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Discovering Human Sexuality, Fourth Edition

Fourth Edition

Simon LeVay, Janice Baldwin, and John Baldwin

Publication Date - February 2018

ISBN: 9781605357294

696 pages

Retail Price to Students: $119.99

An evidence-based, accessible introduction to the study of sexuality and the diverse ways in which it brings joys and challenges to our lives.


An evidence-based, accessible introduction to the study of sexuality and the diverse ways in which it brings joys and challenges to our lives. Now in its fourth edition, Discovering Human Sexuality has established itself as a popular and widely praised text that respects diversity both in the sexual world and among the students who read it. The backgrounds of the authors--in biology, sociology, teaching, and writing--have made possible a text that is multidisciplinary, authoritative, sex-positive, and a delight to read.

The scope of Discovering Human Sexuality ranges from homosexuality in ancient Greece to the recent Harvey Weinstein sexual harassment scandal while covering a stunningly diverse array of topics. Questions considered include: How does the menstrual cycle work? What's "splitting the bamboo"? Can premature ejaculation be treated? If a man has undetectable levels of HIV, can he have sex without condoms? Which sex offenders will repeat their crimes? Is there a gay gene? What's wrong with polygamy? Is emergeny contraception abortion? Which bathrooms should trans women use? This book gives factual answers to important questions and provides material for informed debate for issues without a single solution.

New to this Edition

  • Coverage of recent sex-related developments in research, medicine, law, politics, and social trends has been added and is supported by current data and statistics
  • Several new boxes address such topics as "Tempest in a Toilet: The Culture Wars' Focus on Bathroom Choice by Trans People"; "Culture and Body Weight: The Evidence That Judgments of Attractiveness Can Change--Over Months or Minutes"; "Commercial Gestational Surrogacy--An Ethical Dilemma" and "Campus Rape-Do Alleged Perpetrators Get a Fair Hearing?"
  • All URLs have been replaced with abbreviated URLs, so that readers can type them easily


  • The authors, all experienced writers and teachers, ensure that the text is fully accessible, engaging, and relevant to students of diverse backgrounds
  • An evidence-based approach is employed: statements are supported by current data, ideas presented are tested or testable, and recommendations are based on research
  • References are fully documented, citing original sources
  • Diversity--sexual, as well as racial, ethnic, and religious (as they affect sexuality)--is emphasized
  • Full-color illustrations give complex topics a visual representation that gracefully parallels and clarifies the accompanying text
  • Boxes provide breaks from the steady flow of the text and allow students to consider specific issues in a more relaxed and informal way

About the Author(s)

Simon LeVay, Ph.D is a British born neuroscientist turned science writer and teacher. He has served on the faculty of Harvard Medical School and the Salk Institute for Biological Studies, and has taught at Harvard, the University of California, and Stanford University. He is the author or coauthor of 11 books, including Gay, Straight, and the Reasn Why: The Science of Sexual Orientation. Janice Baldwin, Ph.D, and John Baldwin, Ph.D are sociologists at the University of Californina, Santa Barbara. They have been collaborators and writers on many papers and projects in the area of sex, sexuality, and sex education. The Baldwins co-teach a very dynamic undergraduate Human Sexuality course at UCSB, that has been regularly voted the Best Course there, and they have been named Best Professors multiple times. They also co-created--with their upper division students--a sex information website: SexInfoOnline.


"Out of all the textbooks I have used for Human Sexuality in my thirteen years of teaching, I prefer the LeVay, Baldwin, & Baldwin text. I will continue to use Discovering Human Sexuality because I like the way topics are discussed and explained. The test bank is also easy to use compared to the last textbook I used, and that saves me a lot of time when I am putting an exam together. I particularly like the boxes that are contained in each chapter. They provide a break in the chapter content. The topics discussed in the boxes are important and useful and often lead to interesting discussions." --Celeste Favela, El Paso Community College

"I absolutely love the LeVay et al. text. I would be hard pressed to find a more thorough and approachable text. The layout of the chapters and the box features are excellent." --James Vaughn, University of Science and Arts of Oklahoma

