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Chapter 15: Extreme Sexuality and Paraphilias Discussion Topics Discussion 15.1: Listening for Denial about Sexual Risk Some people cope with risk by not facing it, and even go to great lengths to try to pretend or imagine that they are invulnerable. In addition, they may not realize that they are in denial of reality. Learning to listen for friends’ and lovers’ statements of denial can help to assure them that their participating in extreme sexual behaviors outside the mainstream does not go too far. Consider these possible scenarios: A close friend repeatedly engages in hooking up online with total strangers and agrees to meet with them for sex in person. Yet they say that they are not at risk. Denial of the risk of unintended pregnancy or protection from an STI may sound something like this: “I take the pill but sometimes I forget,” or “I expect my partner to use a condom, but I’m not sure it always happens.” A close friend who has been the victim of abuse appears to be avoiding dealing with the pain and trauma. Listening for statements of denial about ordeals like these may provide opportunities for you to suggest resources to help. You have friends who occasionally engage in risky sex after becoming intoxicated at a party. They remark casually: “Oh, we only spent the night together once, so I didn’t need protection.” Your friend appears to be having a passionate relationship but may not be taking care due to the demands of the intimate partner. That denial may sound something like this: “In a moment of passion, I just lost it and got carried away.” Encountering situations in which people appear to use denial as a way to cope can be a challenge if you care about them. Sometimes the most helpful thing is just to listen to let them know that you care. Other times you can reflect back to your loved ones what they have said, which may make their denial more apparent. That may lead them to seek support, guidance, or additional resources to take care of themselves and their sexual well-being. In the scenarios described, it's important to listen for statements of denial about sexual risk and to respond in a supportive and caring manner. Here are some suggested responses: 1. Close friend engaging in risky behavior: "I hear you say you don't feel at risk, but meeting strangers for sex can be dangerous. Have you thought about ways to stay safe in these situations?" 2. Denial of pregnancy or STI risk: "It's great that you're taking steps to protect yourself, but forgetting to take the pill or relying on your partner to use a condom isn't foolproof. Maybe we could talk about other ways to reduce the risk?" 3. Friend avoiding dealing with trauma: "I've noticed you seem to be avoiding dealing with what happened. It might be helpful to talk to a professional who can offer support and help you work through the pain." 4. Friends engaging in risky sex while intoxicated: "It's understandable that things can get out of hand when you're intoxicated, but it's important to remember that alcohol can impair judgment and increase risky behavior. Have you thought about ways to stay safer in those situations?" 5. Friend neglecting their well-being due to a passionate relationship: "It sounds like things are intense with your partner, but it's important to prioritize your own well-being. Maybe we could talk about finding a balance that works for both of you?" In each of these situations, the goal is to listen actively, express concern, and offer support and resources without being judgmental. This approach can help your friends recognize and address any denial they may be experiencing regarding their sexual behavior and risk. Discussion 15.2: Sexual Addiction—Reality or Myth? Researchers probe issues surrounding sexual compulsivity and sexual addiction, but there is no consensus regarding these issues as of yet (Bancroft & Vukadinovic, 2004). Sexual addiction is apparently not confined to sport celebrities such as golfer Tiger Woods or actors like Michael Douglas, Eric Benét, and Charlie Sheen. Consider the story about Greg, a 28-year-old married man in the retail industry. He states that he has been “addicted” to masturbating and porn for years. Recently his wife discovered messages he was posting on Craigslist looking for women to sexually hook up with. She became furious and threatened to leave him and take their children. He still sits for hours watching online porn, as if he can’t get enough of it. He is shy around women and says that this addiction is taking over his life. He feels powerless to stop it, but even when thinking of seeking help, he also feels an urge to view porn online. Some critics may say that sexual addiction is an easy excuse for people to do what they want, but after learning of stories like Greg’s, they seem to be in distress. Researchers also suggest that the logic of the condition and its diagnosis may be circular: (1) Individuals may be diagnosed with sexual addition (2) This diagnosis relates to extreme sexual behaviors that are not inherently diseased or do not have signs of addiction (3) Once diagnosed this way, these