university students. Psychol. Rep. 66: 65–66. Garrett-Gooding, J., and Senter, R. (1987). Attitudes and acts of sexual aggression on a university campus. Sociol. Inquiry 57: 348–371. Hurst, C. E. (1992). Social Inequality, Allyn and Bacon, Boston, MA. Jack, D. C. (1991). Silencing the Self: Women and Depression , Harvard University Press, Cambridge, MA. Kanekar, S., Shaherwalla, A., Franco, B., Kunju, T., and Pinto, A. J. (1991). The acquaintance predicament of a rape victim. J. Appl. Soc. Psychol. 21: 1524–1544. Koss, M. P., and Dinero, T. E. (1989). Discriminant analysis of risk factors for sexual victimization among a national sample of college women. J. Consult. Clin. Psychol. 57: 242–250. Koss, M. P., Gidycz, C. A., and Wisniewski, N. (1987). The scope of rape: Incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. J. Consult. Clin. Psychol. 55: 162–170. Locke, H. J., and Wallace, K. M. (1959). Short marital-adjustment and prediction tests: Their reliability and validity. Marriage Family Living 251–255. Luther, S. S., and Quinlan, D. M. (1993). Parental image in two cultures: A study of women in India and America. J. Cross-Cult. Psychol. 24: 186–202. McKinney, K. (1986). Perceptions of courtship violence: Gender difference and involvement. Free Inquiry Creat. Sociol. 14: 61–66. Menon, S. A., and Kanekar, S. (1992). Attitudes towards sexual harassment in India. J. Appl. Soc. Psychol. 22: 1940–1952. Muehlenhard, C. L., and Cook, W. S. (1988). Men’s self-reports of unwanted sexual activity. J. Sex Res. 24: 58–72. Mukherjee, M. (1996). Toward gender-aware data systems. Econ. Polit. Week. Oct. 26: 63–71. Muehlenhard, C. L., and Linton, M. A. (1987). Date rape and sexual aggression in dating situations: Incidence and risk factors. J. Counsel. Psychol. 34: 186–196. Nanda, S. (1992). Arranging a marriage in India. In Devita, P. R. (ed.), The Naked Anthropologist: Tales from Around the World, Wadsworth, Belmont, CA, pp. 137–143. Nathawat, S. S., and Mathur, A. (1992). Marital adjustment and subjective well-being in Indianeducated housewives and working women. J. Psychol. 127: 353–358. National Crime Records Bureau (1995). Crime in India, Author & Ministry of Home Affairs, India. Pathak, I. (1996). Violence against women and women’s human rights, Unpublished manuscript. Poppen, P. J., and Segal, N. J. (1988). The in uence of sex and sex-role orientation on sexual coercion. Sex Roles 19: 689–701. Rayaprol, A. (1996). Gender ideologies and practices among South Indian immigrants in Pittsburgh. Http://wwwhost.cc.utexas.parna.rayaprol.art.html. Rosenberg, M. (1965). Society and the Adolescent Self-Image, Princeton University Press, Princeton, NJ. Sharma, S. S. (1994). Untouchables and Brahmins in an Indian Village. In Curtis J., and Tepperman, L. (eds.), Have and the Have-Nots: An International Reader on Social Inequality (eds.), PrenticeHall, Englewood Cliffs, NJ. Smith, R. E., Pine, C. S., and Hawley, M. E. (1988). Social cognitions about male victims of female sexual assault. J. Sex Res. 24: 101–112. Sorenson, S. B., Stein, J. A., Siegal, J. M., Golding, J. M., and Burman, M. A. (1987). The prevalence of adult sexual assault: The Los Angeles epidemiological catchment area project. Am. J. Epidemiol. 126: 1154–1164.

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Struckman-Johnson, C. (1988). Forced Sex on dates: It happens to men, too. J. Sex Res. 24: 234–240. Struckman-Johnson, C., and Struckman-Johnson, D. (1994). Men pressured and forced into sexual experience. Arch. Sex. Behav. 23: 93–114. Tang, C. S., Critelli, J. W., and Porter, J. F. (1995). Sexual aggression and victimization in dating relationships among Chinese college students. Arch. Sex. Behav. 24: 47–53. Waldner-Haugrud, L. K., and Gratch, L.V. (1997). Sexual coercion in gay and lesbian relationships: Descriptives and gender differences. Violence Vict. 12: 87–98. Waldner-Haugrud, L. K., and Magruder, B. (1995). Male and female sexual victimization in dating relationships: Gender differences in coercion techniques and outcomes. Violence Victims 10: 203– 215. Waterman, C. K., Dawson, L. J., and Bologna, M. J. (1989). Sexual coercion in gay male and lesbian relationships: Predictors and implications for support services. J. Sex Res. 26: 118–124.

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Allocation of Attentional Resources During Habituation and Dishabituation of Male Sexual Arousal Eric Koukounas, Ph.D.,1, 3 and Ray Over, Ph.D.2

A secondary-task probe (tone) was presented intermittently while men viewed erotic Ž lm segments across a session involving 18 trials with the same Ž lm segment (habituation), then 2 trials with different Ž lm segments (novelty) and 2 trials with reinstatement of the original segment (dishabituation). Reaction time to the tone (an index of the extent processing resources were being committed to the erotic stimulus) shifted during the session in parallel with changes that occurred in penile tumescence and subjective sexual arousal. The decrease in sexual arousal over the Ž rst 18 trials in the session was accompanied by a progressively faster reaction to the tone, novel stimulation led to recovery of sexual arousal and a slower reaction to the tone, and on trials 21 and 22 sexual arousal and reaction time levels were above the values that prevailed immediately prior to novel stimulation. Results are discussed with reference to the relationship between habituation and attention. KEY WORDS: attentional resources; male sexual arousal; habituation; dishabituation.

INTRODUCTION Habituation is deŽ ned operationally as a reduction in arousal level over the course of repeated stimulation, provided the decrement does not simply re ect sensory adaptation or effector fatigue. Psychophysiological studies have yielded con icting evidence on habituation of sexual arousal. O’Donohue and Geer (1985) measured penile tumescence and subjective sexual arousal when either the same slide was shown repeatedly (constant stimulus) or different slides were presented 1 School

of Psychology, Deakin University, Burwood Road, Burwood, Victoria, Australia 3125. of Behavioural and Social Sciences and Humanities, University of Ballarat, Ballarat, Victoria, Australia 3350. 3 To whom correspondence should be addressed. 2 School

539 0004-0002/99/1200-0539$16.00/0 ° C 1999 Plenum Publishing Corporation

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across trials (varied stimuli). Both physiological and subjective arousal decreased over trials, although decline was slower for varied stimulation than with the constant stimulus. O’Donohue and Plaid (1991), using spoken-text erotic stimuli, found habituation of male sexual arousal with repeated presentation of the same stimulus, but arousal levels remained unchanged when the erotic stimulus varied from trial to trial. Habituation of physiological and subjective sexual arousal has also been demonstrated when women (Meuwissen and Over, 1990) and men (Koukounas and Over, 1993) either repeatedly view the same erotic Ž lm segment or engage trial by trial in the same erotic fantasy. Both studies found that subsequently introducing novel erotic stimulation reversed the decrement in sexual arousal that had occurred during stimulus repetition. Dishabituation also occurred, since reinstating the familiar stimulus yielded higher levels of physiological and subjective arousal than applied immediately prior to novel stimulation (Koukounas and Over, 1993). In contrast, two studies provided no evidence of habituation of sexual arousal. Smith and Over (1987) found that both penile tumescence and subjective sexual arousal remained unchanged when men either engaged repeatedly in the same sexual fantasy across trialsor employed a different fantasy theme on each trial. Laan and Everaerd (1995), in experiments assessing female sexual arousal with slides or Ž lm as the erotic stimulus, reported stability in physiological and subjective sexual arousal levels irrespective of whether stimulation was constant or varied across trials. The six studies described above differ in many respects. Some assessed men and others women, in some cases constant stimulation over trials was contrasted with varied stimulation, the number of stimulus presentations within the experimental session differed, and several modes of erotic stimulation (Ž lm, slides, spoken text, fantasy) were employed. However, discrepancy in outcome between the studies may re ect not so much these variables as whether processes or states that mediate sexual arousal varied over trials within the session. Relying on evidence that sexual arousal during fantasy is correlated with vividness of imagery, Smith and Over (1987) suggested that sexual arousal will decrease with repeated experience of fantasy employing the same sexual theme only if the subject forms progressively less vivid images during fantasy. Trial-by-trial measures of imagery vividness were taken in order to test this possibility. The instructions to subjects emphasized that the same theme was to be employed during fantasy on each trial. Vividness of imagery covaried with sexual arousal in the sense that neither measure changed signiŽ cantly over repeated trials. Instead of fantasy becoming less vivid and less arousing over trials, fantasy continued to be imaged vividly and continued to be sexually arousing. In contrast, the two studies (Meuwissen and Over, 1990; Koukounas and Over, 1993) reporting changes in fantasy-induced sexual arousal over trials found that habituation was accompanied by a decrease over trials in vividness of imagery during fantasy. In addition, recovery in sexual arousal when

Attentional Resources During Male Sexual Arousal

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the familiar fantasy theme was replaced by a novel fantasy theme was accompanied by an increase in vividness of imagery, and the dishabituation of sexual arousal evident when the familiar theme was reinstated was associated with a higher level of vividness of imagery than had applied immediately prior to novel stimulation. Koukounas and Over (1993) identiŽ ed absorption as a further state or process that might change in association with sexual arousal over the course of repeated erotic stimulation. They measured absorption by requiring the subject to rate at the end of each trial the extent to which he had had experienced being a participant (identifying with the feelings expressed by the actors) rather than a spectator (simply an onlooker) when viewing the Ž lm. There was a shift in absorption (from participant orientation to spectator orientation) over a session in which subjects either viewed the same erotic Ž lm segment on each trial or engaged repeatedly in fantasy employing the same erotic theme. Novel stimulation produced recovery in absorption as well as sexual arousal and dishabituation in sexual arousal was accompanied by a higher absorption level than had applied immediately prior to novel stimulation. In interpreting the above results it needs to be recognized that absorption as assessed by Koukounas and Over (1993) may simply have been a proxy measure of sexual arousal. The subjects might have rated absorption primarily with reference to how sexually aroused they felt or in terms of the degree of penile tumescence the erotic stimulus had induced. In such circumstances it would not be surprising that absorption shifted over trials in conjunction with sexual arousal and that partialing out trial effects associated with absorption through analysis of covariance yielded less evident habituation of sexual arousal. Absorption needs to be assessed by means other than self-report in order to overcome the problem of response contamination. The method used for this purpose in the present study is reaction time to a secondary-task stimulus under conditions of divided attention. Measuring attentional commitment to a primary stimulus through performance on a secondary task relies on the assumption that humans have limited capacity to process information. Although two tasks can be performed concurrently without interference when their combined demands are within attentional resource limits, the tasks are processed in accordance with the level of priority when this limit is exceeded (see Posner and Boies, 1971). Responding on the task of secondary importance suffers to the extent attention is committed to the primary task. The secondary-task reaction time technique identiŽ es allocation of attentional resources by measuring reaction time to a probe (such as a tone or light pulse) presented intermittently while the subject is engaged on the primary task (see Dawson, 1990). Several investigators have used this methodology to assess commitment of attention under conditions where repeated stimulation produces habituation within the primary response system. Dawson et al. (1989, 1991) found that habituation of skin conductance across 48 trials involving the presentation of a 1000-Hz tone

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(the primary task) was accompanied by reduced reaction times to intermittently presented light  ashes (the secondary task). Subsequent presentation of a novel primary stimulation (an 800-Hz tone) not only increased the orienting response, but slowed the reaction time to the  ash. In similar research Siddle and Spinks (1991) and Siddle and Jordan (1993) found that a decrease in skin conductance across 24 presentations of a tone or a vibratory stimulus (primary task) was accompanied by more rapid responding to a probe (light  ash) presented intermittently during primary task trials. Novel primary stimulation increased the orienting response and slowed the reaction time to the probe. These Ž ndings are consistent with the claim that subjects cumulatively commit less attention to the primary stimulus over the course of habituation and, thereby, are able to commit more resources to processing the secondary stimulus. The further indication is that attention is shifted back to the primary task when the familiar stimulus is replaced by a novel stimulus. The men tested in the present study viewed the same erotic Ž lm segment in the Ž rst 18 trials in the session. The expectation from Koukounas and Over (1993) is that there will be a decrease over trials not only in sexual arousal (measured in terms of penile tumescence as well as subjective sexual arousal), but in how absorbed the men felt while watching the Ž lm. In addition to viewing the Ž lm (primary task), each subject was required to respond as rapidly as possible (by pressing a microswitch) to a tone (secondary stimulus) presented intermittently while the Ž lm was being shown. If habituation entails reduced commitment to attention to the primary stimulus, the expectation is that, along with becoming less sexually aroused over the course of repeated erotic stimulation and feeling less absorbed, the subjects will progressively respond more rapidly to the secondarytask probe. Novel erotic stimulation on trials 19 and 20 should lengthen the reaction time to the tone, in addition to increasing sexual arousal and level of absorption. Reinstatement of the original Ž lm segment (trials 21 and 22) should yield not only dishabituation of sexual arousal but higher absorption levels and slower responses to the probe than were the case just prior to novel stimulation. METHOD Subjects Sixteen men were recruited for testing through advertisements in a campus newsletter. In order to participate in the study, men responding to the advertisement had to be aged 18–30 years, to be heterosexual without a history of sexual dysfunction or sexually transmitted disease, and not to have used medication within the preceding 3 months that might affect capacity for penile erection. The mean age within the sample was 21.9 years (SD, 4.0 years). As indicated by scores on a modiŽ ed form of the Sexual Behavior Inventory—Male (Bentler, 1968), the

