H

HAIRE, NORMAN
HERMAPHRODITES
HINDUISM
HIRSCHFELD, MAGNUS
HOMOPHOBIA
HOMOSEXUALITY
HOMOSEXUALITY AND LESBIANISM: CROSS-CULTURAL PERSPECTIVES
HORMONES: THE ENDOCRINE SYSTEM
HUMOR AND SEX
HYMEN

HAIRE, NORMAN

Norman Haire (1892-1952), a native Australian, received his degree in medicine at the University of Sydney, moved to London, and opened a practice as a specialist in obstetrics, gynecology, and sexology. He was one of the founders of the first medical birth-control clinics in Great Britain, and in 1922 he served as chairman of the contraceptive section of the International Birth Control Conference in London.

Haire's interest in sex problems started with questions of fertility and sterility but soon covered a much wider field. He visited Magnus Hirschfeld in Berlin and studied briefly with him, and visited many other European countries. He attended the Congress for the International Society for Sexual Research, organized by Albert Moll, but kept in contact with Hirschfeld. Haire was one of the organizers and later an officer of the International Congress of the World League for Sex Reform, whose first officers were Hirschfeld, Havelock Ellis, and August Forel; in 1930, Haire was elected copresident with Magnus Hirschfeld.

After the Nazis came to power, Haire unsuccessfully strove to keep the international sexological movement going. He translated some of Hirschfeld's works and produced his own, including the Encyclopaedia of Sexual Practice. He also founded, edited, and financed the Journal of Sex Education, which ceased publication after his death in 1952.

REFERENCES

Haire, N., ed. The Encyclopaedia of Sex Practice. London: Encyclopaedic Press, 1938.

Haire, N., ed. Sexual Anomalies and Perversion: A Summary of the Works of the Late Magnus Hirschfeld. London: Encyclopaedic Press, 1938, revised 1952.

Hans Lehfeldt
Connie Christine Wheeler

HERMAPHRODITES

Normal Embryonic and Fetal Development
Abnormal Genetic Development
Klinefelter's Syndrome
True Hermaphroditism

Hermaphroditus, a minor god in the ancient Greek pantheon, was the quintessential androgynous being. According to Greek mythology, Hermaphroditus was the son of the messenger god, Hermes, and Aphrodite, the goddess of love; he became united in one body with a nymph while he was bathing. According to the statue found in Centuripe, Hermaphroditus possessed male genetalia, voluptuously developed female breasts and hips, and soft, feminine facial features. There are many surviving statues and murals from ancient Greece and Rome attesting to the interest shown in this phenomenon by these peoples.

The myth of Hermaphroditus embodies the almost universal belief in the ancient eastern Mediterranean world that sexual attraction is due to the two sexes having originally been one. In his Symposium, Plato tells of an ancient time when the world was inhabited by three sexes—males, females, and hermaphrodites. Males had a penis both fore and aft, females had two vaginas, and hermaphrodites had a penis on one side and a vagina on the other. Despite this bounty of organs, reproduction was asexual, being joylessly accomplished by "emission onto the ground, as is the case with grasshoppers." When these proto-humans dared challenge the gods, Zeus had them cut in half lengthwise. Feeling itself an incomplete being, each creature began to yearn for its alter ego. Plato saw in the finding and embracing of one's "better half the origin of love. Because only the former hermaphrodite creatures had the necessary complement of male and female organs, only they could reproduce; the reuniting of the former male and female spheres resulted in gay and lesbian love.

Hermaphroditism and sex reversal abound among plants and many insects and animals. Earthworms can impregnate or become pregnant—even by themselves—and many narcissistic types apparently prefer self-fertilization. Qua-hogs (thick-shelled clams) are all born males and remain so during the activity of their youth, after which about half of them metamorphose into the passivity of femaleness. Guppies can switch their sex back and forth within seconds.

Until the present century, the definition of hermaphroditism was quite simple: a hermaphrodite was a person who possessed to varying degrees the sexual genitalia of both sexes. In this age of exploding knowledge in genetics and endocrinology, simple anatomical definitions no longer suffice. The new terminology defines the true hermaphrodite (hermaphroditus verus) as an individual who possesses both ovarian and testicular tissue. These may be in the form of one ovary and one testicle, gonads composed of both kinds of tissue (ovotestis), or any combination of the preceding. Individuals with matched gonads (two testes or two ovaries) but whose external sexual appearance is ambiguous are now classified as pseudohermaphrodites, of which there are several varieties.