people tend to think of themselves as “sex addicts” and so do their friends and partners (4) They repeat these learned behaviors and dominant institutions of society, such as family and church, stigmatize them because they are not living up to sexual norms and values of those institutions (Levine & Troiden, 1988; Bancroft & Vukadinovic, 2004). Consider these factors about sexual addiction: 1. What seems problematic about the definition of addiction is that it alludes to a physical and psychological dependence. Sexual addiction does not fit this definition of addiction. Is the urge so powerful that it cannot be controlled? Many of the behaviors associated with sexual addiction are considered within the spectrum of sexual variations, albeit extreme (Coleman, 1986; Levine & Troiden, 1988). 2. The notion of sexual addiction is best understood as a progressive intimacy disorder, and not a paraphilia. In fact, some people with this condition express their compulsions online to avoid intimacy (Carnes, 2001). 3. People inclined to compulsive sexual behavior may have low self-esteem combined with fear of intimacy. Some experts believe that some sex addicts do not experience much pleasure in these frequent acts, though they may find relief from guilt, shame, and other negative feelings (MedicineNet.com, 2012). 4. People with extreme cases of sexual compulsion may suffer from childhood sexual victimization and may be filled with such pain, shame, and guilt that they are afraid of sexual pleasure and avoid intimacy by having sex with numerous partners, including strangers (Carnes & Adams, 2002). 5. There may be a link between sexual addiction and sexual orientation. Although heterosexual men may participate in sex tourism and other extreme sexual behaviors, gay men may engage in compulsive sexual contacts and take undue sexual risks. If they engage in such risky behavior frequently enough, the behavior may look like compulsive sexuality. Gay men who have experienced homophobia, discrimination, and victimization may be sad or depressed. They may cope with these effects through substance abuse and risky sexual behavior (Stall et al., 2001). Additionally, gay men may experience a higher incidence of childhood sexual abuse, which may lead them to have fear, pain, and avoidance of intimacy if they were not treated for this abuse, which might contribute to compulsive sexual behavior (Arreola, 2006; Diaz, 1998). Some treatment for sexual addiction follows this protocol: First, people admit that they have a problem; second, they seek help; and third, they change their behavior with the help of professionals and the people who care for them (Carnes & Adams, 2002). Sexual addiction may be a myth, but sexual well-being is not. Taking care of the self in these ways can help people create a healthier life. Discussion 15.3: Are Paraphilias Abnormal or Just Kinky? Would it be better to just say a paraphilia is just kinky sex that is not for everyone, rather than label it a sexual disorder? If it’s labeled just kinky, engaging in a particular sexual behavior then becomes a matter of individual choice and pleasure, rather than a disease or mental illness. Some medical doctors and researchers now question whether it is accurate to label everyone who has a paraphilia abnormal and in need of treatment (Derogatis et al., 2010). The question, then, is this: Is it better for society to allow individual sexual variation and sexual freedom than to label it as mental illness? Yes: It would be better to drop outdated psychiatric models and stereotypes because they belong to another era when everyone was expected to conform to one mode of sexual norm in Western societies—namely, face-to-face sex between a man and a woman. It’s the classic problem of victimless crimes—that is, consenting adults doing what they want in their own bedroom with no one being hurt against their will. The controversy continues to erupt in the basic issues of how therapists provide treatment (Colmes, Stock, & Moser, 2006). Experts say that many people who have paraphilias don’t harm anyone, are not psychologically impaired, and might find partners who enjoy the same pleasures, such as rough anal sex. No: Society needs to set a boundary between what is normal and abnormal in sexual behavior, because some people are not capable of setting such boundaries for themselves. Evidence shows that paraphilias continue to be a serious problem for society and people can become out of control with them. People can be hurt or kill themselves with some forms of paraphilias if they don’t realize what they are getting into. Some doctors say society needs the category of paraphilia, because labeling some sexual behaviors as such helps to keep sex orderly, and may help prevent people from sexually acting out against others or from being imprisoned. Sexual freedom can go too far. What’s Your Perspective? 