Attentional Resources During Male Sexual Arousal

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participants were sexually experienced. All but 2 men reported having at some time engaged in sexual intercourse, and 10 of the 16 men currently had a regular sexual partner. Participation was by informed consent obtained after respondents to the advertisement who met selection criteria had viewed the laboratory and were acquainted with testing procedures. Although each man was paid $20 on completion of the laboratory session, the contract allowed him to terminate involvement in the experiment at any time. Procedure Each man participated in a single laboratory session during which the same erotic Ž lm segment was presented 18 times (habituation trials), novel erotic Ž lm segments were shown on trials 19 and 20 (novelty trials), and the original stimulus was reinstated on trials 21 and 22 (dishabituation trials). Testing was conducted in a dimly lit, sound-attenuated room which contained a television monitor for Ž lm presentation, a screen on which slides could be projected, and an intercom system. Communication between the subject and the experimenter, who was monitoring equipment in an adjacent room, was through the intercom system. Visual contact was not possible. The subject remained seated semisupine in a soft recliner chair throughout the test session. Penile tumescence was measured using a Parks Electronics mercury-in-rubber strain gauge modiŽ ed from the design of Bancroft et al. (1966) in the manner described by Julian and Over (1984). Changes in resistance of the gauge resulting from variation in penile circumference were ampliŽ ed by a Grass preampliŽ er (Model 7P1) and recorded on a Grass polygraph (Model 7). Paper speed was 5 mm/sec for all records. The strain gauge was sterilized in activated gluteraldehyde (Cidex 7) before and after each use. Calibration permitting each subject’s responses to be expressed as millimeters of penile circumference was undertaken by stretching the strain gauge along a standard millimeter rule in regular intervals and measuring the amount of de ection on the polygraph tracing resulting from the stretching (see Julien and Over, 1984). At the beginning of the session, the subject Ž tted the strain gauge around the shaft of his penis, in private, in accord with a demonstration earlier provided using a clay model. The subject was then told to achieve comfortable seating and to relax without engaging in erotic thoughts. When he had settled, guided relaxation was provided for 3 min, followed by baseline measures of penile circumference taken during a classical music excerpt lasting 2 min. The Ž lm segments, each in color and presented without sound, were those employed by Koukounas and Over (1993). The segment used as the habituation stimulus (on trials 1–18) depicted heterosexual intercourse with rear entry. One novel stimulus (presented on trial 19) showed intercourse with the woman in the superior position and the other novel stimulus (presented on trial 20) depicted

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intercourse with the man in the superior position. The actors were different in the three segments. Each Ž lm segment lasted 60 sec, and there was an interstimulus interval of 90 sec. These values have been used in previous research. Although penile circumference did not in all cases return fully to baseline levels during the interstimulus interval, it should be noted that partial rather than complete detumescence between trials (and hence carryover of arousal) would serve to reduce, rather than be responsible for, habituation effects. Instructions given prior to the session emphasized that, during display of the Ž lm segments, the subject was to absorb himself in the depicted situation as though he was the man in the Ž lm engaging in and experiencing through all his senses the sexual acts shown in the Ž lm. Although he could employ fantasy related to the presented sexual theme in order to achieve the experience of being a participant in the depicted activities, the subject was not to engage in sexual fantasy during the interstimulus interval. Penile circumference was recorded continuously during erotic stimulation. Within each interstimulus interval the subject provided, Ž rst, a rating of the extent to which he had felt sexually aroused during the preceding Ž lm segment and, then, a rating of the degree to which he had been absorbed in the events depicted in the Ž lm. Arousal was rated on a 9-point scale ranging from “not sexually aroused” to “wildly sexually aroused,” and absorption on a 9-point scale covering the range from “not absorbed” to “fully absorbed.” Absorption was deŽ ned as the extent to which the subject had experienced himself as a participant in the sexual activity shown in the Ž lm segment. The reaction time task required the subject to press a hand-held microswitch as soon as he heard a tone through the earphones. Thirty practice trials (with the tone presented without concurrent erotic stimulation) were given at the start of the session in order to familiarize the subject with test procedures and to provide sufŽ cient practice for reaction time to reach an asymptotic level prior to the trials where the tone was presented concurrently with the erotic Ž lm segment. The tone was of 70 dB, 1000-Hz frequency, and 500-msec duration. Mean reaction time for the 16 subjects across the last 15 practice trial was 226.0 msec (SD, 21.1 msec) compared with 487.4 msec (SD, 298.0 msec) on the Ž rst 15 practice trials [t(15) = 8.25, p < . 01]. Since reaction time was to remain the secondary task and to serve simply as an index of the attentional resources committed to erotic stimulation, it was important that the tone be presented not only intermittently but on a schedule that could not be predicted by the subject. For this reason the tone was presented during only 12 of the 22 Ž lm segments within the session (9 of the 18 habituation trials, the Ž rst of the two segments involving novel stimulation, and both dishabituation trials). Onset was 10, 30, or 50 sec from the start of the Ž lm segment. For all subjects the 12 probes were scheduled on trials 1 (onset, 10 sec), 2 (30 sec), 4 (50 sec), 8 (10 sec), 10 (30 sec), 12 (50 sec), 15 (10 sec), 17 (30 sec), 18 (50 sec), 19 (10 sec), 21 (30 sec), and 22 (50 sec). The instructions given to each subject at the start of

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the test session emphasized that, although he was to respond to presentation of the tone as rapidly as possible, his primary task was to watch the erotic Ž lm, absorbing himself in the depicted situation as though he was the man in the Ž lm engaging in and experiencing through all his senses the sexual acts shown in the Ž lm. The subjects were told on recruitment that the study was being undertaken to assess sexual arousal but not that the Ž rst 18 trials involved the same stimulus, with novel stimuli presented on the 19th and 20th trials and the original stimulus reinstated on trials 21 and 22. The general instructions emphasized that as movement would produce artifacts in the polygraph recordings, it was important to remain as still as possible during the session. In particular, the subject was not to tense abdominal or pelvic muscles or to touch his penis. At the end of the session (prior to debrieŽ ng) he rated on a 9-point scale (ranging from “not at all” to “completely”) the extent to which he had complied with experimental instructions. As evidenced by responses of 8 or 9 on the 9-point scale, all 16 subjects reported compliance. Data Reduction Physiological sexual arousal was indexed by the difference between the levels of penile circumference recorded during erotic stimulation and during the baseline condition. Average response level (the mean of the values at every 20th sec across a 60-sec trial) and maximum response level (the largest value within a trial) were established for each segment. These measures correlated .92. Since the primary interest is in the extent to which the subjects had become aroused, data analysis is based on maximum response levels. Correlation Between Dependent Variables Correlations were calculated for pairs of measures across trials in the habituation series. Each value identiŽ es the extent to which changes on one measure over the 18 habituation trials was associated with changes in another measure over the same set of trials. There was a correlation of .91 between physiological arousal and subjective arousal, .94 between physiological arousal and absorption, .77 between physiological arousal and reaction time, .93 between subjective arousal and absorption, .84 between subjective arousal reaction time, and .83 between absorption and reaction time. RESULTS The session yielded 22 measures of physiological sexual arousal, 22 ratings of subjective sexual arousal, 22 ratings of absorption, and 12 reaction times for each subject. Values on each measure were converted to standard scores for each subject for ease of comparison between response measures. Figure 1 reports mean levels

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Fig. 1. Mean standard scores per trial for penile circumference, subjective sexual arousal, rated absorption, and reaction time on trials 1–18 (habituation stimulus), trials 19–20 (novel stimuli), and trials 21 and 22 (reintroduction of the habituation stimulus). Absolute levels of response on trials 1–3 for each measure are reported in the text.

of physiological sexual arousal, subjective sexual arousal, absorption, and reaction time (in each case, mean standard score per trial) during repeated stimulation (trials 1–18, in successive blocks of three trials), novel stimulation (trials 19 and 20), and reinstatement of the initial Ž lm segment (trials 21 and 22). As an index of absolute levels, mean values per trial on trials 1–3 were 26.35 (SD, 12.80) for the increase in penile tumescence relative to baseline, 5.75 (SD, 1.69) for subjective sexual arousal, 5.88 (SD, 1.70) for rated absorption, and 776.6 sec (SD, 176.1 sec) for reaction time to the tone. Habituation effects were assessed by determining the extent to which response levels changed over the Ž rst 18 trials of the session (considered as successive blocks of three trials). One-way multivariate analysis of variance was undertaken for this purpose, with physiological arousal, subjective arousal, absorption, and reaction time as the dependent variables. Response levels differed signiŽ cantly across trials [mult. F(20,240) = 13.41, p < .001 ]. Univariate tests showed that repetition of the erotic Ž lm segment led to reductions in physiological arousal [ F(5,75) = 89.37, p < . 001 ], subjective arousal [F (5,75) = 79.31, p < .001], absorption

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[ F(5,75) = 61.90, p < .001 ], and reaction time [F(5,75) = 65.49, p < . 001 ].

Habituation of sexual arousal thus was accompanied by faster responding over trials to the secondary-task probe as well as by decreased absorption. The effects of introducing novel erotic stimulation were identiŽ ed by comparing mean response levels per trial between trials 19 and 20 and trials 16–18. There was overall a signiŽ cant novelty effect [mult. F(4,12) = 152.01, p < . 001 ]. Univariate tests showed that novel stimulation increased physiological arousal [ F(1,15) = 277.21, p < . 001 ], subjective arousal [F(1,15) = 452.78, p < . 001 ], and absorption [ F(1,15) = 425.85, p < . 001 ], and slowed reaction to the tone [ F(1,15) = 65.49, p < . 001 ]. Since mean response levels per trial did not differ signiŽ cantly between trials 19 and 20 and trials 1–3 [mult. F(4,12) = 0.17, p > . 05], novel stimulation restored responses to levels found at the start of the session. Dishabituation requires that response levels on trials 21 and 22 (when the original Ž lm segment is reinstated) differ signiŽ cantly from levels that prevailed immediately prior to novel stimulation (trials 16–18). Mean values differed signiŽ cantly between these two blocks of trials [mult. F(4,12) = 42.41, p < . 001 ]. Univariate tests showed greater physiological arousal [ F (1,15) = 62.58, p < .001], greater subjective arousal [ F(1,15) = 90.00, p < .001 ], and higher absorption [F(1,15) = 139.91, p < . 001 ] on trials 21 and 22 than trials 16–18, while reaction times were slower on trials 21 and 22 than on trials 16–18 [ F(1,15) = 130.04, p < .001]. Analysis of covariance was employed to establish whether habituation, novelty, and dishabituation effects for sexual arousal still remain when allowance is made for trials-related shifts in absorption and/or reaction time. Partialing out the contribution from absorption removed the novelty effect for physiological arousal [ F(1,14) = 0.09, p > .05] and subjective arousal [F (1,14) = 3.09, p > . 05], as well as dishabituation of physiological arousal [ F(1,14) = 1.83, p > .05], and subjective arousal [ F(1,14) = 1.37, p > .05]. However, habituation of physiological arousal [ F(5,74) = 6.63, p < .001] and subjective arousal [ F(5,74) = 4.21, p < .01] was still found. Partialing out effects associated with changes in reaction time over trials similarly led to the disappearance of novelty effects [ F(1,14) = 0.14, p > . 05, for physiological arousal and F(1,14) = 3.83, p > . 05, for subjective arousal ] and dishabituation [ F(1,14) = 4.42, p > .05, for physiological arousal and F(1,14) = 3.16, p > . 05, for subjective arousal ], but habituation was still evident for physiological arousal [ F(5,74) = 14.89, p < . 001 ] and subjective arousal [ F(5,74) = 11.85, p < . 001 ]. The outcomes with absorption and reaction time both included in the analysis as covariates were similar to those obtained with absorption as the sole covariate. Changes in response over trials are perhaps most appropriately indexed not by whether there was a signiŽ cant shift in mean response level over trials but by reference to the proportion of variance in response associated with trials as a variable. Table I reports the magnitude of effect size measures (eta values), expressing the extent to which the four response measures (physiological arousal, subjective arousal, absorption, reaction time) varied across nominated blocks of

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Koukounas and Over Table I. Effect Sizes (Eta Values) Showing the Extent to Which Physiological Arousal, Subjective Sexual Arousal, Absorption, and Reaction Time Varied Across Nominated Blocks of Trials With and Without Allowance for Trial-Related Changes in Absorption and Reaction Time Habituation

Novelty

Dishabituation

Uncorrected Physiological arousal Subjective arousal Absorption Reaction time

.86 .84 .81 .81

.95 .97 .97 .97

.81 .86 .90 .90

Adjusted for absorption Physiological arousal Subjective arousal

.31 .22

.01 .18

.12 .09

Adjusted for reaction time Physiological arousal Subjective arousal

.51 .44

.01 .22

.24 .18

Adjusted for absorption and reaction time Physiological arousal Subjective arousal

.32 .23

.02 .16

.12 .05

trials. It can be seen that allowing for trial-related changes in absorption as a covariate reduced substantially the extent of association between sexual arousal level and trials, whereas partialing out reaction time had lesser in uence on the extent sexual arousal shifted over trials. The reduction in effect size (variance in sexual arousal associated with trials) when absorption and reaction time were both employed as covariates was similar to the pattern found when absorption alone was partialed out. DISCUSSION Changes in sexual arousal across the session were paralleled by changes in reaction time to the secondary-task probe (tone) as well as by shifts in the extent the subject felt absorbed during erotic stimulation. As well as being progressively less sexually aroused and less absorbed during repeated stimulation, the men responded increasingly more rapidly to the tone. Novel stimulation produced increased sexual arousal, greater absorption, and slower responding to the secondary-task probe. The dishabituation of sexual arousal found upon reinstatement of the original was accompanied by higher absorption levels and slower reaction times than had prevailed immediately prior to novel stimulation. The distinctive feature of the data is that reaction time to the secondary-task probe shifted over trials in conjunction with the changes that occurred in penile tumescence, subjective sexual arousal, and absorption. Whereas the basis of the association between the sexual arousal measures and the ratings of absorption can be questioned in terms of response contamination, it cannot be argued that reaction