Humans were all once hermaphrodites of sorts. Our sexual configuration is the product of sex chromosomes passed on by our parents. Because females have only X sex chromosomes, we can receive only an X from our mothers; we can receive an X or a Y from our fathers because males carry both kinds. If we get two Xs, we become XX genotypical females; if we get an X and a Y, we become XY genotypical males. It is the Y chromosome that determines human sex. The "basic" human is female; it is not the presence of two Xs that makes a female, but rather the absence of the Y chromosome. Sometimes children are born with several X chromosomes, such as the XXX, XXY, or even XXXXY patterns. Although the X chromosome carries far more genetic information than the Y, no matter how many X "units" of femaleness the fetus has, the presence of a single Y results in the male pattern of sexual differentiation. The extra Xs, however, do affect development, since it is characterized by hypogonadism As discussed below, individuals with the extra Xs are classified as having Klinefelter syndrome. The single exception to this male differentiation by possessors of a Y chromosome is the XY genotype with androgen-insensitivity syndrome.

Normal Embryonic and Fetal Development

In the normal course of embryonic and fetal development, certain genetic and hormonal events occur that differentiate us along sexual dimorphic lines compatible with our genotype. At about six to ten weeks, a single gene labeled SRY, for "sex determining region of the Y," causes the rudimentary gonads of the male to change to testes; without the SRY gene, they become ovaries. At about five months, testicular androgens cause the penis and scrotal sacs to develop; without androgens, the vagina, clitoris, and labia develop.

Our brains are also "sexed" dimorphically by the action of fetal testosterone and its by-products, dihydrotestosterone and estrogen, as they interact with the hypothalamus, the limbic system, and the cerebral cortex. These hormonal secretions first sensitize the male brain to the effects of testosterone and later activate the brain to engage in male-typical behavior. Male-female brain differences are particularly striking in areas of the hypothalamus that participate in the regulation of male-typical sexual behavior. There are, however, wide individual variations.

Unlike the external genitals, the internal reproductive structures do not develop from the same anlagen. In this sense, all embryos are hermaphroditic, possessing both male Wolffian and female Müllerian ducts. At about three months, androgens from the male testes cause the Wolffian structures to develop into the male internal sex organs (i.e., vas deferens, seminal vesicles, and ejaculatory duct). The fetal testes also secrete Müllerian inhibiting substance (MIS), which causes the Müllerian structures to atrophy. Without androgens, the Wolffian structures degenerate, and without MIS the Müllerian structures develop into the female internal sex organs (i.e., uterus, Fallopian tubes, and upper portions of the vagina).

Abnormal Genetic Development

With all these (and many other) genetic and hormonal events occurring at the embryonic and fetal stages of life, it is inevitable that nature makes occasional mistakes. The substances (androgens and MIS) secreted by the testes are vital in diverting the fetus from the basic human female form. Without testes and the substances they secrete, a fetus will invariably be a female. Persons with a single X chromosome (XO) are known as Turner's syndrome girls. This condition is typically caused by an X-bearing sperm penetrating a sex chromosome-empty egg. A Turner's syndrome child is unmistakably female (often exaggeratedly so) in her behavioral and intellectual patterns, is very short (about 4' 8"), lacks secondary sex characteristics, and is infertile. Although the Turner's syndrome child usually has a normal verbal IQ, she is significantly below population norms on performance (visual-spatial) IQ, which is reflective of low androgen levels.

The importance of the androgens in masculinization is dramatically manifested in the congenital adrenal hyperplasia (CAH) and the androgeninsensitivity syndromes. CAH is an autosomal recessive trait that, through a number of possible enzymatic defects, causes decreased production of cortisol by the adrenal mesodermal cortex. This allows for an increased secretion of adrenal testosterone and results in precocious sexual development in males and the masculinization of the genitalia in females.

CAH is the most common cause of genital ambiguity among females, with infants showing varying degrees of clitoral enlargement (sometimes to the point of matching the male penis in size) and varying degrees of fusion of the labia. Because the androgen stimulus arrives too late to switch on the Wolffian ducts, virilization involves only the external genitalia. If CAH females are given cortisol treatments and have any defects involving their reproductive organs surgically corrected, they will menstruate, gestate, and lactate. CAH is the only intersex condition in which normal sexual functioning, including fertility, is probable. If CAH is untreated, there may be further masculinization of the external sex organs. CAH females evidence significantly more male-typical behavior than normal females, suggesting that their brains have been masculinized to some extent by excess adrenal testosterone.

The androgen-insensitivity syndrome is an X-linked recessive syndrome that causes an XY genetic male to develop as a phenotypical female. Because MIS has done its job and caused the Müllerian structures to atrophy, there are no internal female organs; but since the androgen cannot do its job developing the Wolffian structures because of cell insensitivity, there are no internal male organs either. Because the external genitalia are unambiguously female, this condition is rarely diagnosed until puberty, when patients become concerned over failure to menstruate. Apart from being about three inches taller than the typical XX female and having both little body hair, which depends on androgens, and a short vagina, the XY androgen-insensitive person is totally female in external appearance. These genetic males, unresponsive to the masculinizing effects of testosterone in the brain, conform to the typical behavioral patterns of normal women.