1. What does the concept of paraphilia mean to you? The concept of paraphilia refers to sexual interests or behaviors that deviate from societal norms, often involving unconventional or extreme sexual practices. These behaviors are typically considered atypical or unusual, and they may be the subject of clinical interest or concern. The question of whether to label paraphilias as simply "kinky sex" rather than a sexual disorder is complex and has sparked debate among medical professionals and researchers. Those who argue for dropping the label of paraphilia as a disorder often cite the importance of recognizing individual choice and sexual pleasure. They suggest that consensual sexual behaviors, even if considered unconventional, should not be pathologized. On the other hand, proponents of maintaining the concept of paraphilia as a disorder argue that there are instances where paraphilic behaviors can lead to harm, either to oneself or to others. They emphasize the need for society to set boundaries and distinguish between normal and abnormal sexual behaviors to protect individuals who may not be capable of setting such boundaries for themselves. Ultimately, the debate over paraphilia reflects broader discussions about sexual norms, individual freedom, and societal regulation of sexual behavior. The challenge lies in balancing the rights of individuals to express their sexuality as they choose with the need to prevent harm and maintain social order. 2. If it is better to let people exercise extreme sexual behavior, what should they do to protect themselves from harm? If society chooses to allow individuals to engage in extreme sexual behavior without labeling it as a disorder, there are several steps individuals can take to protect themselves from harm: 1. Education and awareness: Individuals should educate themselves about the risks and potential consequences of their sexual behaviors. This includes understanding the legal implications, potential health risks, and impact on personal relationships. 2. Consent and communication: It is crucial for individuals to ensure that all parties involved in any sexual activity consent and are fully informed about the nature of the activity. Open and honest communication can help prevent misunderstandings and potential harm. 3. Seeking professional help: While not everyone who engages in extreme sexual behavior needs treatment, it can be beneficial for some individuals to seek the guidance of a mental health professional. This can help them better understand their behavior and develop healthy coping mechanisms. 4. Setting boundaries: Individuals should be aware of their own limits and boundaries when it comes to sexual behavior. It is important to recognize when a behavior may be harmful or crossing a personal boundary. 5. Support networks: Having a support network of friends, family, or support groups can provide individuals with a safe space to discuss their feelings and experiences, and seek advice if needed. Ultimately, allowing individuals to exercise extreme sexual behavior while ensuring they protect themselves from harm requires a combination of education, communication, self-awareness, and support. 3. Do you know people who engage in paraphiliac sexual behaviors, and if you do, how do you relate to them? I would approach such individuals with an open mind and without judgment. It's important to recognize that consenting adults have the right to engage in sexual behaviors that bring them pleasure, as long as they do not harm others. If I were to encounter someone who engages in paraphiliac behaviors, I would strive to understand their perspective and respect their choices, provided they are not causing harm to themselves or others. I would also encourage open communication and a non-judgmental attitude, recognizing that everyone has their own unique sexual preferences and boundaries. Discussion 15.4: Should Transvestism be a Mental Disorder? A classroom discussion of the status of transvestism as a mental disorder can draw out a variety of diagnostic issues, especially the significance of “harm” and “dysfunction” as well as the role of values in demarcating normal and abnormal. Male transvestism is unusual, but statistical infrequency in and of itself is insufficient to qualify it as a mental disorder. The DSM requires distress and impairment in order to make the diagnosis, but a recent study found transvestic men to be normal on a wide variety of measures of personality, sexual functioning, and personal distress (Brown et al., 1996, Journal of Nervous & Mental Disease, vol. 184, pp. 265-273). Most peoples’ immediate reaction to descriptions of the disorder involve pathologizing, making this an interesting disorder to discuss with respect to the boundaries of abnormality. The question of whether transvestism should be considered a mental disorder is complex and has evolved over time. Historically, transvestism, now more commonly referred to as cross-dressing, was classified as a mental disorder in diagnostic manuals such as the DSM (Diagnostic and Statistical Manual of Mental Disorders). However, in more recent years, there has been a shift in understanding and the classification of transvestism. One key consideration is the concept of harm and dysfunction. The DSM requires that a condition causes distress or impairment in order to be considered a mental disorder. Research, such as the