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time to the secondary-task probe is directly a proxy measure of sexual arousal. The more plausible explanation is that the time a subject took to respond to the tone re ects the attentional resources he was committing to the concurrently presented erotic Ž lm segment. Studies where attentional demands have been deliberately manipulated (e.g., Geer and Fuhr, 1976; Farkas et al., 1979) have shown that sexual arousal is reduced when subjects are required to perform an attention-demanding activity such as mental arithmetic during presentation of erotic stimulation. The greater the attentional requirements of the competing task (and hence the less the commitment of attention to the erotic stimulus), the more sexual arousal is reduced. The present results suggest that habituation of sexual arousal is accompanied by progressively reduced attention over trials to the erotic stimulus, novel stimulation leads to restored attention, and the original stimulus when reinstated receives more attention than had been the case immediately prior to novel stimulation. While it is tempting to suppose that sexual arousal habituates as a consequence of subjects becoming less absorbed by and attentive to erotic stimulation over trials, the relationship between attentional processes and sexual arousal demonstrated in the present study is correlational and not causal. Instead of sexual arousal decreasing in response to a change in attention, subjects may have committed less attention to the erotic stimulus over trials as a consequence of becoming progressively less sexually aroused. A further possibility is that attentional focus and sexual arousal covary over trials without being necessarily causally related. The issue of causation can be addressed by establishing the effects that manipulation of one process (attention or sexual arousal) has on the other process. A critical test of the proposition that arousal habituates as a consequence of a shift in absorption /attention over trials is whether arousal remains stable over trials when subjects are required to maintain constant absorption /attention throughout the session. Although relevant data for sexual arousal are not available, habituation effects for pain perception conform with this expectation. Arntz et al. (1991) showed that subjective pain induced by electric shock did not decrease across 20 trials when subjects were instructed to concentrate on each trial on the pain stimulation and Ž nd descriptors of the local sensations evoked by the stimulus. In contrast, subjective pain habituated when the subjects were told to concentrate on watching a video shown during the session rather than attend to the pain stimulus. The present study, in common with O’Donohue and Geer (1985), Meuwissen and Over (1990), O’Donohue and Plaud (1991), and Koukounas and Over (1993), demonstrated habituation of sexual arousal. However, Smith and Over (1987) and Laan and Everaerd (1995) found that sexual arousal remained unchanged during repeated erotic stimulation. Five of the seven studies monitored processes or states additional to sexual arousal on a trial-by-trial basis, and it is by reference to these data that the discrepant outcomes regarding habituation can be understood. Both Meuwissen and Over (1990) and Koukounas and Over (1993) reported that habituation of fantasy-induced sexual arousal was accompanied by decreased vividness of sexual imagery over trials, Koukounas and Over (1993) found that

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absorption declined over trials in parallel with sexual arousal, and in the present study habituation of sexual arousal was associated with progressive reduction in absorption and attentional commitment to the erotic stimulus. In contrast, vividness of imagery remained stable over trials in the two experiments in which Smith and Over (1987) failed to obtain habituation of fantasy-induced sexual arousal. Laan and Everaerd (1995) attributed the stability of response over trials in the Ž rst of the two studies they conducted to the low level of sexual arousal induced initially by the slides used as erotic stimuli. A basic methodological requirement in testing for habituation is that the stimulus which is to be presented repeatedly must initially be above the baseline or  oor arousal level (see Over and Koukounas, 1995). Although the second study used an initially arousing stimulus, sexual arousal may have remained stable over trials through use of an attention-monitoring procedure (pressing a button when a dot appeared on the screen) that required subjects to focus on the erotic stimulus throughout the session. Facial muscle response levels (corrugator and zygomatic activity), an index of the affective valency of the erotic stimulus (see Lang et al., 1993), also remained stable ( p > .01) over trials. Although habituation is generally conceptualized as a decline in response in the face of a constant recurring stimulus, the stimulus as processed and experienced by the subject may not remain unchanged over trials. An alternative approach is to treat habituation as an adjustment in level of response to accommodate to changes in information processing and other states over trials (see Over and Koukounas, 1995). Arousal level should thus vary over trials only if relevant processes or states also change. The objective in research undertaken within this perspective is not simply to address the outcome question of whether a speciŽ c response system demonstrates habituation, but to seek to relate arousal levels over trials to process or state measures taken on a trial-by-trial basis. Reference has so far been made to vividness of imagery (in the case of fantasy-induced sexual arousal), absorption, and allocation of attentional resources. Meuwissen and Over (1990), in noting the inverted U-shaped relationship between anxiety and level of sexual arousal (see Barlow, 1986), identiŽ ed anxiety as a state that might change during repeated erotic stimulation. They suggested that state anxiety might be elevated (and result in greater sexual arousal) early in the test session, with the subject subsequently becoming less anxious and, thereby, less sexually aroused. A further possibility is that the demand characteristics implicit in assessment of sexual arousal within the laboratory result in a person being more motivated to enhance arousal at the beginning than at the end of an experimental session involving repeated exposure to the same stimulus. Most men and women can voluntarily enhance sexual arousal when requested to do so (see Dekker and Everaerd, 1989), and perhaps implicit demands change during repeated stimulation. Individual differences in rate of habituation have traditionally been studied in the context of trait measures of personality such as introversion–extraversion (see O’Gorman, 1977) rather than with reference to processes or states assessed concurrently with arousal. Reference to trial-by-trial variation in states such as

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attentional commitment offers a perspective for understanding the nature of and basis for individual differences in habituation. The expectation is that subjects who maintain high attentional commitment (absorption) during stimulus repetition will demonstrate substantially less habituation than subjects who commit progressively less attention over trials to the primary stimulus. Whether habituation rate will correlate with traits will re ect the extent the trait measures are predictive of states that apply in the test situation. Drummond et al. (1978) found differences between subjects with high and low scores on the Betts Questionnaire Upon Mental Imagery in rate of habituation to skin conductance to a tone associated with imagining an electric shock, possibly because a person with a high Betts score forms vivid imagery in all contexts where imagery is involved. In the present study habituation of sexual arousal correlated with changes over trial in absorption measured as a state, but this result does not necessarily imply that habituation of sexual arousal will be associated with trait measures such as the Tellegen Absorption Scale (Tellegen and Atkinson, 1974). Study of relationships between attention and habituation has implications for explanations of why habituation occurs. Whereas some models of habituation make no reference to information processing demands, others relate changes in arousal level during repeated stimulation and on subsequent introduction of a novel stimulus to shifts in attention (see Siddle and Jordan, 1993). For example, although not explicitly claiming that arousal habituates as a consequence of decreased attention to the repeated stimulus, Ohman (1979) referred to the attentional requirements that arise when a stimulus is processed without a matching representation being available in short-term memory. Attentional demands thus are high at the start of the habituation series and, again, when novel stimulation is presented. However, a critical issue for explanation is not simply whether arousal and attention are correlated but whether arousal declines over trials as a direct consequence of reduced attention to the repeated stimulus. Testing a model framed in these terms requires the use of a research design that permits inferences to be drawn about causation. REFERENCES Arntz, A., Dreesen, L., and Merckelbach, H. (1991). Attention, not anxiety, in uences pain. Behav. Res. Ther. 29: 41–50. Bancroft, J. H., Jones, H. C., and Pullan, B. R. (1966). A single transducer for measuring penile erection with comments on its use in the treatment of sexual disorders. Behav. Res. Ther. 4: 239–241. Barlow, D. H. (1986). The causes of sexual dysfunction: The role of anxiety and cognitive interference. J. Consult. Clin. Psychol . 54: 140–148. Bentler, P. M. (1968). Heterosexual behavior assessment—1. Males. Behav. Res. Ther. 6: 21–25. Dawson, M. R. (1990). Psychophysiology at the interface of clinical science, cognitive science, and neuroscience. Psychophysiology 27: 243–255. Dawson, M. R., Filion, D. L., and Schell, A. M. (1989). Is elicitation of the autonomic orienting response associated with allocation of processing resources? Psychophysiology 26: 560–572. Dawson, M. R., Schell, A. M., and Hazlett, E. A. (1991). The relationship between skin conductance orienting and the allocation of processing resources. Psychophysiology 28: 410–424.

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Dekker, J., and Everaerd, W. (1989). Psychological determinants of sexual arousal: A review. Behav. Res. Ther. 27: 353–364. Drummond, F., White, K., and Ashton, R. (1978). Imagery vividness affects habituation rate. Psychophysiology 15: 193–195. Farkas, G. M., Sine, L. F., and Evans, I. M. (1979). The effects of distraction, performance demand, stimulus explicitness, and personality on objective and subjective measures of male sexual arousal. Behav. Res. Ther. 17: 25–32. Geer, J. H., and Fuhr, R. (1976). Cognitive factors in sexual arousal: The role of distraction. J. Consult. Clin. Psychol. 44: 238–243. Julien, E., and Over, R. (1984). Male sexual arousal with repeated exposure to erotic stimuli. Arch. Sex. Behav. 13: 211–222. Koukounas, E., and Over, R. (1993). Habituation and dishabituation of male sexual arousal. Behav. Res. Ther. 31: 575–585. Laan, E., and Everaerd, W. (1995). Habituation of female sexual arousal to slides and Ž lm. Arch. Sex. Behav. 24: 517–541. Lang, P. J., Greenwald, M. K., Bradley, M. M., and Hamm, A. O. (1993). Looking at pictures: Affective, facial, visceral, and behavioral reactions. Psychophysiology 30: 261–273. Meuwissen, I., and Over, R. (1990). Habituation and dishabituation of female sexual arousal. Behav. Res. Ther. 28: 217–226. O’Donohue, W. T., and Geer, J. H. (1985). The habituation of sexual arousal. Arch. Sex. Behav. 14: 233–246. O’Donohue, W., and Plaud, J. J. (1991). The long-term habituation of sexual arousal in the human male. J. Behav. Ther. Exp. Psychiatry 22: 87–96. O’Gorman, J. G. (1977). Individual differences in habituation of human physiological responses: A review of theory, method, and Ž ndings in the study of personality correlates in non-clinical populations. Biol. Psychol. 5: 257–318. Ohman, A. (1979). The orienting response, attention, and learning: An information-processing perspective. In Kimmel, H. D., van Olst, E. H., and Orlebeke, J. F. (eds.), The Orienting Re ex in Humans. Erlbaum, Hillsdale, NJ, pp. 443–471. Over, R., and Koukounas, E. (1995). Habituation of sexual arousal: Product and process. Annu. Rev. Sex Res. 6: 187–223. Posner, M. I., and Boies, S. J. (1971). Components of attention. Psychol. Rev. 78: 391–408. Siddle, D. A. T., and Jordan, J. (1993). Effects of intermodality change on electrodermal orienting and on the allocation of processing resources. Psychophysiology 30: 429–436. Siddle, D. A. T., and Spinke, J. A. (1991). Orienting, habituation, and the allocation of processing resources. In Campbell, B., Richardson, R., and Hayne, H. (eds.), Attention and Information Processing in Infants and Adults: Perspectives from Human and Animal Research , Erlbaum, Hillsdale, NJ, pp. 227–262. Smith, D., and Over, R. (1987). Does fantasy-induced sexual arousal habituate? Behav. Res. Ther. 25: 477–485. Tellegen, A., and Atkinson, G. (1974). Openness to absorbing and self-altering experiences (“absorption”), a trait related to hypnotic susceptibility. J. Abnorm. Psychol. 83: 268–277.

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Sexual Desire Discrepancies: Effects on Sexual and Relationship Satisfaction in Heterosexual Dating Couples Stephenie Davies, M.S.,1, 3 Jennifer Katz, Ph.D.,2 and Joan L. Jackson, Ph.D.1

Sexual desire discrepancies and the associations between desire discrepancies and relationship adjustment (i.e., sexual and relationship satisfaction) in heterosexual dating couples ( N = 72) were examined Desire discrepancies were assessed via two methods: (1) a couple-based index created using both individuals’ reports of sexual desire and (2) an individual-based index using each person’s own subjective perception of a desire discrepancy within the couple. Both indices were associated with women’s adjustment, whereas only individual perceptions of discrepancies were associated with men’s adjustment. The association between desire discrepancies and general relationship satisfaction was fully mediated by level of sexual satisfaction for both men and women. Women whose sexual desire level was lower than their partners’ endorsed lower levels of relationship adjustment relative to women whose desire was either greater than or similar to their partners’. Implications for the assessment of sexual desire differences in couples are discussed. KEY WORDS: sexual desire; desire discrepancies; relationship adjustment; couples.