An interesting variant of the androgen-insensitivity syndrome -was discovered among 23 interrelated families in the Dominican Republic by Imperato-McGinley and her colleagues. They studied 38 individuals who appeared at birth to be unambiguous females, and who were raised as such. Actually, these children were XY males who lacked an enzyme important to male sex-hormone synthesis called 5 alpha-reductase. Although these children had normal male levels of testosterone, they almost entirely lacked dihydrotestosterone because of the missing enzyme. At puberty, these children underwent a physical transformation to maleness, including growth of the penis and descent of the testes.

These guevedoce ("penis at 12") males were able to make the social and psychological transitions to the male role with relative ease despite 12 years of female socialization. This suggested to Imperato-McGinley that while dihydrotestosterone is necessary for the promotion of the external male sex characteristics at birth, testosterone makes for a relatively normal masculine puberty and has a masculinizing effect on the brain in utero to form the normal male gender identity despite the absence of dihydrotestosterone. A study of five 5 alpha-reductase deficient males raised as females in a much more sex-segregated culture (the Sambia of New Guinea) found these individuals had a more difficult time making the gender switch, sometimes in circumstances of social trauma. Thus, although sociocultural factors are significant in the formation of gender identity, the concept of psycho-sexual neutrality at birth is contrary to the evidence and to the laws of biology.

Klinefelter's Syndrome

Klinefelter's syndrome is when males have two or more X chromosomes and one or more Y chromosomes, the XXY pattern being the most common. They are referred to as genetic hermaphrodites because they have both the female (XX) and male (XY) chromosome patterns. Klinefelter's syndrome boys tend to be born to older mothers, and the syndrome appears to be the result of a fault in the genetic control of cell division in the ova. They are undetectable at birth except by genetic karyotyping; they may have smaller-than-normal testes but a penis that is capable of erection and satisfactory intercourse. As a rule, the ejaculate of these men contains no sperm. They tend to be taller than normal males in adulthood and to develop relatively well-formed breasts at puberty. They have about half the male postpubertal amount of testosterone, which accounts for their low level of sexual activity and the female pattern of hair growth and loss. Klinefelter's males often have sexual identity problems, and they are significantly more likely than XY males to be homosexual, bisexual, transvestites, transsexuals, and inmates in prisons and mental hospitals. The risk of mental retardation is greater than among normal males and becomes more likely the greater the frequency of additional chromosomes.

From the above discussion, it might seem that the anatomical definition of sex may be somewhat anachronistic. Today, there is a relatively simple method of precisely determining sex called nuclear sexing. This method takes advantage of the fact that females have two X chromosomes, which means that they have body cells containing both maternal and paternal chromosomes carrying different genetic information. Geneticists call this phenomenon genetic mosaicism. The female is a natural genetic mosaic; the male is not because he has only one X chromosome.

The genetic instructions on both Xs cannot be activated within the same individual, so the genes on one X are inactivated. Which chromosome is inactivated is randomly determined, with different Xs active in different cells. When a chromosome is inactivated it remains so throughout life. The inactivafaon of the genes on a chromosome causes a darkly staining material called chromatin to be visible on the cells of females called the Barr body. If staining reveals the Barr-body (chromatin), the person is a female; if not, a male.

The anomalous thing about this is that the Turner's syndrome individual is considered a female anatomically and behaviorally, yet she is Barr body negative because of the absence of the second X. The Klinefelter individual—male in appearance and rearing—is Barr body positive because he has two or more Xs. So while some believe that the sex-chromatin method is a helpful criterion for correct sex diagnosis and for revising our concepts of hermaphrodism, it has ambiguities.

True Hermaphroditism

The precise etiology of true hermaphroditism is less well known, although it is known that it is genetic rather than hormonal in nature. One kind of true hermaphroditism for which the etiology is known is XX/XY chimerism. A chimera is an individual organ or part having a diverse genetic constitution; for example, a plant graft union is a compound of incongruous parts. True hermaphroditism is sometimes the result of chimerism—the presence in a single individual of cells derived from different zygotes. Three types of chimerism—blood, transplacental, and whole body—have been identified; whole-body chimerism is the most likely type to result in hennaphroditic sexual development (i.e., the presence of both ovarian and testicular tissue and ambiguous genetalia). Whole-body chimerism results from the fusion of two zygotes that normally would have been separate XX and XY dizygotic twins.

Other mosaic or chimeric complements (e.g., XX/XXY, XX/XXYY, XX/XYY) are known, and there has been one documented case of quadruple mosaicism—XO/XX/XY/XXY. This person has the karyotypes for Turner's syndrome, normal femaleness, normal maleness, and Klinefelter's syndrome. He was raised as a male and phenotypically, except for a very small penis, incomplete labioscrotal fusion, and a femalelike fat pattern, appeared so. It was speculated that this complex mosaicism probably arose from multiple disjunctions involving an XXY zygote during mitosis.