"We have a very diverse student population with various ages and education levels. I find the book interesting and yet not overwhelming, in a highly readable format." --Peggy Oberstaller, Lane Community College

"I've been using the LeVay, Baldwin, and Baldwin text since the second time I taught the course. I'd previously used another as recommended by a colleague, but it didn't emphasize biological aspects. I really like Discovering Human Sexuality because of its emphasis on biology and the fact that each edition is great at including recent phenomena, like changes in legal issues related to sexuality. I think it's written in an easy-to-read style. I like the visuals included in the book, and I appreciate the little out-takes/side boxes that give points of view or case studies within them. As I am teaching this within a Psychology Department, I find that my students appreciate the approach the text takes." --Patricia Schiml, Wright State University"

Table of Contents

    Chapter 1. Sexuality: Pathways to Understanding
    Sexuality Is a Broader Concept than Sex
    Studying Sexuality Has Practical Benefits
    Sexuality Has Changed over Time
    Sexuality has been influenced by evolution
    Society has changed sexuality
    Box: Meet My Dads
    Urbanization has been a curse and a blessing
    Marriage has been transformed
    Box: The Media: TV or Not TV?
    Sex researchers followed diverse paths
    Box: Freud and Hirschfeld: Contrasting Theories on Sexual Orientation
    Sexuality Can Be Studied with a Wide Variety of Methods
    Biomedical research focuses on the underlying mechanisms of sex
    Psychology includes diverse approaches to sexuality
    Cultural anthropology focuses on sexual diversity across cultures
    Sociologists focus on the connection between sex and society
    The economic approach weighs costs and benefits
    Organizations promote sex research

    Chapter 2. Women's Bodies
    The Whole Body Is an Erogenous Zone
    A Woman's Vulva Includes Her Mons, Labia, Vaginal Opening, and Clitoris
    There is more to the clitoris than meets the eye
    Box: Pubic Hair Removal
    The appearance of the vaginal opening is variable
    Box: Female Genital Cutting
    The Vagina Is the Outermost Portion of the Female Reproductive Tract
    The vagina undergoes changes during arousal
    The G-spot is a controversial erogenous zone
    The Anus Can Also Be a Sex Organ
    Box: Genital Self-Examination
    The Uterus Serves a Double Duty
    Cancer can affect the cervix or the endometrium
    Other uterine conditions include fibroids, endometriosis, abnormal bleeding, and prolapse
    Should hysterectomy be so common?
    The Oviducts Are the Site of Fertilization
    The Ovaries Produce Ova and Sex Hormones
    Box: The Feedback Loop That Controls Female Hormone Production
    Menstruation Is a Biological Process with Cultural and Practical Aspects
    The menstrual cycle has three phases
    The cycle is driven by hormonal changes
    Does the menstrual cycle influence sexuality?
    Attitudes toward menstruation vary
    Women use pads, tampons, or cups during menstruation
    Box: Where Tampons Aren't an Option
    Menstrual Problems Are Common but Treatable
    Menstrual pain may or may not reflect underlying pelvic disease
    Premenstrual syndrome has physical and psychological aspects
    Menstruation stops during pregnancy--and for other reasons
    Sex steroids affect more than the reproductive tract
    The Breasts Have Both Erotic and Reproductive Significance
    Breast Cancer Mortality Can Be Reduced
    Many factors affect the risk of breast cancer
    Clinical breast exams save lives
    Treatment depends on the diagnostic findings and the woman's choice

    Chapter 3. Men's Bodies
    The Male External Genitalia Are the Penis and Scrotum
    The penis combines erotic, reproductive, and urinary functions
    Box: Male Circumcision
    Some disorders affect penile function
    Box: How Big Should a Penis Be?
    Box: Diphallia
    Penile Erection Involves Nerves, Blood, and Chemistry
    Erection is the filling of the penis with blood
    Muscles are also involved in erection
    Erections occur during sleep
    The scrotum regulates the temperature of the testicles
    The Testicles Produce Sperm and Sex Hormones
    Box: Declining Sperm Counts
    Cancer and other disorders can affect the testicles
    Other glands contribute secretions to the semen
    What is semen?
    Ejaculation Requires Coordination of Muscles and Glands
    The testicles secrete sex hormones
    Box: The Secret Life of Semen
    The brain and pituitary gland regulate hormone levels
    Box: Steroids and Sports
    Nudity Is Culturally Regulated