INTRODUCTION Problems of sexual desire are the most common sexual dysfunctions reported by couples seeking sex therapy, yet have historically been the most difŽ cult to successfully treat (Rosen and Leiblum, 1988). In part, issues of treatment effectiveness are related to our lack of understanding about what sexual desire is and 1 Department

of Psychology, University of Georgia, Athens, Georgia 30602. of Psychology, Washington State University. 3 To whom correspondence should be addressed. e-mail: [email protected]. 2 Department

553 0004-0002/99/1200-0553$16.00/0 ° C 1999 Plenum Publishing Corporation

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how it functions in relationships. Although there is no widely accepted deŽ nition among researchers and theorists, Levine’s (1987) multidimensional model of sexual desire provides a comprehensive description of the construct. He suggests that sexual desire is the force that propels people to behave sexually and views sexual desire as comprised of three components: (1) “sexual drive,” the biological component mediated by the neuroendocrine system; (2) “sexual wish,” the social component re ecting peer and societal expectations; and (3) “sexual motive,” the individual /interpersonal component representing a person’s willingness to engage in sex with a particular person. Levine (1995) points out that the sexual motive has most commonly been the focus of attention. Despite the variability among different theorists’ conceptions, there is some consensus that sexual desire is a subjective, psychological construct, as opposed to a behavioral or purely physiological event (Regan and Berscheid, 1996). Both men and women report having engaged in sexual behavior in the absence of desire, suggesting that the experience of sexual desire does not entirely overlap with sexual behavior (Beck et al., 1991). Accordingly, it has been recommended that researchers increase their focus on subjective desire states and motives, which may be independent of sexual behavior in some cases (Hurlbert and Apt, 1994b). Some theorists conceptualize sexual desire as a relational problem that must be understood within the context of the couple (e.g., Stone Fish et al., 1994). Zilbergeld and Ellison (1980) were the Ž rst to discuss sexual desire problems in terms of couple desire discrepancies. They reasoned that the assessment of sexual desire levels within couples is relative; people perceive that their levels of sexual desire are too low or too high only after comparing their desire levels to their partners’ desire levels. Considering desire discrepancies at the level of the couple has advantages over our current diagnostic system, the DSM-IV (American Psychiatric Association, 1994), which decrees diagnostic status only to the member of the couple with signiŽ cantly low levels of sexual desire. Based upon a clinician’s judgment, this one individual may be diagnosed as having “hypoactive sexual desire disorder.” Conceptualizing a couple seeking therapy for desire problems in terms of a couple sexual desire discrepancy helps shift the clinician from the assessment and treatment of sexual desire problems at the level of the individual to the level of the couple. This also allows people with lower sexual desire, typically women, to be understood within the relational context rather than being pathologized and labeled as dysfunctional. Unfortunately, the empirical study of sexual desire problems often relies solely on one individual’s report (e.g., Hurlbert and Apt, 1994a). Little empirical attention has been paid to the experience of desire discrepancies in couples. Although it is clear that sexual desire has an impact on relationship functioning, there is currently no evidence to suggest that desire discrepancies assessed at the level of the couple are meaningfully related to relationship functioning. Further, there is no research comparing couple- versus individual-based reports of desire discrepancies as related to relationship adjustment.

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Studies of sexual desire discrepancies and their impact on relationship functioning are lacking. We can look only to the related literature for clues about the ways in which desire discrepancies may be related to relationship adjustment. In the general sexual desire literature, individuals with hypoactive sexual desire disorder (HSDD) report lower levels of sexual satisfaction (Hurlbert et al., 1993) and relationship adjustment (Trudel et al., 1993, 1997). Stuart et al. (1987) found that women diagnosed with “inhibited sexual desire” (the diagnosis found in the DSM-III-R) and their partners were signiŽ cantly less maritally satisŽ ed than couples in which neither partner had been diagnosed with a desire disorder. It seems plausible to hypothesize that sexual desire problems may impact relationship functioning via their negative in uence on sexual satisfaction. Indeed, the general couples literature suggests that there is a strong relationship between sexual and marital satisfaction in couples (Apt et al., 1996; Henderson-King and Veroff, 1994; Morokoff and Gilleland, 1993; Purnine and Carey, 1997). Gender, Sexual Desire, and Relationship Adjustment Perhaps because men and women often differ in terms of other areas of relationship and sexual functioning (e.g., Buss et al., 1992; Oliver and Hyde, 1993), many investigators have examined gender differences in sexual desire. Although it is unclear to what extent differences between men and women are due to societal norms and gender socialization processes versus biological differences (Rosen and Leiblum, 1989), research suggests that some differences do exist. SpeciŽ cally, men report experiencing sexual desire more frequently than women (Beck et al., 1991). Men and women also report different beliefs about the causes of sexual desire. Individual and erotic environmental factors are thought to precipitate men’s desire, whereas interpersonal and romantic environmental factors are thought to precipitate women’s desire (Regan and Berscheid, 1995). The same authors also found gender differences in goals associated with sexual desire. Men tended to view sexual activity as the goal of sexual desire, whereas women tended to believe that love and emotional intimacy are the goals of sexual desire (Regan and Berscheid, 1996). It seems that sexual desire represents a more interpersonal and contextual experience for women relative men. More attention has been paid to the absence of sexual desire in one partner than the presence of excessive sexual desire in the other partner in couples. These studies have focused on women as the source of low sexual desire, therefore less is known about men’s experience of low levels of desire and men’s relationship functioning. A few studies have found differences between men and women with HSDD. Age and level of psychological distress were shown to differentiate among men and women with HSDD, such that women were younger and experienced more psychological distress (Donahey and Carroll, 1993). The same study showed that women with HSDD reported less sexual satisfaction than men with HSDD.

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However, another study looking at couples found an opposite pattern of results, that the relationship between marital and sexual desire problems was stronger for men than for women (Rust et al., 1988). The picture is therefore unclear, although sexual desire discrepancy may have differential effects on relationship functioning for men versus women. Summary and Aims of the Current Study Despite the lack of consensus in deŽ ning the construct of sexual desire, several Ž ndings are consistent in the sexual desire literature. There appears to be a link between sexual desire and relationship functioning. However, research to date has focused only on couples in which one partner is labeled as having low desire levels based upon that individual’s subjective report. Furthermore, although low sexual desire is more prevalent in women, the disproportionate focus on women with HSDD in research on sexual desire problems has limited our understanding of how sexual desire relates to relationship adjustment for both men and women. Finally, the focus on sexual disorders and problems in clinical samples of couples has not allowed researchers to understand fully the ways in which sexual desire discrepancies may in uence nondistressed couples. The purpose of the current project was to examine associations among sexual desire discrepancies, sexual satisfaction, and relationship satisfaction in a nonclinical sample of heterosexual dating couples. The current research extends previous work in several important ways. First, sexual desire was indexed and studied both at the level of the couple and at the level of the individual. This is consistent with previous recommendations about conceptualizing and diagnosing sexual desire disorders at the level of the couple in terms of discrepancies (Zilbergeld and Ellison, 1980). We examined associations between each type of desire discrepancy and measures of sexual and relationship satisfaction. SpeciŽ cally, we hypothesized that desire discrepancies would not negatively impact all couple’s relationship satisfaction. Sexual satisfaction was examined as a mediator of the effect of desire discrepancies on general relationship satisfaction. We expected that only those couples who experienced a decrease in sexual satisfaction as a result of experiencing a desire discrepancy would also notice a decrease in relationship satisfaction. Second, sexual desire as reported by both men and women was studied. Given that previous research on sexual desire has focused almost exclusively on women, an examination of sexual desire discrepancies as reported by men and associations with men’s relationship functioning appears timely as well. Third, the use of a nonclinical sample allows for the basic exploration of the effects of sexual desire discrepancies on relationship functioning in nondistressed relationships. This is important because much of the research has focused on clinical samples, without the knowledge of how sexual desire manifests itself in

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relationships and interacts with other important areas of relationship functioning in more normative ways. Finally, the nature of the desire discrepancy in couples may be consequential for their adjustment. We wanted to explore who is speciŽ cally reporting decreases in relationship and sexual satisfaction. Using the couple-based index of desire discrepancy, we compared groups of individuals who reported levels of sexual desire that were greater than, similar to, or lower than their partners’ reported sexual desire. Two comparison hypotheses were explored. On the one hand, individuals with lower desire relative to their partners may endorse the poorest relationship adjustment, compared to individuals whose desire levels are either similar to or greater than their partners’. This would be consistent with the current clinical view that the individual with hypoactive sexual desire disorder should be the focus of treatment. Alternatively, individuals with either type of desire discrepancy (i.e., who have lower or greater desire relative to their partner) may endorse the poorest relationship adjustment, compared to individuals with desire levels that are roughly similar to their partners’. This would be consistent with the hypothesis that having the higher level of sexual desire in a couple with a discrepancy may be equally distressing to the individual as having the lower desire level.

METHOD Participants Heterosexual couples ( N = 72) were recruited from the undergraduate participant pool at a large southeastern university. At least one individual in each couple received credit toward fulŽ lling a research requirement. The average age was approximately 20 years. Most identiŽ ed themselves as Caucasian (88%); however 5.6% were self-identiŽ ed as African American, 2.8% as Asian, 1.4% as Hispanic, and 1.4% as “other.” Efforts were made to recruit sexually active, stable couples who were invested in their relationship. Only couples whose sexual relationship had lasted for 6 months at a minimum were recruited for the present study. On average, couples had been dating for 26.9 months (SD = 19.2 months), with an average sexual relationship lasting for 22.1 months (SD = 17.3 months). Most couples maintained separate residences, although 22 (30.6%) were cohabiting at the time of the study. Measures Index of Sexual Satisfaction (ISS; Hudson et al., 1981). This 25-item scale measures the respondent’s level of sexual satisfaction with a partner. In the current

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study, this measure was scored such that higher scores re ected higher levels of sexual satisfaction. Possible scores range from 0 to 100. A representative item is “My partner is sensitive to my needs and desires.” The ISS shows good reliability, with an a coefŽ cient of .92 and a test–retest coefŽ cient of .93. In support of the scale’s concurrent and discriminant validity, the authors have reported that ISS scores signiŽ cantly correlate with measures of marital adjustment and distinguish between couples with and without sexual problems. In the current sample, the internal consistency coefŽ cient (Cronbach’s a ) was .89 for women and .86 for men. Relationship Assessment Scale (RAS; Hendrix, 1988). This seven-item measure assesses subjective relationship satisfaction. Responses are made on a 5-point Likert scale, with higher scores indicative of higher satisfaction. Possible scores range from 7 to 35. A representative item is “In general, how satisŽ ed are you with your relationship?” Previous research suggests that this scale has good internal consistency. SigniŽ cant correlations between this measure and the Dyadic Adjustment Scale (DAS; Spanier), have been reported by the author, suggesting concurrent validity. Evidence for predictive validity also has been reported, as the RAS distinguishes between couples who do and couples who do not subsequently terminate the relationship. In the present study, Cronbach’s a was .88 for women and .89 for men, suggesting adequate internal consistency. Sexual Desire Inventory (SDI; Spector et al., 1996). The SDI is a 13-item measure that assesses an individual’s interest in both “solitary” and “dyadic” sexual activity. Previous research indicates that these two subscales are reliable, and preliminary evidence for concurrent and discriminant validity has been obtained. Furthermore, scores are uncorrelated with measures of social desirability (Spector, personal communication, 1995). In the current study, the dyadic subscale was used. A representative item is “ When you spend time with your partner, how strong is your sexual desire?” Possible scores range from 0 to 70. The internal consistency coefŽ cient (Cronbach’s a ) was .84 for women and .79 for men. Sexual desire discrepancies within couples were assessed in two ways for the purposes of the current study: at a couple level and at an individual level. The couple desire discrepancy was indexed as the difference between the partners’ standardized dyadic sexual desire score as reported on the SDI. The individual desire discrepancy was indexed via a one-item question, “Do you and your partner have roughly similar sexual desire levels?” Possible responses were yes (1) and no (0). Procedures Couples met in small groups in a classroom on campus. Members of each couple were seated on opposite ends of the room to facilitate privacy. Participants were assured conŽ dentiality to encourage honest and open responding. Each individual was given an envelope with the assessment battery enclosed. Upon completion of the measures, each was fully debriefed and dismissed with thanks.

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RESULTS Couple desire discrepancy scores were calculated as the difference between the partners’ dyadic sexual desire scores (SDI) after standardization. That is, men’s z scores from the SDI were subtracted from women’s z scores from the SDI; positive scores indicate that women endorsed higher levels of desire relative to their male partners, and negative scores indicate that men endorsed higher levels of desire relative to their female partners. The mean couple desire discrepancy was .00 (SD = 1.28; range, ¡ 4.44 to 2.72). With regard to the individual perception of a sexual desire discrepancy, 18 women (25%) and 17 men (24%) disagreed with the one-item individual desire discrepancy measure, indicating that they believed that their own individual desire level was dissimilar to their partners’ sexual desire level. However neither men’s nor women’s individual desire discrepancy measure was signiŽ cantly related to the couple desire discrepancy score [ r(71) = .15 (ns) for women, r(71) = .07 (ns) for men]. Descriptive statistics and zero-order correlations among all the variables of interest are reported in Table I. Both the couple and the individual sexual desire discrepancy scores were correlated with women’s sexual and relationship satisfaction. Women with lower sexual desire relative to their partners and women who perceived sexual desire discrepancies between themselves and their partners endorsed lower levels of both sexual and relationship satisfaction. In contrast, the couple desire discrepancy score was uncorrelated with men’s relationship and sexual satisfaction. Men’s individual desire discrepancy scores, however, were signiŽ cantly related to men’s own sexual and relationship satisfaction. Men who perceived sexual desire discrepancies between themselves and their partners endorsed lower levels of relationship adjustment. Sexual desire discrepancies occur within a relationship context. Accordingly, it is necessary to examine the associations between discrepancy scores, at both Table I. Descriptive Statistics and Zero-Order Correlations (n = 69–72) 1 1. 2. 3. 4. 5. 6. 7.

