Health

Why Do We Know So Little About Human Sex?

We can’t understand the origins of human sexual expression without knowing more about how we actually behave.

By Anne Fausto SterlingJun 1, 1992 5:00 AM

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Because I am a biologist, my friends have assigned me the role of resident expert on any news, rumor, or fad having even the slightest connection to the life sciences. Questions about human sexuality--that topic of eternal interest to us all--certainly top the list of queries my buddies shoot hopefully in my direction. What causes homosexuality? Do farm boys really experiment with animals? Are kids reaching puberty at ever younger ages? I’m as eager as anyone to talk about these questions, even at some length, but deep down I realize that we know far too little to answer them accurately.

Last summer, for example, the newspapers and weekly magazines buzzed with reports of a finding by Simon LeVay that the brains of male homosexuals and male heterosexuals differed. LeVay had found a structural variation located in the hypothalamus, a part of the brain involved with the regulation of hormones and some sexual activities. Many people think he has obtained evidence of a biological cause of homosexuality. But when, inevitably, my friends asked me what I thought, I came back again and again to what I see as a central flaw: LeVay had no specific information about the sexual behavior of the men in his study.

In LeVay’s study either you’re gay or you’re straight. He thinks that the men from his heterosexual group, whose brains he obtained at autopsy, were straight. But he doesn’t really know for sure. They might have been gay but in the closet, or they might have lived straight, married lives yet had an occasional liaison with a man. He also thinks that his homosexual group represented men who engaged in sex with high frequency. But here too he doesn’t know what kinds of sex acts they did nor how often they did them.

The presumption that most people are heterosexual and the idea that heterosexuality and homosexuality represent sharply distinct behaviors seem reasonable to most of us. But human behavior is far more complex than that. One survey of gay men and women in San Francisco, for example, used the plural word homosexualities to emphasize the diversity of behaviors subsumed under the term homosexual. Self-defined homosexuals turned out to live very varied lives. Some were monogamous and in long-term relationships; others engaged in frequent sex with total strangers. Male and female homosexuality were different in practice. They may eventually be shown to differ in origin as well. LeVay surmised that his sample of homosexual men had frequent sex; could the brain differences he found, if confirmed, correlate with frequency of sexual activity rather than with orientation?

We can’t understand the origins of human sexual expression without knowing more about how we actually behave. But sexology, the study of human sexual behavior, began only in the twentieth century. The first, and the most famous, modern scientific survey appeared a mere 44 years ago under the title Sexual Behavior in the Human Male, coauthored by Alfred Kinsey, Wardell Pomeroy, and Clyde Martin. It underwent nine reprintings in the first year and a half of publication.

Kinsey and his co-workers discovered a continuum of sexuality. They developed a heterosexual-homosexual rating scale, which they divided into seven categories, from exclusively or predominantly heterosexual to exclusively or predominantly homosexual. Where sex is concerned, it turned out, you find all sorts of shades of gray. They found that 37 percent of the male population surveyed had some overt homosexual experience, that most of these experiences occurred during adolescence, and that at least 25 percent of adult males had more than incidental homosexual experiences for at least three years of their lives.

Not surprisingly, howls of protest met the Kinsey study’s conclusions. When it comes to the scientific investigation of sexuality, European-American culture does not have a good track record. Pioneer sexologists included the German Richard von Krafft-Ebing and the Englishman Havelock Ellis, and many found their work dangerous. In 1897 Ellis published a book that treated homosexuality in neutral, scientific tones. His British publisher quickly faced criminal prosecution for issuing a lewd, wicked, bawdy, scandalous, and obscene book. In The Well of Loneliness, written a couple of decades later, novelist Radclyffe Hall describes the lesbian protagonist as she comes across one of Krafft-Ebing’s books, which her father has forgotten to return to its locked cabinet. Trembling, she reads for the first time a description of her condition. Hall’s fictional revelation of these secrets led to a 1928 court declaration banning the novel as obscene. The judge ordered all copies seized.