    Chapter 4. Sex Development and Diversity
    Genes and Hormones Guide Sex Development
    Female and male reproductive tracts develop from different precursors
    Female and male external genitalia develop from the same precursors
    The gonads descend during development
    Puberty is sexual maturation
    The brain also differentiates sexually
    Sex Development Is Not Always Binary
    Unusual sets of chromosomes affect growth and fertility
    The gonads or genitals may be sexually ambiguous
    Box: My Life with Androgen Insensitivity Syndrome
    There Are Sex Differences in Many Mental Traits
    Gender identity does not always match anatomical sex
    Women and men differ in a variety of cognitive and personality traits
    There are many differences in sexuality
    Many sex differences arise early in life
    Biological Factors Underlie Sex Differences
    Evolutionary forces act differently on females and males
    Box: Gendered Play in Primates
    Experiments demonstrate a role for sex hormones
    Life Experiences Mold Sex Roles
    Girls and boys are socialized differently
    Cognitive developmental models emphasize thought processes
    Transgender People Challenge Society's Deepest Division
    Box: The Boy Who Was Raised as a Girl
    Transexual individuals are of more than one kind
    Box: Trans Men and Women in Cross-Cultural Perspective
    Changing sex is a multistage process
    Many transgender people do not want surgery
    Trans people struggle for awareness and acceptance
    Box: Tempest in a Toilet

    Chapter 5. Attraction, Arousal, and Response
    Sexual Attraction: It Takes Two
    Beauty is not entirely in the eye of the beholder
    Culture influences the attractiveness of bodies
    Box: Culture and Body Weight
    Attractiveness involves senses besides vision
    Behavior and personality influence sexual attractiveness
    Familiarity may increase or decrease attraction
    Perceived attractiveness varies around the menstrual cycle
    Asexual women and men do not experience sexual attraction
    Sexual Arousal Has Multiple Roots
    Fantasy is a common mode of sexual arousal
    Arousal occurs in response to a partner
    Gonadal steroid hormones influence sexual arousability
    Conditioning may influence arousal
    Sexual Arousal Follows a Response Cycle
    Box: Aphrodisiacs and Drugs
    In the excitement phase, genital responses begin
    In the plateau phase, arousal is maintained
    Orgasm is the climax of sexual arousal
    Box: Female Ejaculation
    Brain imaging suggests where orgasm may be experienced
    Box: Foot Orgasms
    In the resolution phase, arousal subsides
    The phases may be linked in different ways
    Men experience a refractory period
    Pituitary hormones influence the sexual response cycle
    The Masters and Johnson cycle may be incomplete
    People Derive Pleasure from Diverse Sexual Behaviors

    Chapter 6. Sexual Behavior
    Masturbation Is a Very Common Form of Sexual Expression
    Box: Sex and Happiness
    Negative attitudes toward masturbation are still prevalent
    Several demographic factors influence masturbation
    Women use more diverse techniques of masturbation than men
    Gay people masturbate more than heterosexuals
    The Kiss Represents True Love--Sometimes
    Sexual Touching Takes Many Forms
    Oral Sex Is Increasingly Popular
    Fellatio is oral stimulation of the penis
    Cunnilingus is oral stimulation of the vulva
    Most Male-Female Sex Includes Coitus
    Coitus can be performed in many different positions
    Box: Progress in Coitus Research
    The man-above position is a traditional favorite
    The 1970s women's movement encouraged alternative positions
    Anal Sex May Be a Part of Either Opposite-sex or Male Same-sex Behavior
    Men and Women May Have Different Preferences for Sexual Encounters
    Sex Toys Are Used to Enhance Sexual Pleasure
    Sex May Be in Groups
    Box: What Is "Great Sex"?
    Sexual Behavior and Attitudes Vary Across Cultures
    The Kama Sutra is the classic work on how to make love
    Taoists recommended the avoidance of ejaculation
    The Aka emphasize the importance of frequent sex
    Box: Dry Sex
    Many Disabled People Have Active Sex Lives
    Many intellectually disabled people are competent to make sexual choices
    Spinal cord injuries present a major challenge to sexual expression
    Arthritis is the number one disability affecting sex
    People Are Having Less Partnered Sex