Couple desire discrepancy W perceived discrepancy W sexual satisfaction W relationship satisfaction M perceived discrepancy M sexual satisfaction M relationship satisfaction M SD Range

— .15 .46 ¤ .26 ¤ .07 .05 ¡ .08

2

¤ ¤

— .41¤ ¤ .23¤ .30 ¤ .24 ¤ .16

3

¤

0.00 .75 1.28 0.44 ¡ 4.44–2.72 0–1.0

— .72¤ .25¤ .39¤ .36¤

4

¤

¤ ¤ ¤ ¤

— .21 .42¤ .63¤

5

¤ ¤ ¤ ¤

82.63 30.12 12.34 4.46 33–100 15–35

— .44¤ ¤ .35¤ ¤

6

¤

.76 .43 0–1.0

— ¡ .50¤

80.32 11.35 38–98

7

¤ ¤

— 28.76 5.03 9–35

Note. Couple desire scores indicate the extent to which women’s standardized sexual desire levels exceed men’s standardized sexual desire levels. W, women; M, men. ¤ p < .05; ¤ ¤ p < .01; ¤ ¤ ¤ p < .001.

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the couple and the individual level, and measures of relationship adjustment after controlling for the partner’s adjustment as well. Multiple regression analyses were conducted to examine whether and to what extent the two types of desire discrepancy scores contributed unique variance to individuals’ relationship adjustment after controlling for partner adjustment. The relative associations between the couple and the individual discrepancy scores on women’s sexual and relationship satisfaction were examined. However, given that the couple desire discrepancy score was unrelated to men’s sexual and relationship satisfaction, the couple desire discrepancy was not examined further for its contribution to men’s adjustment. Rather, the association between men’s individual perception of a desire discrepancy and men’s adjustment, after controlling for women’s adjustment, were of interest and are reported below. Desire Discrepancies and Sexual Satisfaction In one step, the couple desire discrepancy ( b = . 39, p < . 001) and women’s individual desire discrepancy ( b = . 28, p < .01), as well as the male-partner sexual satisfaction ( b = .31, p < .01), were entered simultaneously as predictors of women’s sexual satisfaction [overall F(3,66) = 15.89, p < . 001, adjusted R 2 = . 39]. Women with lower sexual desire relative to their partners endorsed lower sexual satisfaction than women who reported higher relative sexual desire levels. At the same time, women who perceived that their partners were dissimilar to them in their levels of sexual desire endorsed lower levels of sexual satisfaction than women who perceived the couple was similar. The signiŽ cant beta weights associated with each term suggested that, even after controlling for men’s sexual satisfaction, both couple desire discrepancy and women’s individual perceived desire discrepancy accounted for unique variance in woman’s sexual satisfaction. Men’s individual desire discrepancy ( b = . 37, p < . 01) and female-partner sexual satisfaction ( b = .31, p < .01) were both entered simultaneously as predictors of men’s sexual satisfaction [overall F(2,67) = 13. 49, p < . 001, adjusted R 2 = .27]. This pattern of Ž ndings suggested that, even after controlling for partners’ sexual satisfaction, men’s individual perception of a desire discrepancy within the couple was signiŽ cantly associated with lower sexual satisfaction among men.

Sexual Desire Discrepancies and Relationship Satisfaction Multiple regression equations also were calculated to examine the associations between relationship satisfaction and both sexual desire discrepancies and partner satisfaction. In addition, the proposed mediational role of sexual satisfaction was tested. Individuals’ own sexual satisfaction was hypothesized fully to mediate or account for the effect of sexual desire discrepancies on indivdiuals’

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relationship satisfaction. Criteria for mediation as outlined by Baron and Kenny (1986) were followed. Again, separate analyses were conducted by gender and partner satisfaction was controlled for in all analyses. In a Ž rst step, women’s relationship satisfaction was regressed on the couple desire discrepancy ( b = .29, p < .01) and women’s individual desire discrepancy (b = . 09, ns), as well as male-partner relationship satisfaction ( b = . 64, p < . 001) [overall F(3,67) = 22. 20, p < . 001, adjusted R 2 = .48]. Only the couple desire discrepancy variable accounted for unique variance in women’s relationship satisfaction. To the extent that women’s levels of sexual desire were lower than their partners’, women endorsed lower levels of relationship satisfaction. Next we tested the hypothesis that sexual satisfaction mediates the relationship between sexual desire discrepancies and relationship satisfaction for women. Women’s sexual satisfaction was added to the regression model ( b = .58, p < . 001) in a second step [overall F(4,66) = 35.90, p < .001, adjusted R 2 = .67]. After women’s sexual satisfaction was added to the model, the beta weight associated with the couple desire discrepancy score was reduced to nonsigniŽ cance (b = .03, ns). This pattern of results suggested that women’s sexual satisfaction fully mediated the effect of couple desire discrepancies on women’s relationship satisfaction. Parallel analyses were conducted with men. In the Ž rst step, men’s relationship satisfaction was regressed on men’s individual desire discrepancy ( b = .23, p < . 05) and female partner relationship satisfaction (b = . 59, p < .001) [overall F(2,67) = 27.66, p < .001, adjusted R 2 = .44]. The signiŽ cant beta weights associated with each term indicated that, even after controlling for female-partner relationship satisfaction, men who perceived a sexual desire discrepancy between themselves and their female partners were less satisŽ ed in their relationships than men who did not perceive such a discrepancy. To test the mediational hypothesis, men’s sexual satisfaction was added to the model (b = .24, p < .05) in the second step [overall F (3,66) = 21. 09, p < . 001, adjusted R 2 = .47]. Again, after sexual satisfaction was added to the model, the effect of the individual discrepancy variable on relationship satisfaction was reduced to nonsigniŽ cance ( b = .14, ns). Thus, men’s sexual satisfaction fully mediated the effect of perceived sexual desire discrepancies on men’s relationship satisfaction. High Versus Low Desire Discrepancies in Couples Correlational and regression analyses have established the associations between desire discrepancies and both indices of relationship adjustment: sexual and relationship satisfaction. Sexual desire discrepancies are associated with lower sexual satisfaction which is in turn related to lowered relationship satisfaction. Next hypotheses about the nature of the discrepancy, i.e., high versus low, and

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individual relationship functioning were addressed. The sample was divided into three groups based upon § .75 SD of the couple desire discrepancy score. This value was selected so that the groups would be roughly equivalent in size but would re ect fairly large differences in desire discrepancy magnitudes. Group 1 was comprised of couples in which the women reported lower sexual desire scores than their male partners (n = 17). Group 2 was comprised of couples in which the women and men had roughly similar sexual desire scores (n = 35). Group 3 was comprised of couples in which the women reported higher sexual desire scores than their male partners (n = 20). One-way analyses of variance (ANOVAs) were conducted to examine sexual and relationship satisfaction as a function of between-group differences on the couple desire discrepancy score. Separate analyses were conducted for women and men. For descriptive purposes, the patterns of cell means for both genders are presented in Table II. SigniŽ cant between-group differences emerged for women with regard to sexual satisfaction [ F(2,69) = 5.03, p < .01]. Betweengroup differences in relationship satisfaction approached signiŽ cance [ F(2,69) = 2.58, p = . 083 ]. Results of the ANOVA for men did not reveal reliable betweengroup differences on couple desire scores with regard to sexual satisfaction [ F(2,68) = 0.41, ns], or relationship satisfaction [F(2,68) = 0.50, ns]. Planned comparisons were conducted only for women to examine (1) lowersexual desire women (Group 1) versus women with similar or greater sexual desire relative to their partners (Groups 2 and 3) and (2) women with similar sexual desire to their partners (Group 2) versus women with either lower or higher desire than their partners (Groups 1 and 3). SigniŽ cant effects were obtained with regard to the Ž rst planned comparison. Lower-desire women evidenced signiŽ cantly lower levels of sexual satisfaction than women whose desire was either similar or greater than their partners’ [F(1,69) = 10. 07, p < .01]. Lower-desire women Table II. Sexual and Relationship Satisfaction as a Function of Couple Sexual Desire Discrepancy Scores Women

Sexual satisfaction Relationship satisfaction

Group 1 (n = 17)

Group 2 (n = 35)

Group 3 (n = 20)

74.82 (16.02) 28.06 (5.48)

84.54 (8.79) 30.94 (3.91)

85.90 (11.94) 30.45 (4.06)

F (2,69) 5.04¤ 2.58¤

¤

Men Sexual satisfaction Relationship satisfaction

Group 1 (n = 16)

Group 2 (n = 35)

Group 3 (n = 20)

81.00 (14.82) 29.50 (4.38)

81.14 (9.45) 28.91 (5.06)

78.35 (11.64) 27.85 (5.69)

.41 .50

Note. Group 1, women have lower sexual desire scores than men; Group 2, women and men have roughly similar sexual desire scores; Group 3, women have higher sexual desire scores than men. ¤ p < .10; ¤ ¤ p < .01.

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also evidenced lower levels of relationship satisfaction than either other group [ F(1,69) = 4. 66, p < . 05]. Next planned comparisons were conducted to test whether women who were similar to their partners in terms of sexual desire levels differed from women who were dissimilar (either higher or lower in sexual desire). SigniŽ cant results were not obtained. Women who were similar to their partners in terms of sexual desire levels did not endorse greater sexual satisfaction [ F(1,69) = 2. 29, ns] or relationship satisfaction [ F (1,69) = 2. 68, ns] compared to women who were dissimilar to their partners. In summary, examination of between-group differences as a function of the couple desire discrepancy score suggested meaningful differences among women but not men. Planned comparisons revealed that the nature of the discrepancy relative to male partners, high or low, is important. Women who endorsed lower sexual desire relative to their partners evidenced the least sexual satisfaction and relationship satisfaction. DISCUSSION In the current study, we assessed sexual desire discrepancies in heterosexual dating couples via two methods. One was a couple-based index of desire discrepancy, calculated as the difference between each partner’s self-reported level of sexual desire (i.e., the couple discrepancy score). The other was an index of discrepancy based upon the individuals’ own perception obtained by asking each partner whether he/she and the partner experienced roughly similar desire levels (i.e., the individual discrepancy score). Interestingly, different Ž ndings emerged when these different indices were examined. First, the frequency at which desire discrepancies occurred within couples differed across these two measures. Based upon the couple discrepancy measure, sexual desire discrepancies occurred rather frequently in the current sample. However, there are no data to indicate how large a discrepancy must be to be reported as clinically signiŽ cant. It is equally striking that women emerged as the lowerdesire member in roughly half of the discrepant samples, whereas men emerged as the lower-desire member in the other half. At the individual level, use of a oneitem index assessing desire discrepancies resulted in somewhat fewer individuals (roughly 25%) who perceived that their own sexual desire levels were dissimilar to their partners’. This suggests that not all couples with actual discrepant levels of sexual desire experience or label it as such. Next these two desire discrepancy scores were differentially associated with relationship adjustment. Relationship adjustment was indexed via measures of both sexual and relationship satisfaction. Couple discrepancy scores were associated with women’s adjustment, but not men’s adjustment. This is consistent with past literature showing that women experience sexual desire as more interpersonal

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and romantic than men (Regan and Berscheid, 1995). Men’s and women’s individual perceptions of a sexual desire discrepancy, however, were associated with relationship adjustment for both men and women. This Ž nding suggests that different methods of assessing for sexual desire differences in men and women may yield different results. Despite these differences, both types of discrepancy variables were associated with indices of relationship adjustment in similar ways. For women, both the couple discrepancy score and their individual perception of a sexual desire discrepancy were independently associated with sexual satisfaction, whereas only the couple discrepancy score was uniquely associated with women’s relationship satisfaction. Women with lower levels of desire relative to their partners had signiŽ cantly lower levels of relationship adjustment. For men, the individual perception of a sexual desire discrepancy was also associated with both sexual and relationship satisfaction levels. Furthermore, for both women and men, the effects of sexual desire discrepancies on relationship satisfaction were fully mediated by levels of sexual satisfaction. This suggests that sexual desire discrepancies may impact general relationship satisfaction only to the extent that sexual desire discrepancies impact sexual satisfaction speciŽ cally. Finally, between-group analyses were conducted to examine mean differences in relationship adjustment as a function of the nature of the couple discrepancy. Consistent with the correlational data, between-group differences emerged only for women. Two hypotheses about the nature of these between-group differences were explored. We found support for the Ž rst hypothesis; women who reported lower desire relative to their partners endorsed less adjustment than women whose desire levels were either similar to or greater than their partners’. Findings were signiŽ cant with regard to sexual satisfaction and showed a trend toward signiŽ cance with regard to general relationship satisfaction. Support for the second hypothesis about between-group differences was not obtained. Women who reported levels of sexual desire that were dissimilar to their partners’ reports in either direction (i.e., either lower desire or higher desire relative to their partners) did not endorse less adjustment than women whose reports of desire were similar to their partners’. This suggests that, based upon assessment of both partners’ sexual desire levels, women with higher levels of desire relative to their partners may experience fewer relationship adjustment problems than women with lower levels of desire relative to their partners. These results complement literature focusing on men and women with HSDD. Women diagnosed with HSDD report lower marital satisfaction than women without such a diagnosis (Trudel et al., 1993), as did the women in our sample who had lower sexual desire levels than their partners. Unlike the partners of the women diagnosed with HSDD, who also reported signiŽ cantly lower relationship adjustment (Trudel et al., 1993), the partners of the women in our sample who experienced lower levels of sexual desire did not report lower sexual or relationship satisfaction.