The majority (about 70 percent) of true hermaphrodites have karyotypes indistinguishable from those of the normal male or female. XY hermaphrodites are Barr body negative and XX hermaphrodites are Barr body positive (XX/XY hermaphrodites are Barr body positive, but they have a lower chromatin count than normal). Since both karyotypes have ovarian and testicular tis- sue, they offer rare proof that ovarian tissue can develop absent a second X chromosome and that testicular tissue can develop absent a Y chromosome.

It is possible that XX and XY hermaphrodites may constitute cases of undetected chimerism, but the great majority of these cases have been traced to genetic accidents. There is a single gene on the Y chromosome that carries the Testes Determining Factor. All females, then, have all the genes necessary to make a male except this crucial one, and all males would be females without its diverting power.

Recent studies of XX males and XY females have verified this. Y-specific DNA has been found in XX males, indicating that Y-linked sequences leading to testis differentiation have been transferred to the X chromosome (translocation). An abnormal gene on the X chromosome homologous to the gene for testis differentiation on the Y chromosome has been discovered among XX hermaphrodites. On the other hand, the loss of these Y-linked sequences in individuals with XY gonadal dysgenesis allows for female differentiation. Thus discordance among karyotype, phenotype, and gonadal histology may be explained in terms of translocation (in the XX case) or deletion (in the XY case) of a critical segment of the Y short arm that carries the Testes Determining Factor. Cases of XX hermaphroditism have been reported that could not be explained by translocation, deletion, or chimerism, however.

Most true hermaphrodites (about 57 percent) are XX, and approximately 80 percent have internal female organs capable of sexual functioning and with some potential for fertility. However, stones of self-fertilization or of true hermaphrodites who have both sired and given birth to infants are fanciful myths. As of 1988, there were only 528 cases of true hermaphroditism documented in the world literature, and pregnancy has been documented in only seven XX true hermaphrodites and in one XX/XY chimera as of 1990. There are no reported cases of male hermaphrodite fertility.

A classification scheme for the external gem-taha of true hermaphrodites has been proposed by Luks and his colleagues based on the degree of male or female genital appearance. These classes range from class I (clitoris normal or slightly enlarged) to class VI (penis normal to small) and are distributed in an approximate normal curve with the two extreme classes being the rarest and classes III and IV the most common.

Although it appears that we have come full circle by again using external genital appearance to assign sex of rearing, doing so has practical consequences. The degree of virilization of the genitalia provides an indication of the extent of brain masculimzation: the more masculinized the genital features, the more likely the brain has been organized along male lines, the more feminine the genital features, the less brain masculinization has taken place. Although only about 30 percent of true hermaphrodites fall into the "male" classes (V and VI) in the Luks classification scheme, most true hermaphrodites have been reared as males. Physically and psychologically, most hermaphrodites would be better off raised as females. Surgical intervention can correct minor problems of the external female genitalia and even reconstruct a functional genitourinary system, but reconstructing a functioning penis is not possible at this time.

Needless to say, the social and psychological lot of the hermaphrodite is not a happy one Our sexual and gender identities are fundamental to defining who we are and how others respond to us. Depression, low self-esteem, and suicidal ideation are common among hermaphrodites of all types. Hermaphrodites were usually destroyed at birth in ancient Greece, and at least one female who turned into a male at puberty was burned alive in Rome.

There were some executions of hermaphrodites during the Middle Ages in Europe, although both civil and canon law of the time recognized hermaphroditism and allowed the father or godfather to choose the sex the child would be raised as at the time of baptism. At puberty, hermaphrodites were given the choice to retain the given sex or to change it. Having made the choice, it was imperative, on pain of being charged with sodomy, that they hold to the declared sex for life.

During certain periods in Hindu history, hermaphrodites were considered favorably, probably because of the belief that the Supreme Being possessed both the complete male and female principles A man was a man only because he had an "excess" of masculinity, and a woman was a woman only because she contained an "excess" of femininity, the ideal being harmony of the male and female principles. Hermaphrodites were also valued in practice as well as in principle as providers of alternative methods of sexual gratification.

REFERENCES

Barbin, H. Herculine Barbin: Being the Recently Discovered Memoirs of a Nineteenth-Century French Hermaphrodite. New York: Pantheon, 1980.

Borghi, et al. True Hermaphroditism: A New Case with Complex Mosaicism. Genetic Counseling, Vol. 1 (1990), pp. 81-88.

Bullough, V. Sexual Variance in Society and History. Chicago Univ. of Chicago Press, 1976.

Goodman, R. Genetic and Hormonal Factors in Human Sexuality: Evolutionary and Development Perspectives. In G Wilson, ed., Variant Sexuality Research and Theory. Baltimore: Johns Hopkins Univ. Press, 1987.

Herdt, G., and J. Davidson. The Sambian "turnim man": Sociocultural and Clinical Aspects of Gender Formation in Male Pseudohermaphrodites With 5-alpha-reductase Deficiency in Papua, New Guinea Archives of 'Sexual Behavior, Vol. 17 (1988), pp. 33-56.

Hoyenga, K.B., and K.T. Hoyenga. The Question of Sex Differences. Boston: Little, Brown, 1979.