    Chapter 7. Sexual Relationships
    Sexual Relationships Are Motivated by Many Factors
    Demographic Factors Affect Sexual Attitudes
    Box: Who May Marry?
    Casual Sex Has More Appeal to Men than to Women
    Hooking up--the new norm?
    Box: Straight Women, Gay Sex
    The hookup culture--some like it, some loathe it
    Casual sex is more accepted in the gay male community
    Negotiating sex involves flirting
    Non-Cohabiting Relationships Are Often Short-Lived
    Long-distance relationships can be very successful
    Same-sex relationships have their own scripts
    Non-cohabiting relationships may evolve rapidly
    Love Cements Many Sexual Relationships
    There are different kinds of love
    Liking and reciprocal attraction precede falling in love
    Researchers are probing the biological basis of love
    Life Experiences Mold Our Sexual Relationships
    Relationship styles are influenced by childhood attachments
    Couples in relationships resemble each other
    Communication Is a Key Factor in the Success of Relationships
    Communication may be inhibited by upbringing or by the gender barrier
    Marriage and relationship education teaches communication skills
    How couples deal with conflict affects the stability of their relationships
    In sexual relationships, sex matters
    Box: Lasting Relationships: Gottman's Seven Principles
    Love, Jealousy, and Infidelity Are Intertwined
    Jealousy can have a positive function
    Unrequited Love Is Painful for Both Parties
    The rejector may experience guilt
    Extra-Pair Relationships Have Many Styles and Motivations
    Personal and evolutionary factors influence infidelity
    Box: We Just Clicked
    Extra-pair relationships are uncommon

    Chapter 8. Fertility, Pregnancy, and Childbirth
    Pregnancy and Childbirth Raise Major Health Concerns
    The Fertilization of an Ovum Is Followed by Implantation
    Box: Birth Facts
    Pregnancy Is Confirmed by Hormonal Tests
    Infertility Can Result from a Problem in the Woman or in the Man
    A variety of factors can reduce sperm counts
    Box: The Scent of an Ovum
    Sperm can be donated
    In vitro fertilization can circumvent many sperm problems
    Abnormalities of the female reproductive tract may reduce fertility
    Failure to ovulate can be dealt with by drugs or by egg donation
    Box: Choosing Children's Sex
    Surrogate mothers bear children for others
    Adoption is limited by the supply of healthy infants
    Fertility declines with age
    Box: Commercial Gestational Surrogacy--An Ethical Minefield
    Many Embryos Do Not Survive
    Rh factor incompatibility can threaten second pregnancies
    Ectopic pregnancy can endanger the mother's life
    Pregnancy Is Conventionally Divided into Three Trimesters
    The First Trimester Is a Period of Major Changes
    Prenatal care provides health screening, education, and support
    Adequate nutrition is vital to a successful pregnancy
    Tobacco, alcohol, drugs, and radiation can harm the fetus
    The Second Trimester Is the Easiest
    Tests can detect fetal abnormalities
    Sex during pregnancy is healthy
    Moderate exercise during pregnancy is beneficial
    The Third Trimester Is a Time of Preparation
    A hospital is the best location for childbirth if complications are foreseen
    Childbirth classes prepare parents for birth
    The fetus also makes preparations for birth
    Labor Has Three Stages
    The first stage of labor is marked by uterine contractions and cervical dilation
    The second stage is the delivery of the baby
    Box: Pain-free Childbirth
    The newborn child adapts quickly
    The third stage is the expulsion of the placenta
    Premature or delayed birth is hazardous
    Box: Cesarean Section
    The Period after Birth Places Many Demands on Parents
    Postpartum depression may be accompanied by disordered thinking
    Childbirth and parenthood affect sexuality
    Breast-Feeding Is the Preferred Method of Nourishing the Infant
    Lactation is orchestrated by hormones
    The content of breast milk changes over time
    Infant formula is an alternative to breast milk
    Breast-feeding has many advantages and some drawbacks