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This may be because these were not couples reporting clinically signiŽ cant difŽ culties. Consistent with Donahey and Carroll’s (1993) Ž nding that women with HSDD are less sexually satisŽ ed than men with HSDD, in our sample, women who reported lower desire than their partners experienced signiŽ cantly lower levels of sexual satisfaction then the other women. The men who reported lower sexual desire levels than their partners did not indicate experiencing signiŽ cantly lower levels of sexual satisfaction than the other men. Therefore, it appears that our results are similar to those found in studies with clinical samples looking at individuals with a diagnosis of HSDD. It should be noted that we did not directly assess desire disorder problems for these couples. Rather, both the couple and the individual desire discrepancy scores assessed differences between the self and the partner. It is not clear whether these differences served as signiŽ cant problems for the couples in our sample. Regardless, these differences were meaningfully related to indices of relationship adjustment, such that greater relative differences were associated with poorer adjustment. It could be speculated that more direct questions concerned with problems of sexual desire in couples might yield even stronger effects. Some limitations of the study should be highlighted. First, an undergraduate sample of young, dating couples was employed for this investigation. Although Ž ndings obtained from such a sample may not be representative of married couples, the study of relationship functioning among dating samples is interesting in its own right. Inclusion criteria ensured that all couples were involved in fairly stable relationships, and sexual involvement has been shown to predict relationship longevity in similar samples (Simpson, 1987). Second, the relative homogeneity of the sample may limit its generalizability. Additional research comparing couple versus individualized approaches to deŽ ning and studying sexual desire within more diverse populations is warranted. Next it should be highlighted that the data in this study are correlational and caution must be used in inferring causality. While we tested a mediational model suggesting that desire discrepancies have an effect on relationship adjustment, lower levels of relationship adjustment could be causing desire discrepancies. Indeed, the relationship is likely bidirectional. LoPiccolo and Friedman (1988) suggest that relationship distress and low sexual desire affect each other in a reciprocal, mutually causal relationship, as opposed to a one-way linear relationship. For relationship distress to have a causal effect on desire discrepancy (as opposed to a low desire level), it would mean that the relationship difŽ culties must differentially affect sexual desire in one partner. Consistent with Ž ndings presented here and in other studies, one could speculate that since men’s experience of sexual desire is less related to love and intimacy than women’s (Regan and Berscheid, 1996), decreases in relationship adjustment may be more likely to affect the female partner’s sexual desire level, thus leading to a desire discrepancy between the couple. This

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is consistent with our Ž nding that sexual and relationship adjustment is associated more with the woman experiencing less desire than her partner than the woman experiencing more. While our mediational model tested only one directionality, further employing more sophisticated methodologies could test a bidirectional model. Fourth, the couples investigated did not necessarily report clinically distressed levels of sexual desire. Since sexual desire discrepancies likely occur with more frequency and severity within more longstanding relationships and within clinical samples of distressed individuals and couples, this would render the current nonclinical study a conservative test of the hypotheses herein. Further research of desire discrepancies in couples reporting to sexual dysfunction clinics is called for. And Ž nally, we did not assess actual sexual behavior in these couples. As noted previously, sexual behavior seems at times to be independent of sexual desire (Beck et al., 1991). However sexual desire discrepancies in couples engaging in high levels of sexual behavior may be different than in couples engaging in low levels of sexual behavior. Future studies may be useful in studying whether couple- and individual-based desire discrepancies differ as a function of actual sexual behavior. Conclusion Sexual desire discrepancies assessed via both couple and individual levels appear to be associated with relationship quality in different ways. Couples may not always label themselves as experiencing sexual desire discrepancies. Regardless, at least for women, the presence of a couple-level discrepancy may in uence relationship functioning. Current results suggest that sexual desire discrepancies are meaningfully associated with both sexual and relationship satisfaction. Additional research may further our understanding of how sexual desire discrepancies operate in both nonclinical and clinical samples. Such efforts could advance our basic understanding of these processes as well as aiding in the development of effective treatments for desire-based dysfunctions in couples. REFERENCES American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders , 4th ed., APA, Washington, DC. Apt, C., Hurlbert, D. F., Pierce, A. P., and White, L. C. (1996). Relationship satisfaction, sexual characteristics and the psychosocial well-being of women. Can. J. Hum. Sex. 5: 195–210. Beck, J. G. (1995). Hypoactive sexual desire disorder: An overview. J. Consult. Clin. Psychol. 63: 919–927. Beck, J. G., Bozman, A. W., and Qualtrough, T. (1991). The experience of sexual desire: Psychological correlates in a college sample. J. Sex Res. 28: 443–456. Buss, D. M., Larsen, R. J., Westen, D., and Senmelroth, J. (1992). Sex differences in jealousy: Evolution, physiology, and psychology. Psychol. Sci. 3: 251–255.

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Donahey, K. M., and Carroll, R. A. (1993). Gender differences in factors associated with hypoactive sexual desire. J. Sex Marital Ther. 19: 25–40. Henderson-King, D., and Veroff, J. (1994). Sexual satisfaction and marital well-being in the Ž rst years of marriage. J. Soc. Pers. Relation. 11: 509–534. Hendrix, S. S. (1988). A generic measure of relationship satisfaction. J. Marriage Family 50: 93–98. Hudson, W. W., Harrison, D. F., and Crosscup, P. C. (1981). A short-form scale to measure sexual discord in dyadic relationships. J. Sex Res. 17: 157–174. Hurlbert, D. F., and Apt, C. (1994a). What constitutes sexual satisfaction? Directions for future research. Sex. Marital Ther. 9: 285–289. Hurlbert, D. F., and Apt, C. (1994b). Female sexual desire, response, and behavior. Behav. Modif. 18: 488–504. Hurlbert, D. F., Apt, C., and Rabehl, S. M. (1993). Key variables to understanding female sexual satisfaction: An examination of women in nondistressed marriages. J. Sex Marital Ther. 19: 154– 165. Levine, S. B. (1987). More on the nature of sexual desire. J. Sex Marital Ther. 13: 35–44. Levine, S. B. (1995). The vagaries of sexual desire. In Rosen, R. C., and Leiblum, S. R. (eds.), Case Studies in Sex Therapy, Guilford Press, New York, pp. 96–109. LoPiccolo, J., and Friedman, J. M. (1988). Broad-spectrum treatment of low sexual desire: Integration of cognitive, behavioral, and systemic therapy. In Leiblum, S. R., and Rosen, R. C. (eds.), Principles and Practice of Sex Therapy; Update for the 1990s , Guilford Press, New York, pp. 107–144. Morokoff, P. J., and Gillilland, R. (1993). Stress, sexual functioning, and marital satisfaction. J. Sex Res. 30: 43–53. Oliver, M. B., and Hyde, J. S. (1993). Gender differences in sexuality: A meta analysis. Psychol. Bull. 114: 29–51. Purnine, D. M., and Carey, M. P. (1997). Interpersonal communication and sexual adjustment: The roles of understanding and agreement. J. Consult. Clin. Psychol. 65: 1017–1025. Regan, P. C., and Berscheid, E. (1995). Gender differences in beliefs about the causes of male and female sexual desire. Pers. Relation. 2: 345–358. Regan, P. C., and Berscheid, E. (1996). Beliefs about the state, goals, and objects of sexual desire. J. Sex Marital Ther. 22: 110–120. Rosen, R. C., and Leiblum, S. R. (1989). Assessment and treatment of desire disorders. In Leiblum, S. R., and Rosen, R. C. (eds.), Principles and Practice of Sex Therapy; Update for the 1990s , Guilford Press, New York, pp. 19–47. Rust, J., Golombok, S., and Collier, J. (1988). Marital problems and sexual dysfunction: How are they related? Br. J. Psychiatry 152: 629–631. Spector, I. P., Carey, M. P., and Steinberg, L. (1996). The Sexual Desire Inventory: Development, factor structure, and evidence of reliability. J. Sex Marital Ther. 22: 175–190. Stone Fish, L., Busby, D., and Killian, K. (1994). Structural couple therapy in the treatment of inhibited sexual desire. Am. J. Family Ther. 22: 113–123. Stuart, F. M., Hammond, D. C., and Pett, M. A. (1987). Inhibited sexual desire in women. Arch. Sex. Behav. 16: 91–106. Trudel, G., Boulos, L., and Matte, B. (1993). Dyadic adjustment in couples with hypoactive sexual desire disorder. J. Sex Educ. Ther. 19: 31–36. Trudel, G., Landry, L., and Larose, Y. (1997). Low sexual desire: The role of anxiety, depression, and marital adjustment. Sex. Marital Ther. 12: 95–99. Zilbergeld, B., and Ellison, C. R. (1980). Desire discrepancies and arousal problems in sex therapy. In Leiblum, S. R., and Pervin, L. A. (eds.), Principles and Practice of Sex Therapy , Guilford Press, New York.

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

BOOK REVIEWS Annual Review of Sex Research (Vol. VII). Edited by Raymond C. Rosen. Society for the ScientiŽ c Study of Sexuality, Mt. Vernon, Iowa, 1996, 306 pp., $48.00. Reviewed by Richard Lippa, Ph.D. 1

Volume VII of the Annual Review of Sex Research re ects the diversity of contemporary scholarly work on sexuality and thus, necessarily, also re ects the many cross-currents within the Ž eld. Social constructionist perspectives are presented by Devor’s chapter on female gender dysphoria and Tiefer’s chapter on the medicalization of sexuality, whereas unabashed biological perspectives are presented in Herbert’s chapter on sexuality, stress, and brain chemistry and Bradford and Greenberg’s chapter on pharmacological treatments of deviant sexual behavior. Ussher’s chapter on premenstrual syndrome offers an eclectic position, with a lean toward social constructionism. Other chapters address sexuality education for health care professionals, cognitive approaches to sexuality, female prostitution, and recent survey research on sex in France. I brie y consider each chapter in turn. In an era when biologically oriented articles often seem accessible only to specialists, Herbert’s chapter, “Sexuality, Stress, and the Chemical Architecture of the Brain,” is an admirable effort in providing background and context for the nonspecialist. Herbert contrasts the “neurochemical” coding in the limbic system with the more “informational” coding of the cerebral cortex, and he describes how “reproductive processes” are inhibited by social stress and how the neurotransmitter b endorphin may moderate this effect. Herbert emphasizes the complexity of factors in uencing sexuality, including sensory stimuli, hormones, processing in various brain regions, and peptides, such as b -endorphin, which may moderate other links. Devor’s chapter, “Female Gender Dysphoria in Context: Social Problem or Personal Problem,” takes a strong social constructionist view of gender and argues, in essence, that all women suffer from some variety of gender dysphoria (i.e., 1 Department

of Psychology, California State University, Fullerton, California 92834. 569 0004-0002/99/1200-0569$16.00/0 ° C 1999 Plenum Publishing Corporation

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psychological and/or physical distress at the hands of society’s gender prescriptions). In a section entitled, “Feminists, and Other Partial Socialization Failures,” Devor makes the telling point that women who violate society’s gender prescriptions (e.g., women who don’t marry or bear children, women who don’t groom themselves to be attractive to men, women who are not heterosexual, women who do “men’s work”) are often the targets of social opprobrium. Devor considers eating disorders as a symptom of many women’s inability to live up to unrealistic and unattainable societal standards of female appearance. This chapter describes women who violate cultural gender standards by virtue of their sexuality, their dress, and their gender identities. Devor places the problem of gender dysphoria clearly with society, not the individual: . . . Female gender dysphorias exist for two interlocking reasons. On the one hand, humanity is naturally diverse. On the other hand . . . modes of social organization concerning sex and gender . . . are unable to match the reality of that diversity. (p. 80)

In the chapter “Gender Differences in Cognitive Processes in Sexuality,” Geer and Manguno-Mire draw heavily on Laumann and co-workers’ (1994) sex survey and Oliver and Hyde’s (1993) meta-analysis of gender differences in sexuality. There have been disputes over some of Oliver and Hyde’s conclusions. Their assertion that there are no gender differences in attitudes toward homosexuality, for example, has been challenged by Whitley and Kite (1993; Kite and Whitley, 1996). Despite such problems, Geer and Manguno-Mire summarize evidence for gender differences in sexuality (e.g., men masturbate more, men are more interested in visual erotica, women report Ž nding “romantic” erotica more appealing than sexually explicit erotica), and they then theorize how cognitive factors, such as attention, encoding, accessibility, and retrieval of information, may serve as antecedents of gender differences in sexual attitudes and behaviors. The authors describe their programmatic research on this topic. However, documenting cognitive differences in men and women’s processing of sexual information is not the same as explaining them, as the authors themselves seem to acknowledge toward the end of their chapter. I found Giami and Schiltz’s chapter, “Representation of Sexuality and Relations Between Partners: Sex Research in France in the Era of AIDS,” hard to digest. It certainly provides numerous citations and lots of data from sex surveys in France, but in my view, it suffers from “review article disease,” namely, a welter of information without much of an overarching, take-home message. And then there are the sentences like “The multiple discourses on AIDS are also the object of ‘reinterpretations’ that are a function of biographies of individuals, the social and relational environment, and the needs they encounter” (p. 152). Bullough and Bullough’s chapter, “Female Prostitution: Current Research and Changing Interpretations,” offers a humane and informative analysis of female “sex workers” and provides a rich source of references on the topic. The reader is forced to consider the contradictions of societies that stigmatize prostitution but that also create the social and economic conditions that guarantee its existence.