Imperato-McGinley, J., et al. Androgens and the Evolution of Male Gender Identity Among Male Pseudohermaphrodites With 5 Alfa reductase Deficiency. New England Journal of Medicine, Vol. 300 (1979), pp. 1233-37.

LeVay, S.A Difference in Hypothalamic Structure Between Heterosexual and Homosexual Men. Science, Vol. 253 (1991), pp. 1034-37.

Luks, F., et al. Early Gender Assignment in True Hermaphroditism. Journal of Pediatric Surgery, Vol. 23 (1988), pp. 1122-26.

Money, J. Love and Lovesickness: The Science of Sex, Gender Difference, and Pair Bonding. Baltimore: Johns Hopkins Univ. Press, 1980.

Murchie, G. The Seven Mysteries of Life. Boston: Houghton Mifflin, 1978.

Page, D., et al. The Sex Determining Region of the Human Y Chromosome Encodes a Finger Protein. Cell, Vol. 51 (1987), pp. 1091-1104.

Raine, M. Absence of Y Specific DNA Sequence in Two Siblings With 46XX Hermaphrodism. Archives of Disease in Childhood, Vol. 64 (1989), pp. 1185-87.

Simpson, J. Disorders of Sexual Differentiation: Etiology and Clinical Delineation. New York: Academic Press, 1976.

Talerman, A., et al. True Hermaphrodite With Bilateral Ovotestes, Bilateral Gonadoblastomas and Dysgerminomas, 46, XX/46, XY Karyotype and a Successful Pregnancy. Cancer, Vol. 66 (1990), pp. 2668-72.

Anthony Walsh

HINDUISM

Hinduism, the traditional religion of the Indian subcontinent, teaches that the literature of love and sex is of divine origin, derived from a collection of all knowledge compiled in some 100,000 chapters by Prajâpati, the supreme god, creator of heaven and earth. Included in this was kâma, or the pursuit of pleasure particularly sexual pleasure. The transmission of this knowledge involved a complicated process, but eventually it was put down in the form in which it has survived by the sage Vâtsyâna (fl 450 C.E.) in his Kâmasûtra ("love text")

The Kâmasûtra covers most aspects of human courtship and mating, including positions in intercourse, and serves as the basic text for later writings on the subject by peoples of the Indian subcontinent. Chronologically next in line are the Kuþþani-mata, or the Lessons of a Prostitute, written by Dâmodaragupta in the eighth century and surviving in fragments; Samaya-mâtrikâ, or Prostitute's Breviary, written by Kshemendra (990-1065), the Ratt-rahasya (Mysteries of Passion) by Koka Pandita, dating from the 12th century, Panchaœayala (Five Arrows) written by Jvonrîúa in the 14th century; and the Anana Ranga (Theater of the Love God) wntten by Kalyanamalla in the 15th century. This last, because its author was a Hindu in the employ of a Muslim nobleman, spread throughout the Islamic world. There are many other sex manuals, hundreds of them, many quite crude, found in the various Indian vernaculars as well as Sanskrit; many commentaries on the various love manuals also exist. Though all detail more or less the same themes, some, such as the Ratt-rahasya, are more detailed in spelling out sexual positions. The Rati-rahasya also gives a classification system for a variety of female types.

The number of erotic classics suggests that the peoples of the Indian subcontinent did not hold the fear of sex that some of their Western counterparts did. In fact, unlike the Judaeo-Christian description of the creation of humanity as an asexual affair, Hindus put creation itself in sexual terms. The "Hymn of Creation" in the Rig Veda attributes the beginning of creation to sexual desire and calls it the primal germ of the mind. Indian religious documents such as the Atharva Veda, the fourth of the Hindu Vedas, include many magical formulations and incantations to help or hinder lovemaking, recover virility, or allow one to steal unnoticed into the home of the beloved.

This does not mean that Hinduism was without sex prohibitions Bestiality was condemned (although not by all), as was incest, rape, and adultery, and there are prohibitions against having sex with a woman during her menses and against having sex with the wrong caste. Although the ancient code of Manu, the mythical Indian lawgiver, has had the effect of law throughout much of the history of Hinduism, interpretations of the law have varied because of the wide range of cultural and doctrinal beliefs combined within Hinduism. This very diversity makes it difficult to single out any view of sexuality as official, since Hinduism lacks a common creed, set of dogmas, or practice and has no universally acceptable canon, no organized church as such, and no uniformity of worship. The religion itself could best be defined as a medley of faiths linked to some degree by the same pantheon of gods. There are hundreds of sects and, within most, numerous splinter groups based on a particular deity, guru, trait, or tenet held sacred. Obviously, within such a multitude of sects, sexual attitudes vary widely, and every generalization has exceptions.