    Chapter 9. Contraception and Abortion
    Birth Control Has a Long History
    Feminists led the campaign to legalize contraception
    Box: Margaret Sanger and the Birth Control Movement
    Contraception has not yet solved the problem of unintended pregnancy
    Different users have different contraceptive needs
    Physical Methods Block Sperm Transport
    Male condoms are reliable when properly used
    Female condoms are relatively intrusive
    Box: Male Contraceptives of the Future?
    Diaphragms and cervical caps are inconvenient but have few side effects
    Spermicides are not very reliable when used alone
    Hormone-Based Methods Are Easy to Use
    Combination pills offer health benefits
    Continuous use of combination pills eliminates menstrual periods
    Progestin-only pills have fewer side effects
    Hormones Can Be Administered by Non-Oral Routes
    Transdermal patches last a week
    Vaginal rings last three weeks
    Depo-Provera lasts three months
    Implants are extremely reliable
    Intrauterine devices require little attention
    The Availability of Hormonal Contraceptives May Be Limited
    Behavioral Methods Can Be Demanding
    In fertility awareness methods, couples avoid coitus during the fertile window
    The withdrawal method is simple but challenging
    Noncoital sex can be used as a means of avoiding pregnancy
    Combining long-acting methods and condoms makes sense
    Box: Contraceptives and the Environment
    There Are Contraceptive Options after Unprotected Coitus
    Sterilization Is Highly Reliable
    Vasectomy is a brief outpatient procedure
    Tubal sterilization is more invasive and expensive
    Disabled Persons Have Special Contraceptive Needs
    Lack of Access to Contraception Is a Global Problem
    Several Safe Abortion Procedures Are Available
    Box: Abortion in the United States: Key Statistics
    Vacuum aspiration is the standard first-trimester surgical method
    Dilation and evacuation is used early in the second trimester
    Induced labor and hysterotomy are performed late in the second trimester
    Medical abortions are two-step procedures
    Abortions do not cause long-lasting ill effects
    Americans Are Divided on Abortion, but Most Favor Restricted Availability
    The availability of abortion is decreasing
    Box: Feticide

    Chapter 10. Sexuality across the Life Span: From Birth to Adolescence
    Some Forms of Childhood Sexual Expression Are Common
    In contemporary Western culture, children are insulated from sex
    Box: Talking with Children about Sex
    Some children engage in solitary sexual activity
    Sex with others can occur during childhood
    Cultures vary in their attitudes toward childhood sexuality
    Some Children Have Sexual Contacts with Adults
    Most adult-child contacts involve older children and are single encounters
    Some kinds of adult-child sex are more harmful than others
    Box: Sex and Suggestibility
    Strategies to prevent adult-child sex are quite effective
    Preadolescence May Be Marked by an Increase in Sexual Interest
    Preadolescent children segregate by sex
    Strict gender norms may traumatize children who become gay or trans adults
    Puberty Is a Period of Rapid Maturation
    Puberty is marked by visible and invisible changes
    Box: My First Period
    Puberty occurs earlier in girls than boys
    What drives puberty?
    The body signals its readiness for puberty to the brain
    Puberty may come too early or too late
    Adolescence Is a Time of Sexual Exploration
    Many cultures have puberty rites
    There are social influences on teen sexual behavior
    Box: Sex-ed--What Teens Say
    Social media have risks and benefits
    Males masturbate more than females
    The sexual activity of American teens increased and then decreased
    The meaning of "virginity loss" varies
    Teen Sexuality Is Central to Identity Development
    Teen relationships are often short-lived
    Teen pregnancy is declining but is still too common