In 1919 in Germany, Magnus Hirschfeld founded the Institute for the Study of Sexual Behavior, which housed more than 20,000 volumes, numerous photographs, and archival material. Interest in the topic grew, and by the 1930s about 80 sex-reform organizations opened clinics in which professionals and laypeople offered medical and sexual information. The flourishing of such knowledge didn’t last long. In 1933, months after their rise to power, the Nazis attacked Hirschfeld’s institute and burned its books and papers in the street.

Nor did Kinsey escape unscathed. In 1954 the American Medical Association attacked him for contributing to a wave of sex hysteria. Conservative congressman Louis Heller called for an investigation, urging that Kinsey’s work be barred from the U.S. mails. He accused him of contributing to the depravity of a whole generation and the spread of juvenile delinquency. Under political pressure from the House Committee to Investigate Tax-Exempt Foundations, the Rockefeller Foundation, which had funded Kinsey’s work, withdrew its support. Kinsey died of a heart attack two years later, a death some say was hastened by the vilification of his work.

Regrettably, this story turns out to have a contemporary echo. Over the past three years conservative House members and senators have again intervened to halt studies and a new national sex survey that would have provided us with the first truly comprehensive accounting of sexual behavior in this country since the Kinsey report. Current epidemiological estimates of the spreading patterns of sexually transmitted diseases still rely on Kinsey’s data even though they are badly out of date. Behavior has certainly changed in the interim, and Kinsey’s sample, large as it was, did not represent a cross section of the American population.

Indeed, such is our state of ignorance that in 1989 scientists from the National Research Council warned in a report that we don’t know enough to win the war against sexually transmitted diseases, including AIDS. To devise a sensible strategy, they reported, we need to know the prevalence of sexually risky behaviors associated with AIDS transmission in low-risk as well as in high-risk groups. We also have to understand the social contexts promoting risky behavior, and the relationships among sex, drug use, and alcohol consumption.

The report called for longitudinal studies--following the behavior of groups of teens for several years, for example--and for research on how to accurately gather information about behavior that many feel squeamish discussing. There are still many puzzles about AIDS transmission. Among them is that in developing countries the virus is spread mostly by heterosexual sex. But in the United States heterosexual sex seems a minor means of transmission, at least so far, compared with homosexual sex or intravenous drug use. What makes our country so different? At the time of the National Research Council report, studies to answer some of these questions were just getting under way, but since then projects have ground to a sudden and discouraging halt.

Here’s what happened. About four years ago the National Institute of Child Health and Development (NICHD) awarded a contract to Edward Laumann, dean of the division of social sciences at the University of Chicago. He was to plan an update of the outmoded Kinsey report and amass the kind of information that would guide public health decisions. Laumann assembled a national team to design a survey that would throw light on practices relating to contraception, fertility, and disease prevention. The researchers wanted the science in the study to be beyond reproach, so they worked hard to solve difficult methodological problems. They asked very basic questions: How would they get the answers they needed from people without violating their privacy? Could they control for interviewer bias-- would a male respond differently to a female interviewer than to a male interviewer? How would they check the validity of the answers?

But Laumann and his co-workers wanted to do more than simply gather raw statistics. They wanted to know how social networks influence behavior. Most epidemiological models of the spread of sexually transmitted diseases use estimates of the average number of sexual partners a person has in a given population. For example, statistics might show that on average, women born after 1950 have ten partners in their lifetime.Traditional models would presume that their mating is more or less random. Laumann thinks this is a poor way to model the spread of sexually transmitted diseases. People engage in different patterns of sexual activity at different times of their lives. For instance, after a burst of experimentation in her teens and twenties, a woman might remain monogamous for 20 years, divorce, and have several sexual partners before returning to monogamy. Hence you might expect a different pattern of disease spread in a population where most women are under age 30 than in one where most women are older. Social and economic status also play a role. Sex between partners of the same age, ethnic group, and economic standing may be more openly negotiated, thereby lessening the risk of unprotected sex.