study by Brown et al. (1996), has found that many transvestic individuals do not experience significant distress or impairment in other areas of their lives. This challenges the notion that transvestism should be automatically classified as a mental disorder based solely on statistical infrequency or atypical behavior. Moreover, the classification of mental disorders is not solely based on objective criteria but also involves societal values and norms. The immediate reaction of many people to descriptions of transvestism as pathologizing highlights the role of societal attitudes in defining what is considered normal or abnormal behavior. In conclusion, the discussion of whether transvestism should be classified as a mental disorder involves considering not only the presence of distress or impairment but also the role of societal values in defining abnormality. The evolving understanding of gender identity and expression further complicates this discussion, highlighting the importance of a nuanced and inclusive approach to mental health classification. Discussion 15.5: Double Standards How would you know if a woman had a transvestic fetishism? In fact, DSM-IV-TR recognizes transvestism only in males. Do class members view women who dress in men’s clothing differently than they view men who dress in women’s clothing? What would a woman have to wear to unambiguously be in male attire – a tuxedo? More generally, how are feminine males perceived compared to masculine females? Why is the term “sissy” more pejorative than the term “tomboy”? Why can women stand closer to each other and have more intimate friendships with each other than men? We often speak of the narrow social constraints placed on female gender roles, but isn’t the opposite more the case? The question of how to identify transvestic fetishism in women raises important issues related to gender norms and societal perceptions of gender expression. It is worth noting that the DSM-IV-TR, which is an older version of the Diagnostic and Statistical Manual of Mental Disorders, does indeed focus on transvestism in males, reflecting historical biases and assumptions about gender and sexuality. In many societies, there is a double standard regarding gender expression, with women often having more flexibility in their attire and behavior compared to men. A woman wearing traditionally male clothing, such as a tuxedo, may not be automatically seen as having a fetish, as women are generally more socially permitted to cross traditional gender boundaries in their dress. In contrast, men who dress in traditionally female clothing may face more stigma and assumptions about their motives or sexual preferences. The terms "sissy" and "tomboy" reflect societal attitudes toward gender expression. "Sissy" is often used in a derogatory manner to shame boys or men who are perceived as feminine, reinforcing the idea that femininity in males is undesirable. "Tomboy," on the other hand, is often seen as a more positive or acceptable term for girls who exhibit more masculine traits, reflecting societal norms that value masculinity over femininity. The perception of feminine males compared to masculine females is often influenced by societal stereotypes and expectations. Masculine females may be seen as strong, independent, and empowered, traits that are often valued in many societies. On the other hand, feminine males may be viewed with more suspicion or disdain, as they are seen as deviating from traditional masculine norms. The question also touches on the idea of social constraints placed on gender roles. While it is true that women have historically faced narrow constraints in terms of their gender roles, particularly in terms of domesticity and caregiving, men have also faced constraints related to expressing emotions, seeking help, or deviating from traditional masculine roles. The perception of women being able to have closer and more intimate friendships with each other than men may be related to societal norms that encourage emotional expression and closeness among women, while men are often socialized to be more reserved and stoic in their relationships. Overall, the discussion of double standards in gender expression highlights the complex interplay between societal norms, stereotypes, and individual expression of gender identity. It underscores the importance of challenging rigid gender norms and promoting acceptance and understanding of diverse gender expressions. Discussion 15.6: What’s the Concern with Voyeurism? Ask students what’s the big deal with concerns over voyeurism? What about exhibitionism? Why would APA be concerned about these behaviors? Remind students that these behaviors are largely illegal firstly (e.g., peeking toms, flashers on subways), secondly they may also be related to criminal escalating behaviors which would be the real concern. That is, much like drug use, tolerance increases. What starts as peeking in a neighbor’s window may eventually no longer provide sexual release for the perpetrator and eventually the individual may need to up the ante so to say to achieve sexual release (e.g., breaking in to houses). Some researchers have argued that voyeurism should not be considered a separate disorder, as most exhibitionists are also voyeurs (Langevin, 1983) The concerns over voyeurism and exhibitionism are multifaceted and relate to both legal and psychological issues. 