    Chapter 11. Sexuality across the Life Span: Adulthood
    In Young Adulthood, Conflicting Demands Influence Sexual Expression
    Most young men and women have only a few sex partners
    Dating relationships are short-lived
    Cohabitation is an increasingly prevalent lifestyle
    Cohabitation has diverse meanings
    Cohabitation does not harm a subsequent marriage
    Marriage Takes Diverse Forms
    The formalization of sexual unions has social and personal functions
    Many societies have permitted polygamy
    Box: Mormon Polygamy
    Polyamory includes a variety of nonmonogamous relationships
    The Institution of Marriage Is Evolving
    Companionate marriage makes the availability of divorce a necessity
    Marriage is becoming a minority status
    Relationship options have diversified
    Most Long-Term Couples Are Satisfied with Their Sex Lives
    The frequency of sex declines over the course of long-term relationships
    Marital satisfaction declines during middle age
    Box: You Know the Future of Your Marriage
    A Variety of Factors Bring Relationships to an End
    Several demographic factors increase the likelihood of a breakup
    There are more personal reasons for breakups
    Marital Disruption Can Have Negative and Positive Consequences
    Divorced men and women can suffer psychological, physical, and economic damage
    Divorce may be the start of a new life
    Many divorced people remarry
    Does marriage have a future?
    Menopause Marks Women's Transition to Infertility
    Menopause may be caused by depletion of ova
    Women may experience a decline in sexual function at menopause
    Decreased hormone levels affect a woman's physiology
    Hormone therapy can reduce menopausal symptoms
    Men's Fertility Declines Gradually with Age
    Old People Face Challenges to Their Sex Lives--Often Successfully

    Aging is accompanied by physiological changes in the sexual response
    Medical conditions, drugs, and social factors can impair the sexuality of older people
    Old age may be a time for romance
    Box: Seniors on Sex

    Chapter 12. Sexual Orientation
    There Is a Spectrum of Sexual Orientations
    Sexual Orientation Is Not an Isolated Trait
    Box: Boys Will Be Girls
    Diverse Theories Attempt to Explain Sexual Orientation
    Freud proposed psychodynamic models
    Sexual orientation has been attributed to socialization
    Biological theories focus on prenatal hormones and genes
    Box: Why Gay Genes?
    The Gay Community Has Struggled for Equal Rights
    The gay rights movement began in Germany
    Box: Gay Martyrs
    Gay rights are a global issue
    Growing Up Gay Presents Challenges
    Coming out is a lifelong process
    Lesbians and gay men are well represented in certain occupations
    Gay People Who Belong to Minorities Have Special Concerns
    Gay Sex Has Its Own Style
    Some same-sex couples differ in gender characteristics
    Gay people aren't all of a kind
    Box: Beyond Gay and Straight
    Some gay people are parents
    Changing One's Sexual Orientation Is Difficult or Impossible
    Homophobia Has Multiple Roots
    Cultural indoctrination transmits homophobia across generations
    Gays are seen as rule breakers
    Box: Born That Way? And Does It Matter?
    Overcoming homophobia is a communal enterprise
    Bisexual People Are Caught between Two Worlds
    The prevalence of bisexuality depends on definitions
    Bisexual people face prejudice
    Lesbian, gay, straight, bi, other--more alike than different

    Chapter 13. Atypical Sexuality
    Sexual Variety Is the Spice of Life
    Sadomasochism involves the infliction or receipt of pain or degradation
    Box: In the Dungeon
    Most fetishes are related to the body
    People cross-dress for a variety of reasons
    Box: Crush Fetishes
    Box: Rubber Fetishism and the Internet
    Some men are aroused by trans women
    Adult babies reenact infancy
    Furries wear animal costumes
    Paraphilic Disorders Cause Distress or Harm Others
    Exhibitionists expose themselves to nonconsenting persons
    Obscene telephone calling is related to exhibitionism
    Voyeurs are aroused by watching others
    Frotteurism involves surreptitious physical contact
    Box: Frotteurism: First-person Accounts
    Some Adults Are Sexually Attracted to Children
    Pedophilia and child molestation are not synonymous
    "Child molestation" is a behavioral and legal term
    Priests and others may molest children under their care
    Some organizations support "minor-attracted people"
    A Variety of Other Paraphilic Disorders Exist
    Zoophiles are sexually attracted to animals
    In necrophilia, nonresistance of the partner may be arousing
    Sexual violence can be paraphilic
    Box: Autoerotic Asphyxia
    Sex Offenders Do Not Necessarily Repeat Their Offenses
    There Are Numerous Theories of Paraphilic Disorders
    Theories of Causation Have Suggested a Variety of Treatments
    Conditioning is intended to change sexual desires
    Cognitive therapy is aimed at preventing repeat offenses
    The efficacy of psychological treatments is limited
    Drug treatments interact with neurotransmitters or hormones
    Castration is a treatment of last resort
    Few "Kinks" Are Disorders