The ultimate ends of men and women—salvation, bliss, knowledge, and pleasure—can be achieved by following any number of different paths, which vary according to the cult, creed, sect, and system. Such a variety is believed necessary because individuals differ in special abilities and competencies. Some adopt the method of good works, others perform the necessary rituals and sacrifices or follow certain ascetic principles, while still others make idols and build and consecrate temples. Usually, no single path is all-sufficient, a blending of two or more being regarded as essential. Faith is balanced with works, devotion with ritual, and so forth. Different sects adopt or encourage different ways, and a number of these emphasize sexuality.

The most celebrated deity of the Hindu pantheon is Krishna, worshiped as an independent god in his own right but also as the eighth incarnation of Vishnu Krishna is particularly noted for his interest in and devotion to the female sex, having some 16,018 wives according to tradition, each of whom gave him ten sons and a daughter. He is often portrayed in an amorous posture. His favorite sexual partner was Râdhâ, the loveliest of all milk maids, whose love for him was so all consuming that she ignored her family honor and disregarded her husband. Hindu poetry up to the 14th century delighted in describing their stormy, adulterous liaisons, but since that tune she has been portrayed as conforming to more conventional mores, and she came to be described as a wife rather than a mistress. One of the more famous poems about the love of the two was Gitâ-govinda ("Song of the Cowherd") by the 12th century Bengali poet Jayadeva. Jayadeva describes their lovemaking in some detail.

With the examples of the gods and the poets before them, the Hindus could give much freer reign to feelings of sensuality and sexuality than the Christians of the West. Sex was not only for procreation but could be engaged in for pleasure, power, and even magical purposes. The sex manuals pay little attention to sex for procreation but emphasize the other purposes. Pleasure, however, is defined primarily from a male rather than a female point of view. Women are portrayed as voluptuous creatures who are fair game for the more predatory male. There are a number of handbooks devoted to Stritantra, literally "the female lore," describing different kinds of females and their use as an instrument for man's passion. They also deal with women's physiological functions and other aspects of being female. The handbooks emphasize the need to arouse a woman, and to do so the male must acquire a thorough knowledge of the female erogenous zones—the breasts, nipples, nape of the neck, folds of the buttocks, labia, and clitoris. Different types of women have different sensitive areas or passion pulses to be explored, including the lobe of the ear, the middle of the palm, the navel, the anus, or the arch of the foot.

The chief source of ecstasy in the female is the yoni ("holder"), in a narrow sense the vulva; but in a broader sense it includes pubic hair, the opening or cleft of the labia, and the uterus. The yoni is considered to have a life of its own, being regarded as a sacred area, a pad of pleasure, an occult region worthy of reverence, and a symbol of the cosmic mysteries. It is described as the abode of pleasure, the source of great bliss, and the delight of delights, and is said to have been created specifically as honey to attract the male organ. It is likened to the second mouth, and it continually sends out a silent command to man to come and sip. It is the chief ruler of the universe, for it brings men in all walks of life under its control and subjection.

The penis is called the linga, and like the yoni it was also an object of veneration. The center of excitement for the male sexual feelings, the chakra, is situated at the root of the penis. The testes disclose the mystery of the yoni place, and the semen is called bindu Like women, men have erotic areas, and one especially sensitive place is the guda (anus).

In the sexual handbooks, lovemaking is often referred to as a refined form of combat. The man attacks, the woman resists, and, by the subtle interplay of advance and retreat, assault and defense, desires are mutually built up. But love differs from war in that the final result is a delightful victory for both partners. During the various stages of combat, the love partners can bite, scratch, pull each other's hair, or beat or slap each other on the shoulders, back, bosom, and buttocks with the palm of the hand, the back of the hand, the side of the hand, a half-open fist, or even a closed fist. Partners are cautioned, however, to avoid becoming too violent because neither the giving nor the receiving partner is always sensitive to the seventy of the blows delivered in passion. Various kinds of love marks (technically kamanka), such as the tiger's claw or the broken cloud, are described and placed into two categones, those made with the fingernails and those with the teeth. Lovemaking is also accompanied by vocal sounds, sitkrita, varying from a slow expulsion of breath through clenched teeth to sounds like the neighing of a horse, a deep sigh, or the hushing of a baby. There are various sobbing, cooing, moaning, humming, hissing, clucking, bellowing, and roaring sounds, which require the well-matched partners to respond Occasionally, there are verbal exclamations such as "I can endure no more."

Various postures are described for precoital foreplay and intercourse. There are as many as 16 precoital positions, depending on whether the couple is standing, sitting, or lying down. When the couple engages in intercourse they are faced with choosing from a number of different positions. Vatsyayana describes some 84 postures (if minor variations are included), but one of his commentators lists 729 variations. Not all these variations can be performed by a single couple; some also are highly dependent on the physical peculiarities of the individual or the genitalia. Postures are often named after animals, such as the cow, mule, donkey, cat, dog, tiger, and frog. Movements accompanying the postures are described as being like using the tongs, spinning the top, biting the board, churning the milk, and so forth.