1. Legal Concerns: Both voyeurism (the act of observing unsuspecting individuals, usually strangers, who are naked, in the process of disrobing, or engaging in sexual activity) and exhibitionism (exposing one's genitals to others) are often illegal, as they violate the privacy and consent of others. Peeping Toms and flashers are examples of individuals who engage in these behaviors illegally, often causing distress and fear in their victims. 2. Psychological Concerns: The American Psychiatric Association (APA) and other mental health professionals are concerned about these behaviors because they can be indicative of deeper psychological issues. For example, voyeurism and exhibitionism may be related to a lack of empathy or respect for others' boundaries, as well as underlying sexual dysfunction or dissatisfaction. 3. Escalating Behaviors: One of the primary concerns with voyeurism and exhibitionism is the potential for escalating behaviors. Just like drug use, individuals engaging in these behaviors may develop a tolerance over time, leading them to seek more extreme or risky behaviors to achieve the same level of arousal. This can lead to increasingly dangerous and criminal behaviors, such as breaking into houses or engaging in more aggressive forms of exhibitionism. 4. Overlap Between Voyeurism and Exhibitionism: Some researchers argue that voyeurism and exhibitionism should not be considered separate disorders because many individuals who engage in exhibitionism also have voyeuristic tendencies. This overlap suggests a common underlying issue related to sexual arousal and boundary violations. In conclusion, the concerns over voyeurism and exhibitionism are not only related to their illegal nature but also to the potential for escalating behaviors and underlying psychological issues. Recognizing and addressing these behaviors early on is important for the well-being of both the individuals engaging in them and their potential victims. Discussion 15.7: Why Are Paraphilias So Much More Common Among Men? The paraphilias are almost never diagnosed in females. Sexual masochism is the most common paraphilia found among women, but even masochism is diagnosed 20 times more frequently in men. What might account for this enormous difference? Among the possible explanations is the fact that men are generally more likely to be arrested, and their sexual misbehaviors are therefore more likely to come to the attention of authorities. Anthropologically speaking, it may be that male external genitalia have become more sexually conditionable via evolutionary pressures. Similarly, lower male investment in gestation and nursing of offspring might confer reproductive advantages on promiscuity and sexual improvisation that would not have benefited females. Finally, as described in Lecture Launcher 12.3 Double Standards, men may operate within narrower sex roles, pushing more activities outside accepted ranges. For instance, women are permitted to wear men’s clothing but not vice versa. The higher prevalence of paraphilias among men compared to women can be attributed to a combination of biological, social, and cultural factors. Here are some possible explanations: 1. Biological Factors: There may be biological differences between men and women that contribute to the development of paraphilias. For example, some researchers suggest that male external genitalia may be more sexually conditionable due to evolutionary pressures. Additionally, differences in brain chemistry and hormonal influences could play a role in the expression of paraphilic behaviors. 2. Evolutionary Pressures: From an evolutionary perspective, men's lower investment in gestation and nursing of offspring may have led to a greater emphasis on promiscuity and sexual improvisation, behaviors that could increase reproductive success. This may have contributed to a higher prevalence of paraphilias among men. 3. Social and Cultural Factors: Societal expectations and norms around gender roles may also play a role. Men may feel more pressure to conform to narrow definitions of masculinity, which could lead to the exploration of sexual behaviors outside of traditional norms. Additionally, social and cultural attitudes toward male and female sexuality may influence the reporting and diagnosis of paraphilias, with women potentially facing greater stigma and reluctance to seek help for paraphilic behaviors. 4. Detection and Reporting Bias: There may be a bias in the detection and reporting of paraphilic behaviors, with men more likely to be arrested or otherwise come to the attention of authorities for their sexual behaviors. This could lead to an overrepresentation of men in clinical diagnoses of paraphilias. 