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Bullough and Bullough consider topics such as deŽ nitions of prostitution, the extent of prostitution, and the relation of prostitution to the military. The interesting information in this chapter is colored by a strong emphasis on social as opposed to biological factors. Example: Because women have a potential for sexual enjoyment that is at least equal to men, we have to conclude that a male prostitute who serves a female clientele is not as prevalent in society either because it is physiologically more difŽ cult for a male to serve in this role or because of other norms, values, and power systems in society as they relate to differences between the sexes. (p. 172)

Weerakoon and Stiernborg’s chapter, “Sexuality Education for Health Care Professionals: A Critical Review of the Literature,” gives a detailed account of survey research on the nature, content, and diversity of sex education for health care professionals. They consider the effectiveness, evaluation, and goals of such education. The following remarks from their conclusion give, I think, the  avor of this chapter, as well as pause for thought: It would seem that the development and implementation of a sexuality education program in a health professional curriculum depends more on the enthusiasm and individual interest of the members of the teaching faculty than on the recognized need for the course or the appropriateness of its placement or format. The low priority given to sexuality education in the curriculum by both faculty and administrators often results in the course being offered as an elective . . . . (p. 211)

Ussher’s chapter, “Premenstrual Syndrome: Reconciling Disciplinary Divides Through the Adoption of a Material Discursive Epistemological Standpoint,” despite its tongue-twisting title, provides a lot of useful information and provides a classic example of a paradigm clash in construing the nature of a “disorder” (or even, in deciding whether the “disorder” actually exists). While Ussher is quite sympathetic to social constructionist critiques of the notion of premenstrual syndrome (PMS), she also notes that “ironically, many women adopt a biological discourse in explaining their PMS symptoms; the body is blamed for what is clearly positioned as illness . . . ” (p. 238). Social constructionist analyses may seem to have little to say to these women; they stand in opposition to what women “know” and may be further rejected for apparently suggesting that PMS is “all in the mind.” This is a problem facing all those who would put forward a radical critique of mental illness: how to reconcile a deconstructive critique at a macro level with the needs of the individual at a micro level. Read Ussher to see how she resolves this problem. Tiefer’s chapter, “The Medicalization of Sexuality: Conceptual, Normative, and Professional Issues,” is one of the most interesting in this volume—an example of a constructionist position at its most astute. Tiefer sets her agenda in her Ž rst sentence: A growing chorus of sexologists, myself included, have written about ‘the medicalization of sexuality’ as it affects the contemporary understanding and management of patients with erectile dysfunction, low desire, premature ejaculation, and sexual pain . . . . (p. 252)

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Tiefer proceeds with a compelling, intelligently argued, and thought-provoking critique of the medicalization of sexuality. Here are some tantalizing sentences from her chapter: In the medical model, the separation of mind from body produces a universalized body governed by empirical laws and processes that work independently of social life, culture and history. (p. 256) Masters and Johnson’s . . . human sexual response cycle epitomizes the medicalized sexuality of universal human capacities, tendencies, and functions. (p. 259; italics in original)

And later: The important thing about “the human sexual response cycle” is the way it so perfectly Ž lled a social and professional need for a bodily, biological, universal, natural sexuality that, 3 decades later, it continues to be sexual dogma and to completely dominate our Ž eld. (p. 259)

And consider this provocative passage: Premature ejaculation is obviously in uenced by cultural values (relating to gender, pleasure, and sexual scripts), and medication might sometimes be an appropriate element of a treatment plan. A nonmedical way to view premature ejaculation or any other sexual complaint is as a discrepancy from the normative sexual script which might appropriately be addressed by script changes, attitude changes, medications, psychotherapy, education, etc. (p. 263)

Finally, consider the delicious analogy Tiefer presents here: Doing medicine centers around diagnosis . . . . Diagnosis plays a role in modern medical practice not unlike that of orgasm in modern sexual practice—it legitimates the activity, it displaces other purposes, one ‘reaches’ it after focused effort, participants feel socially lost without it, efforts toward it can persist long after common sense might dictate halting, and it operates as both verb and noun! (p. 264)

After Tiefer’s tour de force constructionist critique, it is perhaps appropriate that the volume concludes with a review of biological treatments of sexual deviance. Bradford and Greenberg’s chapter, “Pharmacological Treatment of Deviant Sexual Behavior,” reviews evidence on serotonin reuptake inhibitors, antiandrogens, and castration. In general, they suggest that various pharmacological treatments hold great promise in treating paraphilias and hypersexuality, and they encourage further research on the topic. In summary, this volume of the Annual Review of Sex Research re ects the great diversity of contemporary research on sexuality. It contains much useful information, and it is guaranteed to annoy sexologists of all theoretical persuasions. For maximum therapeutic value, make sure you read the chapters you think will annoy you most. REFERENCES Kite, M. E., and Whitley, B. E. (1996). Sex differences in attitudes toward homosexual persons, behaviors, and civil rights: A meta-analysis. Pers. Soc. Psychol. Bull. 22: 336–353. Laumann, E. O., Gagnon, J. H., Michael, R. T., and Michaels, S. (1994). The Social Organization of Sexuality: Sexual Practices in the United States, University of Chicago Press, Chicago.

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Oliver, M. B., and Hyde, J. S. (1993). Gender differences in sexuality: A meta-analysis. Psychol. Bull. 114: 29–51. Whitley, B. E., and Kite, M. E. (1993). Sex differences in attitudes toward homosexuality: A comment on Oliver and Hyde (1993). Psychol. Bull. 117: 146–154.

The Recovered Memory/False Memory Debate. Edited by Kathy Pezdek and William P. Banks. Academic Press, San Diego, California, 1996, 394 pp., $49.95. Reviewed by Martin A. Conway, Ph.D.2

This edited volume by Pezdek and Banks brings together papers originally published in a 1994 special issue of the journal Consciousness and Cognition with eight new chapters. The volume also includes a short introduction by the authors and brief notes on each of the four sections of the book. In my view, this is a useful collection of papers which, together with other edited books on this topic, could form part of a fairly exhaustive library covering most of the clinical and experimental work into false and recovered memories. In the case of the present volume, important reprinted papers by, for instance, Goodman et al., Howe et al., Ceci et al., Courtois, and Schooler are of considerable use. Of the new chapters, Brown’s attempt to locate the recovered memory debate in terms of who owns and deŽ nes family history represents a potentially important approach but, at least in this treatment, does not provide an analysis of sufŽ cient breadth, instead focusing only on the implications for winners or losers of the debate. The analysis might well have been broadened to evaluate cultural belief systems the purpose of which is to blame and condemn versus systems which aim to heal and make whole. Terr’s coverage of loss of details from trauma memories and, indeed, amnesia for whole experiences, although going over old ground, nonetheless makes the point that knowledge can be temporarily forgotten and later remembered. But, of course, one does not need to turn to memory of trauma to observe this: Who has not remembered something they had previously forgotten? In general, this is a useful collection and will Ž nd its way onto the bookshelves of many researchers and practicing clinicians. When it does, however, I hope that those readers will become aware, as I did, that the book demonstrates strikingly well the central shortcoming in the study of false and recovered memories: lack of theory. This is not to say that there are no “local theories” addressing very narrow ranges of data; on the contrary, these abound, but the problem with them is that 2 Department

of Experimental Psychology, Centre for Learning and Memory, University of Bristol, 8 Woodland Road, Bristol BS8 1TN, England.

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they are too speciŽ c and become vacuous when extended beyond the small set of Ž ndings for which they were originally intended to account. Thus, when reading a set of papers, such as the present collection, one emerges with the feeling that nothing much has been understood. Calls for more corroborative case studies, more informed and more cautious clinical practice, and even more surveys appear little more than worthy and do not much advance understanding. It seems to me that the central (and unacknowledged) force of the recovered and false memory debate is that the debate cannot be resolved until we have a theory of memory, and that is what we most assuredly do not currently have. But my point is that the debate itself should be driving us on to bring forward such theories. Clearly, it is highly unlikely that any proposed theory will be correct, but unless we start asking the important questions now, such as “What is memory for?” we will be condemned to, for example, run endless surveys, admittedly of increasing sophistication, data from which will remain forever meaningless. Consider the following. I have argued that one of the main functions of autobiographical memories is to “ground” the self (Conway, 1997). In other words, memories constrain what sort of self one can be. One cannot hold an ambition to be a father for the Ž rst time if one can remember that one has a son or daughter. A person who held goals and motives that were directly contradicted by memory would be considered to have psychological problems. How convenient, then, if some knowledge could be forgotten, which might allow the generation of a different self—one that would not have been realizable if certain information were available in memory. Memories, then, provide the boundaries of self and facilitate the generation of meaningful personal goals. Taking this view (and I make no claim here that it is the “correct” or only view), the accessibility and accuracy of memories are closely bound up with the nature of self and the grounding of self in experience—remembered experience. In some respects, accuracy may not be especially important; instead, the function of memories in facilitating some aspect of the self may be altogether of more signiŽ cance, and this may be true whether or not the recalled knowledge, believed by the rememberer to be a “memory,” is accurate or is a fantasy. I detect a sense in collections such as the Pezdek and Banks volume that people are overawed by the task that faces them and shrink back from making bold (scientiŽ c) statements. For instance, it clearly is a mistake to think that “memory” is some kind of isolated faculty. Memory enters into all forms of human cognition (and I include emotion within the term cognition) in many different ways and so an account is needed that sites memory within the personal goal and motivational system of individuals, not to mention the sociohistorical matrix of cultural belief systems in which individual cognitive systems are instantiated. Hints of such understanding can be see in chapters such as Terr’s or Brown’s more beliefsystem oriented approach, but these hardly represent the bold and broad theoretical statements that I believe this area needs if it is to progress further. So I guess the question is, Who is going to stick their head above the parapet Ž rst?

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Machos, Maricones, and Gays: Cuba and Homosexuality. By Ian Lumsden. Temple University Press, Philadelphia, 1996, 263 pp., $19.95. Reviewed by Stephen O. Murray, Ph.D. 3

Lumsden, a gay Canadian political scientist who grew up in Argentina and Ž nds North American homosexuality alienatingly“regulated and commodiŽ ed” (p. 158), has visited Cuba regularly since 1965. He does not seem to have systematically gathered data on sexual behavior (or, indeed, anything else), but provides his impressions and value judgments based on conversations he has had with some Cubans and reading about Cuba. From the perspective of a long-time apologist for the regime who is troubled by its continued suppression of any civil society or culture outside direct supervision by the state, he writes about changes over time in ofŽ cial attempts to eliminate or control homosexuality and about popular attitudes about male homosexuality and gender. Lumsden argues that in the early 1960s Cubans were no different from other Latin Americans in equating male homosexuality with effeminacy and in stigmatizing gender variation while not conceiving of homosexual desire in masculineappearing men, including those who regularly mounted other males. The defense of the revolution was believed to require more machismo, which exacerbated the pan-Latino stigmatization of unmasculine males. Moreover, as Cuba became a dependent neocolony within the Soviet empire, focus on growing more of a single crop (sugarcane) for export intensiŽ ed. Rounding up “antisocial deviants” provided cheap labor for state-run sugar plantations, isolated rebels (sexual and other kinds), and was rationalized as therapeutic, in the same way as sending Chinese urban intellectuals to till Ž elds was supposed to redeem them during the Cultural Revolution (only “coincidentally” removing articulate, potential critics from where they might be heard). After the involuntary Military Units to Aid Production (UMAP) camps were closed, homosexuals continued to be banned from many occupations. And after the failure of the Cuban analogue of the Great Leap Forward (the dislocation of the whole economy to attain a fantasized 1970 sugar harvest), scapegoats were needed. Purges of homosexuals were accompanied by codiŽ cation of policies to “contain deviance” and to “protect” youth from exposure to “corrupting in uences” in 1971. In 1980, the regime gladly sent off various “antisocial” elements and then used their presence among the Mariel emigrants to claim that only criminals and sexual /gender deviants wanted to leave the socialist utopia of Cuba. Lumsden does not mention the practice of a variant of aversion therapy used on effeminate boys (assigned to “Yellow Brigades”) (see Leiner, 1994). He also fails to note the continuity in assumptions, rationales, and administration of the 3 El

Instituto Obreg´on, 1360 De Haro, San Francisco, California 94107-3239.

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UMAP concentration camps and the sidatoria to which persons testing positive for HIV antibodies were involuntarily removed, starting in 1986. Both kinds of concentration camps were initially run by the army. Both were premised on removing potential contagion. Both stimulated international condemnations and Castro backing off. Lumsden stresses that those incarcerated in Los Cocos (the only 1 of the 12 sidatoria foreigners have been allowed to visit, as he notes on p. 240) received better food than was available to other Cubans along with better housing, free medical care, and continued payment of their salaries (although, on the irrelevance of salaries in Cuba during the 1990s, see p. 148). Despite the difŽ culties of life outside, since conŽ able (trustworthy, a category into which it is more difŽ cult for “homosexuals” to be included than former soldiers in Cuba’s African military adventures) inmates were allowed to move out in 1994, none have chosen to return even to the show-sidatorium (p. 173). This datum shows that freedom from paternalistic control is important to Cubans, not only to those in more individualistic societies. With the collapse of its patron, the USSR, and the concomitant loss of market and loss of subsidies, the Cuban economy all but collapsed. Foreign tourism has been actively sought, and concessions have been made to sex tourism. Prostitution has revived. Less direct payment by foreign visitors for sex with Cubans has been encouraged (e.g., the  ood of Cuban personal ads in European gay magazines could not have occurred unbeknownst to the regime). Hard-currency gay discos have been tolerated. And the interest in the immensely popular Ž lm Fresa y Chocolate has demonstrated that the Cuban people’s intolerance of homosexuals (even effeminate ones) has been exaggerated in claims by Castro and his subordinates that the people would not accept representations of homosexuality as tolerable (p. 192). As did Leiner (1994), Lumsden notes that, given the highly developed health education infrastructure and block-level organization (the Committees to Defend the Revolution), Cuba was uniquely able to launch a grassroots educational campaign when AIDS appeared, but, instead, chose to spend scarce resources on mass testing (with suspect ELISA tests) and the incarceration of those who were apparently infected with HIV. A pan-Latino belief that males cannot control themselves and must have sex if an opportunity occurs is one basis of this policy. Statist paternalism is another (a re ex in Cuba). I would attribute low rates of infectivity to the isolation from infected non-Cubans during the late 1970s and early 1980s. Since then, sexual contact with foreigners has dramatically increased. Sexually active young Cubans have had little or no realistic HIV-prevention education and have felt reassured that incarceration of those infected ensured their safety, so long-term judgment of the success of Cuba’s HIV containment policy will likely be negative from either a collectivist or individualist perspective. This book is much better written than Lumsden’s (1991) book on Mexico, but similarly deŽ cient in recognition of empirical work on Latin American