It was a common belief in Hinduism that women enjoy sex much more than men do. One Indian proverb states that woman's power in eating is twice as great as man's, her cunning or bashfulness four times as great, her decisive-ness or boldness six times as great, and her impetuosity or delight in love eight times as great.

The sex act is also regarded as a form of psychospiritual communing. The rich, deep fulfillment of love between a man and a woman is a condition of happiness so natural, so simple, yet so real that it is the best of all earthly conditions. Inevitably, it was employed by the mystics as a symbol of divine communication in its transcendent and esoteric meaning. Sex is a way of revealing to man the hidden truth of the universe.

Copulation itself could bring about supernatural power, but only if the practitioner had learned to transcend the carnal state of sexual activity and risen above passion. To realize this state of absoluteness, the man had to conceive of himself as the male deity; then by worship he transfigured his partner until she became a female god and served as a consecrated field for his operation. The pair then united, physically, mentally, and spiritually. Hindu cultism is most active in this aspect of sex, with each sect or cult stipulating different ways of preparing for this union.

Some sects worship the linga, or male phallus; others, such as the Œaktás, consider the godhead to be essentially feminine and concentrate on Œakti, the wife of Œiva, although both are also known under different names. Her worshipers are broadly divided into two groups: "right-handed" adherents who worship the god in public and "left-handed" ones who worship her in secrecy. The left in Hindu mythology is associated with the female, and this type of worship can be classed as a form of Tantrism, so called because its adherents follow scriptures known as tantras. Essentially, tantric cults are antinomian, that is, they teach that men and women are not always bound by moral law but can reach a state that takes them so far beyond its purview that they can cease to obey its precepts. This results in a disregard for societal conventions. Hindu tantrics believe that the goddess Œakti is particularly gratified by prohibited and reprehensible acts that either ignore or transgress the established laws of society, morality, and religion; a key teaching is that spiritual union -with the god can best be attained through sexual union in the flesh. One such cult, the Sakhibhava, holds that only the godhead, Krishna, was truly male, while every other creature in the world was female, subject to the pleasure of Krishna. They worship Radha, the favorite consort of Krishna, and the object of their devotion is to become a female attendant upon her. Female followers of the sect grant sexual favors freely to anyone because they believe that all their sexual partners are Krishna himself. Male followers dress like women and affect the behavior, movements, and habits of women, including the imitation of menstruation, during which they abstain from worship. In the past, many of them emasculated themselves, and all were supposed to play the female part during sexual intercourse (allowing themselves to be penetrated) as an act of devotion. The technical term hijra is applied to these men, and there are still colonies of them in the India of today.

In the tantric sects, promiscuous intercourse is spoken of as an act of devotion to the deity and regarded as obligatory for all members. Tantrism teaches that there are two kinds of semen, male and female, and that these primordial male and female elements can be united into the nondual state of Absolute Reality through learning the secrets of intercourse. This can be done if the man does not ejaculate but practices coitus reservatus, which, according to tantric belief, allows the semen to be drawn up the spinal column. This technique of not spilling the seed is represented symbolically in Hindu art by the nîcha medhra, or "down penis." Such a penis is shown on the famous statue of the Jain saint Gomatesvara. Jainism, in fact, teaches that although sex is a gateway to salvation, sexual indulgence itself is a weakness and an evil to overcome because it is the chief manifestation of lust. The most extreme puritanical sect in Jainism is the Digambara, or nude sect, whose members at one time went about nude. Today, only the holy ones observe strict nudity.

All varieties of sexual intercourse were tolerated by Hinduism, although some forms were regarded by some groups with greater hostility than others. Oral-genital contact, for example, was classed by some lawgivers as equivalent to killing a Brahmin, and the sin involved could not be expiated in fewer than 100 incarnations. Nevertheless, the erotic manuals discussed it at length. The anus is regarded as one of the most important centers of psychic energy in the body, and anal intercourse either between males or between males and females is one of the main expedients for using the potential of this erotic center. Some medieval Indian writers regarded the practice as quite common and in no way perverse, but others claimed that men who engaged in it with other men were reborn as men incapable of begetting. Manu said that men who engaged in such activities lost their caste. Nonetheless, it seems clear that sex between males was tolerated if not encouraged at least among some sects of Hinduism. Lesbianism is also mentioned, and the 4th-century writer Kautilya, who looked with some disfavor on such practices, recommended imposing very minimal fines, much less than those for many other sexual activities, when people were discovered in such relationships. Bestiality, though condemned by Manu, was also tolerated under certain conditions, and many of the gods had contacts with animals. Even necrophilia played a part in some of the tantric rituals and in some of the Saivite sects. The practitioner sits in a graveyard or cremation ground with a skull pressed against his genitals. In other cases, he lies prostrate or squats on a cadaver until the flesh decays. In the so-called black ritual, the adept sits astride a recently deceased male and animates the body until the penis becomes erect and ejaculates, the fluid is then collected.