5. Diagnostic Criteria: The diagnostic criteria for paraphilias may also contribute to the underdiagnosis of paraphilias in women. The criteria may be biased toward male expressions of paraphilic behavior, leading to a perception that paraphilias are primarily a male phenomenon. In conclusion, the higher prevalence of paraphilias among men compared to women is likely due to a complex interplay of biological, social, and cultural factors. Further research is needed to fully understand the underlying causes of this disparity. Discussion 15.8: Mutual Consent: When to Say “Yes,” “No,” or “Maybe”? Consent means agreeing to something, even in the area of sexual novelty between longtime partners. Giving consent to be bound and gagged for sex, however, seems more complicated than how people usually talk about giving consent. Possibly that’s because such a behavior seems more extreme, and it’s unknown how willing the partner may be to go along with this request, let alone find it sexually arousing. Giving mutual consent to engage in a sexual interaction that involves pain, punishment, and humiliation thus raises issues about how people agree to engage in any behavior that goes beyond the mainstream sexual norms. When people have powerful sexual urges and are not able to control them, at least not entirely, the question arises as to whether we should think of consent differently, not as a yes-or- no choice, but as a spectrum of possible willingness that could include “maybe” or “yes, but be careful,” or “we have to have a ritual that you have to do exactly as I say or else I won’t agree” (Stoller, 1991). In fact, many couples who engage in S and M create signals to communicate “that’s enough” or “stop” or “do it but in this way.” These ritual rules of S and M can help the masochist feel in control of the sexual interaction and may actually have power over the sadist, whether in reality or in a mental fantasy script (Stoller, 1986). The concept of mutual consent in sexual relationships, especially in the context of sexual novelty and behaviors that go beyond mainstream norms, is complex and nuanced. While consent is typically understood as a clear yes or no choice, in certain situations where there are powerful sexual urges or desires, the idea of consent may need to be expanded to include a spectrum of possible willingness. This spectrum could include responses such as "maybe," "yes, but be careful," or even the establishment of specific ritual rules to ensure both partners feel in control and comfortable. In the context of behaviors like bondage, domination, and sadomasochism (BDSM), where pain, punishment, and humiliation may be involved, clear communication and mutual understanding of boundaries and desires are crucial. Many couples who engage in BDSM create signals or establish rules to indicate when an activity should stop or how it should be carried out. These rituals can help the masochist feel in control of the sexual interaction and may also give them power over the sadist, either in reality or in a mental fantasy. It's important to recognize that consent in these situations is not just a one-time agreement but an ongoing process of communication and negotiation. Both partners should feel empowered to express their desires, set boundaries, and communicate their comfort levels throughout the sexual interaction. This approach can help ensure that both partners are fully consenting and that the experience is safe, consensual, and mutually satisfying. Polling Questions Polling 15.1: Sexual Addiction—Reality or Myth? Researchers probe issues surrounding sexual compulsivity and sexual addiction, but there is no consensus regarding these issues as of yet (Bancroft & Vukadinovic, 2004). Sexual addiction is apparently not confined to sport celebrities such as golfer Tiger Woods or actors like Michael Douglas, Eric Benét, and Charlie Sheen. Consider the story about Greg, a 28-year-old married man in the retail industry. He states that he has been “addicted” to masturbating and porn for years. Recently his wife discovered messages he was posting on Craigslist looking for women to sexually hook up with. She became furious and threatened to leave him and take their children. He still sits for hours watching online porn, as if he can’t get enough of it. He is shy around women and says that this addiction is taking over his life. He feels powerless to stop it, but even when thinking of seeking help, he also feels an urge to view porn online. Some critics may say that sexual addiction is an easy excuse for people to do what they want, but after learning of stories like Greg’s, they seem to be in distress. How many of you think that sexual addiction is real? How many of you know someone who says they are addicted to sex? The question of whether sexual addiction is real or a myth is a topic of ongoing debate among researchers and mental health professionals. While some argue that sexual addiction is a legitimate disorder characterized by compulsive and harmful sexual behavior, others believe that it may be better understood as a symptom of other underlying issues, such as anxiety, depression, or trauma. Greg's story highlights some of the characteristics often associated with sexual addiction, such as a sense of powerlessness to control sexual urges, continued engagement in the behavior despite negative consequences, and a feeling that the behavior is taking over one's life. However, it's important to note that not everyone who engages in excessive sexual behavior meets the criteria for addiction, and the concept of sexual addiction is not universally accepted by all experts in the field. In discussing this issue, it can be helpful to consider the following points: 1. Complexity of Human Behavior: Human sexuality is complex, and what may appear as addiction in one person may be a different issue in another. Factors such as personal values, cultural norms, and individual experiences can all influence how sexual behavior is perceived and experienced. 