    Chapter 14. Sexual Disorders
    Sexual Disorders Are Common
    A multidisciplinary approach to treatment is preferred
    Box: Sensate Focus
    Female Sexual Arousal Disorder Involves Insufficient Genital Response
    There Are Many Reasons for Sexual Pain in Women
    Vaginismus may make intercourse impossible
    Box: Dyspareunia: A Case History
    Difficulty in Reaching Orgasm Is Common among Women
    Psychotherapy and directed masturbation may be helpful
    Box: Kegel Exercises
    Faked orgasms offer a questionable solution
    Lack of Interest in Sex Is Not Necessarily a Problem
    Estrogen or androgen treatment may improve sexual desire in women
    Sex therapy may be helpful for low sexual desire in women
    Alternative views on women's response cycles may influence treatment options
    Premature Ejaculation Is Men's Number One Sex Problem
    There are different kinds of premature ejaculation
    Sex therapy helps some men
    Drug treatment may be effective
    Delayed Ejaculation Is Not Well Understood
    Erectile Disorder Has Many Causes and Treatments
    Erectile disorder can have physical or psychological causes
    Simple measures may alleviate the problem
    Psychological treatments may be useful
    PDE5 inhibitors have become the leading treatments
    Erectile disorder can be treated with devices and implants
    Men May Have Little Interest in Sex
    Sexual Pain Is Uncommon in Men
    Too Much Interest in Sex Can Cause Problems
    Treatment depends on theoretical models
    LGBT People Have Special Concerns

    Chapter 15. Sexually Transmitted Infections
    Venereal Diseases Were Seen as Punishment for Sexual License
    STIs Are Still a Major Problem in the United States
    Lice and Mites Are More of an Annoyance Than a Danger
    Pubic lice itch, and that's all they do
    Scabies may be transmitted sexually or nonsexually
    Trichomoniasis Is Caused by a Protozoan
    Bacterial STIs Can Usually Be Treated with Antibiotics
    Syphilis Is Down but Not Out
    Untreated syphilis progresses through three stages
    Syphilis has resisted elimination
    Box: The Tuskegee Syphilis Study
    Gonorrhea Can Lead to Infertility
    Chlamydia Causes a Common Infection with Serious Complications
    The Status of Bacterial Vaginosis as an STI Is Uncertain
    Urethritis Can Be Caused by a Variety of Organisms
    Box: Zika--The virus that came and went
    Viral STIs Can Be Dangerous and Hard to Treat
    Molluscum Contagiosum Is a Self-Limiting Condition
    Genital Herpes Is a Lifelong but Not Life-Threatening Infection
    Recurrent outbreaks are the rule
    Drug treatment can shorten or prevent outbreaks
    Human Papillomaviruses Can Cause Genital Warts--and Cancer
    An HPV vaccine is available
    Hepatitis Viruses Can Be Sexually Transmitted
    AIDS Is Caused by the Human Immunodeficiency Virus
    Sexual transmission is chiefly by coitus and anal sex
    HIV infection progresses in a characteristic way
    Antiretroviral drugs suppress but don't eliminate HIV
    You Can Reduce Your STI Risks
    Abstinence prevents STIs
    Sexually active people can reduce their risk of STIs
    Box: Partner Notification
    Some sexual behaviors are riskier than others for STI transmission
    Condoms are the mainstay of STI prevention
    Not Everything Is an STI

    Chapter 16. Sexual Assault, Harassment, and Partner Violence
    What Is Sexual Assault?
    Young women are the
    most frequent victims
    Most sexual assaults are not reported
    Box: It Happened to Me
    Sexual Assaults in College Are Becoming Less Common