So Laumann proposed a model of sexual behavior as something done by couples living in social networks, rather than by randomly acting individuals, as most epidemiological models presume. His proposal was of such high quality that the NICHD was set to launch the national study when, in 1989, Senator Jesse Helms (Republican of North Carolina) and Congressman William Dannemeyer (Republican of California) caught wind of it. When they were done, the Office of Management and Budget and the House Appropriations Committee had withdrawn funding for the project.

Meanwhile, researchers at the Carolina Population Center (part of the University of North Carolina) had designed a longitudinal study of teenage sexuality of the sort called for by the National Research Council. They planned to study teens’ sexual behavior, ranging from contraceptive use to homosexual activities, taking into account education, religion, and family and peer-group interactions. Their proposal was submitted to the NICHD (the appropriate branch of the National Institutes of Health), was peer-reviewed, and received a high-priority score; in 1991 the researchers received their first year of funding for a five-year survey of 24,000 teenagers and their parents. In July 1991, however, Helms and Dannemeyer reentered the scene and successfully pressured Secretary of Health and Human Services Louis Sullivan into canceling the project.

The story doesn’t end there. In October 1990 Laumann applied for a grant from the NICHD to do a more limited adult sex study, using the approaches developed for his ill-fated national survey. His application received rave reviews and a funding priority placing him in the top 2 percent of grants reviewed at the time. Funding seemed all but assured. The following year NICHD director Wendy Baldwin told him it would be political suicide to award him the money.

It so happened that on September 12, 1991, Senator Helms had introduced an amendment to the NIH appropriations bill, which determines the money allotted to projects and individual institutes within the NIH. Helms proposed that the money earmarked for sex surveys be removed from the NIH budget. Instead, he wanted the same dollar amount transferred to that portion of the Adolescent Family Life Act devoted to encouraging premarital celibacy (that is, just say no). Voting on the amendment, he argued, would provide senators with a clear choice between right and wrong. In a one- two punch Congressman Dannemeyer introduced the same amendment in the House. The amendment passed in the Senate, failed in the House, and the House-Senate Conference Committee later dropped it from the final bill. Nevertheless, the debate on both the House and Senate floors had the desired effect. Funding for Laumann’s research is on indefinite hold.

Why were the surveys canceled? A broad cross section of the scientific and medical community felt they represented cutting-edge research. The quality of the science had never been in question. Instead, it seems that Senator Helms and Congressman Dannemeyer’s deep-seated hatred and fear of homosexuality are at issue. Last August Dannemeyer told a Los Angeles Times columnist that he believes the sex surveys are the idea of a conspiratorial cell of homosexuals who operate inside the Department of Health and Human Services. The following month Helms took the Senate floor to say: The NIH funds these sex surveys . . . to ‘cook the books,’ so to speak, in terms of presenting ‘scientific facts’--in order to do what? To legitimize homosexual life-styles, of course.

Mr. President, he went on, let me just say that I am sick and tired of pandering to the homosexuals in this country.

The surveys, Helms argued, are not really intended to stop the spread of AIDS. The real purpose is to compile supposedly scientific facts to support the left-wing liberal argument that homosexuality is a normal, acceptable life-style. . . . As long as I am able to stand on the floor of the U.S. Senate, he added, I am never going to yield to that sort of thing, because it is not just another life-style; it is sodomy.

Helms concluded by gay-baiting both of Laumann’s coinvestigators- -distinguished social scientists and acknowledged homosexuals--repeating that the surveys are part and parcel of the homosexual movement’s agenda to legitimize their sexual behavior.

And so the battle rages on. On one side stands the social science and medical community, which wants to know what people do behind closed doors. These researchers don’t want to gain prurient pleasure from it, or judge it, or encourage it. They wish merely to devise sound public health policies aimed at stopping the spread of a deadly disease. On the other stand two powerful legislators and their conservative constituencies. Their approach to stopping the spread of sexually transmitted diseases is simple: just say no to any kind of sexual activity other than heterosexual relations within the confines of marriage. During the past three rounds of the fight, the top managers at Health and Human Services have put their money on the conservatives. Who will be left standing at the end of the fight remains to be seen.

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