2. Diagnostic Criteria: One challenge in defining sexual addiction is the lack of consensus on diagnostic criteria. Unlike substance use disorders, which have clear criteria outlined in the DSM-5, there is no universally accepted set of criteria for diagnosing sexual addiction. 3. Treatment and Support: Regardless of whether sexual addiction is considered a legitimate disorder, individuals who feel their sexual behavior is causing distress or negatively impacting their lives can benefit from seeking help from mental health professionals. Therapy and support groups can provide a safe space to explore underlying issues and develop healthier coping mechanisms. 4. Personal Experiences: The perception of sexual addiction may vary among individuals based on their personal experiences and beliefs. Some may feel that the concept of sexual addiction resonates with their own struggles, while others may view it as an excuse for irresponsible behavior. In conclusion, the question of whether sexual addiction is real or a myth is complex and multifaceted. While some argue that it is a legitimate disorder that requires treatment, others believe that it may be better understood within the context of broader psychological and social factors. Regardless of the terminology used, it is important to approach issues related to excessive sexual behavior with compassion, understanding, and a willingness to explore underlying issues. Activities Activity 15.1: What Do You Consider Pleasurable Sex? Test your own feelings regarding what is pleasurable by taking the following quick self assessment. To help determine how you feel about each question, answer using this scale: 1 – Never; 2 – Almost never; 3 – Sometimes; 4 – Often; 5 – Always 1. Anal sex is enjoyable to me. 2. I like my partner to kiss me against my will. 3. I enjoy being tied up with a scarf or some restraint that I can get out of easily because it feels exciting to me. 4. I enjoy being spanked sometimes, but not too hard. 5. I enjoy wearing sexy clothes that are so revealing that some people might say I am exposing myself. 6. I like my intimate partner to handle me roughly. 7. Oral sex is very pleasurable to me and I can’t get enough of it. 8. Watching porn with my partner to get aroused is very exciting to me. 9. I can get turned on easily watching other people have sex. 10. I like seeing two people of the same sex make out because it arouses me. 11. I like my partner to play with my genitals to the extent that sometimes I feel sore afterward. 12. I like to act out my fantasies of being treated like a naughty school child by my partner who then gets aroused to have sex with me. 13. I really like sex toys and want to use them to get aroused when I make love. 14. The idea of my partner bringing home a stranger to have sex with us in a 3-way is exciting. 15. I like dressing up in the clothes of the opposite gender and pretending that I am like that when I have sex with my partner. Now score yourself. If you answer with all “1s,” meaning all “never,” you would score 16 points and may find plain vanilla sex pleasurable. If you answer with all 5s (all “always”), you would score 80 points and may find very kinky sex pleasurable. 65—80 points Very kinky sex 49—64 points 33—48 points Moderately kinky sex 17—32 points 0—16 points Vanilla sex Activity 15.2: Does Pornography Enhance or Damage Sexual Relationships? One of the most controversial issues in sexuality and human relationships is pornography. Psychologists, sociologists, therapists, clergy, and politicians all seem to quibble about the impact that pornography has on people and their intimate relationships. Pornography, which at one time was not very accessible, is now easily found on the Internet and on adult cable channels and on-demand services. Researchers have begun to study whether easy access to pornography affects relationships and reshapes expectations about sex (Paul, 2004). In other words, does pornography damage sexual relationships? Place students in groups make some “yes” and some “no” provide the groups with 20 minutes and then have them debate the topic. This could also be done on the discussion board easily. Yes: Some psychologists and sociologists argue that men who frequently view porn may develop unrealistic expectations about how women should look and behave. Due to these unrealistic expectations, men may have a more difficult time forming and sustaining relationships and feeling sexually