    Many sexual assaults are committed by college athletes
    Colleges must balance the rights of the accuser and the accused
    The number one "date rape drug" is alcohol
    Sexual Assault Can Have Severe Effects on the Victim
    Box: Reducing the Risk of Sexual Assault
    Services are available for rape victims
    Rape can inflict long-lasting harm
    Box: Ten Ways Men Can Prevent Sexual Violence
    Male victims have special concerns
    LGBT people are at high risk
    Rape Laws Have Become More Protective of Victims
    Reforms began in the 1970s
    What happens to men who rape?
    Repeat offending is common
    Why Do Men Rape?
    Rape may have evolutionary roots
    Some characteristics distinguish rapists from nonrapists
    Social forces influence the likelihood of rape
    Box: Rape and War
    Intervention Programs Are of Uncertain Value
    Intimate Partner Violence Is a Crime with Many Names
    Intimate partner violence follows an escalating cycle
    Breaking up is hard to do
    Help is available
    Sexual Harassment Occurs in Many Environments
    There are two kinds of workplace sexual harassment
    Sexual harassment often begins early
    Box: The Superstar Harasser
    Sexual harassment harms its victims
    Victims of sexual harassment can take steps to end it
    There Are Three Kinds of Stalkers

    Chapter 17. Sex Work
    Sex Is an Industry
    Prostitution Is on the Decline
    Historically, prostitution was viewed as a necessary evil
    There are moral and practical reasons for the decline
    There Is a Hierarchy of Prostitution
    Street prostitution has many risks
    Box: The Economics of Prostitution
    Female, male, and transgender streetwalkers have different experiences
    Some prostitutes work out of massage parlors and strip clubs
    Escort services are the main form of prostitution in the United States
    Many prostitutes work for pimps
    Box: Sugaring
    Men who use escorts have liberal attitudes
    Some women use male prostitutes
    Juvenile prostitution is of special concern
    Box:Juvenile Prostitutes in Portland, Oregon
    Sex trafficking is a global business
    There Are Conflicting Views on Prostitution
    There are several options for legal reform
    There Is More to Sex Work than Prostitution
    Stripping is going mainstream
    Phone sex has diversified
    Pornography Has Always Been Part of Human Culture
    Pornography has battled censorship
    New technologies mean new kinds of pornography
    Box: What's It Like to Be a Porn Star?
    There is some pornography for women
    There Are Conflicting Perspectives on the Value or Harm of Pornography
    Research has not resolved the question of pornography's effects
    Sex Is Part of the Mass Media
    Sex sells, sometimes

    Appendix A. Sex and Evolution
    Rival Theories Offer Explanations for Sexual Reproduction
    Sexual reproduction removes harmful mutations
    Sexual reproduction may generate beneficial gene combinations
    Why Are There Two Sexes?
    Hermaphrodites combine male and female reproductive functions
    Evolution Has Led to Diverse Methods of Sex Determination
    In mammals, sex is determined by chromosomes
    Sexual Selection Produces Anatomical and Behavioral Differences between Males and Females
    Males and females follow different reproductive strategies
    Females and males are exposed to different reproductive risks
    Males often compete for access to females
    Females often choose among males
    Sometimes males make significant investments in reproduction
    If males invest, sexual selection may work differently
    Sexual selection protects against extinction
    Diverse Relationship Styles Have Evolved
    Social and sexual arrangements are not necessarily the same
    Male promiscuity offers obvious evolutionary benefits
    Why are females promiscuous?
    Female promiscuity leads to adaptive responses by males
    Males may copulate with females by force
    Sometimes, Helping Relatives Reproduce Is a Good Strategy
    Avoiding Incest Is an Evolved Behavior
    Sex Has Acquired Other Functions beyond Reproduction
    Female and male bonobos engage in nonreproductive sex
    Bonobos use sex for conflict resolution and alliance formation

    Appendix B. Sex and the Nervous System
    Box: The Nervous System
    Erection Can Be Mediated by a Spinal Reflex
    Sensory innervation of the genitalia
    The pudendal and pelvic nerves
    Erectile Tissue Forms a Hydraulic System
    Muscles Are Also Involved in Erection
    The Brain Influences Erection and Ejaculation

    Author Index
    Subject Index

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