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homosexualities (see, e.g., Carrier, 1995). His book is more focused on homosexuality than Leiner’s (1994) similarly disappointed socialist analysis of revolutionary puritanism in Cuba or Lancaster’s (1992) sympathetic critical analysis of Sandinista grappling with machismo even while battling U.S.-sponsored terrorist attacks. Of the three books, Lancaster’s comes closest to lived experience (albeit of women, not of “homosexuals,” whom he avoided) and provides the most materialist account of Latino machismo. [For lived experience of Cuban repression of homosexuals in the Ž rst two decades after Castro seized power, see Arenas (1989, 1993). ] Although Lumsden recurrently produces special pleading (writing that the object of this or that repression was “not homosexuality per se”), he is certainly right to note that the records of the other states in the Western Hemisphere for permitting positive representations of homosexuality, providing realistic HIV-prevention education, and caring for persons with AIDS have been inadequate, and also that there have been recent changes in Cuban policies. Something of a sexual revolution seems to have occurred, despite the puritanism of a typically Stalinist state apparatus. Lumsden notes that “teenage girls become sexually active when they are scarcely beyond puberty” now (p. 22). Condoms are little used, abortion is much used [80 abortions for every 100 live births during the 1980s, with the rate of abortions exceeding the rate of live births for teenage females (pp. 21–22) ], and same-sex acts are more accepted (though housing shortages make it difŽ cult for same-sex couples to live together). Moreover, there seems to be less role dichotomization in homosexuality than before. Although he lacks quantitative data, Lumsden asserts that those who are younger, better-educated, and resident in the capital city are increasingly likely to be completo, rather than committed to the activo or the pasivo role, and to be openly gay (pp. 149–50), as is true elsewhere in Latin America (see Murray, 1995). REFERENCES Arenas, R. (1989). Old Rosa, Grove Press, New York. Arenas, R. (1993). Before Night Falls, Viking, New York. Carrier, J. M. (1995). De Los Otros: Intimacy and Homosexuality Among Mexican Men, Columbia University Press, New York. Lancaster, R. N. (1992). Life is Hard: Machismo, Danger, and the Intimacy of Power in Nicaragua , University of California Press, Berkeley. Leiner, M. (1994). Sexual Politics in Cuba: Machismo, Homosexuality, and AIDS, Westview Press, Boulder, CO. Lumsden, I. (1991). Homosexuality, Society and the State in Mexico, Canadian Gay Archives, Toronto. Murray, S. O. (1995). Latin American Male Homosexualities , University of New Mexico Press, Albuquerque.

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Gender and Psychopathology. Edited by Mary V. Seeman. American Psychiatric Press, Washington, DC, 1995, 402 pp., $52.00. Reviewed by Kathleen A. Lindsay, Ph.D. 4, 5

This is a worthwhile text for those interested in studying ways in which psychopathology can differ between men and women, such as prevalence, age at onset, expression of symptoms, course, severity, treatment response, and risk factors. Many chapters in this edited book focus nicely on the “why” as well as the “what” of these differences. Topics addressed include a psychodynamic view of gender, development, and psychopathology; a historical approach to multiple personality disorder and gender; non-Mendelian inheritance; and gender differences in mood, anxiety, eating, sleep, and somatoform disorders, schizophrenia, alcohol and other forms of substance dependence, and health care provision. Seeman intended the book’s organization to be  exible, allowing the reader to study chapters in any order and receive cross-references to related chapters. Seeman prefaces the volume by stating that her original goal of discussing each current psychiatric diagnosis was unrealistic, and she opted for a more feasible project. However, it is not clear why Seeman presents four chapters on schizophrenia but none on other disorders of signiŽ cant clinical interest and concern, such as personality disorders. There has been substantial research, discussion, and controversy concerning gender differences among the personality disorders, and the inclusion of such topics might have enhanced this text. Seeman concludes the book by presenting the theoretical perspective from which the authors addressed gender differences in psychopathology. It might have been more useful to have this chapter appear at the beginning of the book. Seeman describes the authors’ “essentialist” position. That is, “real and essential differences do exist in the expression of psychopathology” (p. 377). Meanwhile, the authors reject the “structuralist” approach of modern psychiatry, which promotes categorization, precision, and demarcation of more speciŽ c psychopathological syndromes. The authors “collectively afŽ rm a poststructuralist stance, advancing the unity of medical/social, biological/psychological, and nature/nurture perspectives on psychiatric distress” (p. 379). They assert that biological sex (genetics, anatomy, hormones) and psychosocial gender (assigned and adopted roles within family, political, and economic structures) provide two powerful determinants of psychopathology. Although some chapters lean primarily toward one or the other of these broad factors, the book contains a nice mix of theoretical view-points. I found especially informative and enjoyable Chapter 4 (“Epidemiology and Theories of Gender Differences in Unipolar Depression”), by Nolen-Hoeksema, 4 Department

of Psychology, University of Kentucky, Lexington, Kentucky 40506-0044. to 737 Clayvis Court, Lexington, Kentucky 40515-6329.

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and Chapter 8 (“The Impact of Gender on Understanding the Epidemiology of Schizophrenia”), by Goldstein. Nolen-Hoeksema brings a thoughtful feminist perspective to her careful review of biological, personality, and social theories of developmental gender differences in depression. Goldstein presents a well-written look at the recent Ž ndings of gender differences in the incidence, prevalence, onset age, premorbid history, expression of illness, and course of schizophrenia. She provides a critical review of studies from 1980 on, as well as comprehensive tables of incidence and prevalence Ž ndings from each study. (Chapter 8 might provide readers a useful lead-in to Chapter 7—“Gender, Brain, and Schizophrenia”—which is informative but more cumbersome due to its subject and extensive literature presentation.) In addition, Chapter 10, by Seeman (“Gender Differences in Treatment Response in Schizophrenia”), is notable for its refreshing, reader-friendly approach of using case presentations. I also appreciated Chapter 15, in which Lisansky Gomberg addresses some rarely discussed gender differences in health care behaviors and provision (e.g., prescription of sedatives). The chapters vary in the depth of their discussion and the presentation of empirical support. Although many chapters provide a nice balance of theory and research, a more detailed and critical presentation of the literature would have strengthened several of them, including Chapter 6 (“Gender Differences in the Prevalence and Expression of Anxiety Disorders”) and Chapter 11 (“Gender Differences in Eating Disorders”). In the former, Yonkers and Gurguis provide some interesting and useful information, such as gender-divergent features of obsessivecompulsive and posttraumatic stress disorders. However, they focus too heavily on the basic deŽ nitions and descriptions of these disorders while providing insufŽ cient information on gender differences and theoretical explanations. In the eating disorders chapter, Woodside and Kennedy appear to bring strong clinical experience to their discussion of issues such as gender differences in treatment response. However, their discussion seems only to skim the surface of important, useful, and interesting hypotheses, such as a multidetermined model involving an interaction of biological, genetic, psychological, and societal factors in producing eating disorders. Several chapters present strong, provocative statements without presenting sufŽ cient supportive research or acknowledging inconsistent research. Chapter 2, on developmental psychopathology, by Hacking, for example, contains many general truisms with little or no speciŽ c empirical support cited [e.g., “the role of cultural practices, including gender differences in child rearing, are manifest from infancy” (p. 2)]. A little warning: before reading Chapter 3 (“Psychopathology and NonMendelian Inheritance”), the reader may want to take a few deep breaths and a quick course in biogenetics. If you lack this background (as I admittedly do), this chapter will be of little utility. However, readers with adequate background may appreciate information such as, “Based on the strict Lyon Hypothesis, mothers of boys with [Lesch–Nyhan syndrome ] would be expected to have an inactivated

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X chromosome containing the normal hypoxanthine-guanine phosphoribosyltransferase gene half the time” (p. 44). In the conclusion, Seeman draws readers’ attention to two edited books covering similar topics (Al-Issa, 1982; Gomberg and Franks, 1979). She suggests that these older texts provide a good background from which to evaluate progress that has been made in this area—progress re ected in the current text. However, I respected Seeman’s acknowledgment that “reading from a historical perspective expands our horizons and evokes our humility” in that “there are a few new answers, but the old questions remain” (p. 385). This text usefully highlights many of those questions that will continue to compel research. REFERENCES Al-Issa, I. (ed.) (1982). Gender and Psychopathology , Academic Press, New York. Gomberg, E. S., and Franks, V. (eds.) (1979). Gender and Disordered Behavior: Sex Differences in Psychopathology, Brunner/Mazel, New York.

Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Letter to the Editor

To the Editor: Daskalos’ recent paper (1998), purporting to show changes in sexual orientation in six male-to-female (MtF) transsexuals, ironically appeared only weeks after the American Psychiatric Association (APA) condemned “reparative therapy” for homosexuals (American Psychiatric Association Board of Trustees, 1998). The APA and most other authorities believe that sexual orientation is extremely resistant to change, even in highly motivated individuals. Yet Daskalos purports to document dramatic changes in the sexual orientation of six of his transsexual informants— changes that seem to have occurred almost effortlessly. However, a careful reading of Daskalos’ paper reveals that he has demonstrated no such thing. Although his informants’ self-reports include some changes in sexual behavior and in sexual fantasies, Daskalos offers no evidence of a true change in sexual orientation, at least as that term is commonly used. Sexual orientation is usually deŽ ned as a preference for a particular body type: for an “identiŽ able male or female body shape, particularly the type of external genitals” (Freund, 1985). Male to female (MtF) transsexuals’ self-reports of partner preference and sexual fantasies may not re ect sexual orientation in this more rigorous sense. Sometimes such self-reports may be conscious deceptions, designed to increase the likelihood that the transsexual will qualify for sex reassignment surgery (Harry Benjamin International Gender Dysphoria Association, 1998). Transsexuals have candidly admitted to engaging in such deliberate deceptions (Nettick and Elliot, 1996). Interestingly, two of Daskalos’ informants had in fact not yet undergone sex reassignment surgery. In other cases, such self-reports by transsexuals may re ect the autogynephilic fantasy of sex with a male partner, in the absence of a genuine preference for the male somatotype. Freund (1985) summarized the difŽ culty of accepting these self-reports at face value: It is not easy, and is often impossible, to decide whether these patients deliberately try to mislead the examiner, just appearing as feminine as possible in order to have a better chance of obtaining a recommendation for sex reassignment surgery, or whether their wish to be in the female role in sexual interaction results in fantasies of sexual intercourse as a female with a male and that this makes them prefer the male as a sexual partner, in spite of not being attracted toward male but toward female body shapes.

581 0004-0002/99/1200-0581$16.00/0 ° C 1999 Plenum Publishing Corporation

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Letter to the Editor

Of course, yet another possibility is the one Daskalos proposes: that a genuine change in sexual orientation might occur. Although this possibility cannot be disproved based on his evidence, neither can it be supported. Blanchard and colleagues (1985) demonstrated that among gender dysphoric males with heterosexual histories, the tendency to portray oneself as currently attracted to males and unattracted to females is highly correlated with the tendency to otherwise describe oneself in a socially approved way, as measured by the Crowne–Marlowe Social Desirability Scale. This provides an obvious explanation for Daskalos’ Ž ndings, one that is also explicitly suggested by some of his informants’ remarks. Given the cautionary indications in the published literature, it is remarkable that Daskalos seems not to have explored the central question of whether a genuine change in somatotypic preference had occurred. Likewise, his sweeping generalization that his informants’ feelings went beyond autogynephilic fantasies as deŽ ned by Blanchard (1991) is unsupported, based on the evidence he provides. Perhaps most remarkable is Daskalos’ implicit endorsement of the idea that his informants’ purported change in sexual orientation may somehow have been related to hormone therapy. In view of the fact that all 20 his informants received hormone therapy, but only 6 reported a change in sexual attraction, this deductive leap can only be called breathtaking. Twenty years ago, formerly heterosexual MtF transsexuals who maintained their sexual attraction to women posttransition were considered rare enough to inspire case reports (Feinbloom et al., 1976). Daskalos’ paper suggests that the situation has come full circle and that now changes in sexual attraction are considered unusual enough to be reportable. Perhaps this is a measure of progress. It may be some time before rigorous studies of sexual arousal patterns in MtF transsexuals can clarify whether changes in sexual orientation after gender transition genuinely do occur. Meanwhile, papers such as Daskalos’ only cloud our understanding of this complicated issue. Anne A. Lawrence, M.D. 6801 28th Avenue NE Seattle, Washington 98115

REFERENCES American Psychiatric Association Board of Trustees (1998). Position statement on psychiatric treatment and sexual orientation. Adopted Dec. 11. Blanchard, R. (1991). Clinical observations and systematic studies of autogynephilia. J. Sex Marital Ther. 17(4): 235–251. Blanchard, R., Clemmensen, L. H., and Steiner, B. W. (1985). Social desirability response set and systematic distortion in the self-report of adult male gender patients. Arch. Sex. Behav. 14: 505– 516.

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Daskalos, C. T. (1998). Changes in sexual orientation of six heterosexual male-to-female transsexuals. Arch. Sex. Behav. 27: 605–613. Feinbloom, D. H., Fleming, M., Kijewski, V., and Schulter, M. P. (1976). Lesbian/feminist orientation among male-to-female transsexuals. J. Homosex. 2(1): 59–71. Freund, K. (1985). Cross gender identity in a broader context. In Steiner, B. (ed.), Gender Dysphoria , Plenum, New York. Harry Benjamin International Gender Dysphoria Association (1998). The Standards of Care for Gender Identity Disorders , Symposion Publishing, Dusseldorf. Nettick, G., and Elliot, B. (1996). Mirrors: Portrait of a Lesbian Transsexual , Masquerade Books, New York.