satisfied. Some therapists think that Internet pornography is giving rise to a new form of sexual compulsiveness. According to one researcher, 15% of regular consumers of online pornography develop sexual behavior that disrupts their lives (Schneider & Weiss, 2001). Sometimes pornography can tear couples apart. At a 2003 meeting of the American Academy of Matrimonial Lawyers, two-thirds of the 350 divorce lawyers who attended said that the Internet played a significant role in divorces in the previous year, with excessive interest in online porn contributing to more than half of such cases (Paul, 2004). No: Most consumers of online pornography say that sex online is nothing more than good fun. According to a 2001 online survey of more than 7,000 adults, two thirds of those who visited pornographic websites said their online activities did not affect their level of sexual activity with their partners (Paul, 2004). Some therapists believe that pornography is a healthy way to refresh relationships or spark desire. The key is for consumption of porn to be mutual and seductive to the partners. The partners need to find the material to be “erotic” rather than “pornographic.” The difference is that porn can be objectifying and derogatory while erotica depicts mutually satisfying sex between equal partners. You can then assign students to write a brief paragraph describing their perspective. 1. Do you think pornography is a healthy way to enhance or spice up intimacy? Enhancement of Intimacy: Some argue that pornography can be a healthy way to enhance or spice up intimacy. It can serve as a tool for couples to explore their sexual desires, learn new techniques, and communicate openly about their preferences. When both partners are comfortable with it, pornography can add variety and excitement to a relationship. 2. Do you believe that it presents an element of danger to personal and intimate aspects of a relationship? Damage to Intimacy: On the other hand, critics argue that pornography can present an element of danger to personal and intimate aspects of a relationship. Excessive consumption of pornography can lead to unrealistic expectations about sex, body image issues, and a diminished desire for real-life intimacy with a partner. It may also contribute to feelings of betrayal or insecurity if one partner feels that the other is prioritizing pornography over their relationship. In conclusion, whether pornography enhances or damages sexual relationships can vary greatly depending on the individuals involved, the nature of their relationship, and how pornography is incorporated into their sexual interactions. It's important for couples to communicate openly, set boundaries, and ensure that both partners feel comfortable and respected in their sexual activities. Internet Resources http://www.forensicpsychiatry.ca/paraphilia/overview.htm An overview of the paraphilias http://archive.constantcontact.com/fs003/1102908923221/archive/1103050720626.html National Coalition for Sexual Freedom http://www.psychologytoday.com/conditions/paraphilias An overview of treatment of paraphilias http://www.mhhe.com/socscience/sex/common/ibank/set-1.htm McGraw Hill Image Gallery for Human Sexuality. http://www.mhhe.com/socscience/psychology/psychonline/general.html McGraw Hill Higher Education General Resources for Students and Faculty. http://www.apa.org/ The APA website. http://www.apa.org/topics/sexuality/index.aspx APA site for research on sexuality. The Ten-Minute Test Name: __________ Answer the questions below utilizing the following terms: Extreme Paraphilias BDSM Kink Consent Pornography Sexual addiction Sex toys Behavioral Vibrators 1. _____ sexual behaviors are risky sexual behaviors between consenting adults that test the limit of what a culture tolerates within its sexual spectrum. 2. _____ is an expanding area of sexual culture that is about extreme sexual behavior and not about paraphilias. 3. _____ is a concept that points toward compulsive sexuality. 4. A medical category created in the 1920s to describe abnormal sexual arousal to individuals, objects, or situations that depart from mainstream normative or typical behavior in a community and cause distress or serious problems is _____. 5. _____ is not a paraphilia but may involve behaviors that connect some people with paraphilias. 6. Theories about the origins of paraphilia include psychoanalytic, _____, and sociobiological ones. 7. _____ and other sexual enhancements are now accepted as mainstream. 8. People may use _____ to enhance pleasure in their sexual experience. 9. _____ and respect is a critical part of all normative sexual relationships. 10. One way to enhance sexual novelty and well-being for individuals and between couples if kept in balance with other aspects of life is for them to involve _____. Answers to the Ten-Minute Test 1. Extreme 2. Kink 3. Sexual addiction 4. Paraphilias 5. BDSM 6. Behavioral 7. Vibrators 8. Sex toys 9. Consent 10. Pornography Solution Manual for Human Sexuality: Self, Society, and Culture Gilbert Herdt, Nicole Polen-Petit 9780073532165, 9780077817527

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