Hinduism embraces a wide variety of cults and sects, and within it can be found a range of adherants from ascetic celibates to necrophiliacs. In all its forms, it recognizes the pleasures inherent in sexuality, and in much of Hinduism this is exalted and praised. Temple statues, particularly those made before the Muslim conquests and the entry of the British into India, often portray sexually symbolic scenes. The gods themselves were very sexual. The Hindu sex manuals have achieved a worldwide reading public and influenced ideas about sex in religious traditions from Buddhism to Islam to Christianity.

REFERENCES

Bullough, V.L. Sexual Variance in Society and History. Chicago Univ. of Chicago, 1956.

Chunder, P.C. Kautilya on Love and Morals. Calcutta: Jayanti, 1970.

Devi, K. The Eastern Way of Love: Tantric Sex and Erotic Mysticism. New York: Simon & Schaumann, 1977.

Kalyânamalla. Ananga Ranga. Translated with an introduction and comments by T.Ray. New York: Citadel Press, 1964.

Lal, K. The Cult of Desire. New Hyde Park, N.Y.: University Books, 1966.

Meyer, J.J. Sexual Life in Ancient India. Reprint. New York: Barnes & Noble, 1953.

Rajneesh, B.S. The Book of Secrets. New York: Harper Colophon, 1976.

Thomas, P. Kama Kalpa or the Hindu Ritual of Love. Bombay: D.B. Taraporevla, 1959.

Vâtsyâna. Kama Sutra. Translated by R. Burton. Reprint. New York: Dutton, 1925.

Walker, B. The Hindu World. 2 vols. New York: Praeger, 1968.

Vern L. Bullough

HIRSCHFELD, MAGNUS

German sexologist Magnus Hirschfeld (1868-1935) was born in the seaside town of Kolberg, the son of Jewish parents and the seventh of eight children. During his student days, he vacillated between writing and medicine before finally following his father and two older brothers into medicine.

Early in his practice, Hirschfeld received a letter from a patient, an officer who had committed suicide the previous day, on the eve of his wedding. The officer explained that he could no longer pretend to be heterosexual and asked Hirschfeld to make his story public so others could benefit from it. The suicide and Hirschfeld's writing about it strongly influenced him to study sexual variations and to work for the rights of homosexuals.

Hirschfeld probably did more for homosexuals than anyone else of his generation. In 1897, he cofounded the Wissenschaftlich-Humanitäre Komitee (Scientific-Humanitarian Committee); its purpose was both to conduct research on homosexuality and other sexual variations and to work toward abolishing Paragraph 175 of the German criminal code, which defined homosexuality as a criminal offense. Himself a homosexual, Hirschfeld viewed homosexuality as a natural, inborn condition, not a sickness, and was deeply committed to eradicating pubic prejudice against homosexuals through education. After studying 10,000 male and female homosexuals, he used their histories as the basis for his book Die Homosexualität des Mannes und des Weibes (The Homosexuality of Men and Women), which convinced many that homosexuality was not a perversion.

In addition to his work on homosexuality, Hirschfeld studied and published on a wide variety of topics, among them love, bisexuality, prostitution, sex crimes, and alcoholism (including the effects of drinking on the unborn fetus and the effects of drugs and alcohol on sexuality). Using direct observation, he was the first to study transvestites and argued that transvestism—a term he coined—is a sexual variation distinct from homosexuality. (Psychoanalysts at the time believed it fell into the category of homosexuality.)

During his long career, Hirschfeld brought to fruition many "firsts" in sexology. In 1899, he edited the first scientific journal on homosexuality, Jahrbuch für Sexuelle Zwschenstufen (Yearbook for Sexual Intermediaries). Published for 24 years, it was a valuable recording of the scientific contributions of the time. In 1908, he edited the first scholarly publication dedicated to a wide range of sexual issues, Zeitschrift für Sexual-wissenschaft (Journal of Sexual Science); it was published for one year before being incorporated into another periodical. And in 1919, he was both consultant and actor for Anders als die Andern (Different From the Others), the first film aimed at educating the public about homosexuality.

Also in 1919, Hirschfeld opened the Institute for Sexual Science in Berlin, the first of its kind in the world. Located in a palatial mansion he had purchased, the Institute housed the first marital counseling clinic, a medical department, research laboratories, and a library with more than 20,000 volumes, 35,000 photographs, and 40,000 biographical letters and confessions. The primary aim of the Institute was to conduct research in sexual biology (e.g., the role of the endocrine system in sexual physiology and psychology), sexual pathology (case histories of sexual minorities or people with psychosexual problems), sexual sociology (e.g., abstinence, marriage, and prostitution) and sexual ethnology (sexuality in other cultures and at other times). Courses were also available to physicians and students interested in sexual science, while question-and-answer sessions were offered to the public. In addition, the Institute provided treatment for problems such as lack of sexual desire, sexually transmitted disease, infertility, and vaginismus, as well as medical and legal expert testimony. In the first year alone, more than 4,000 people, many from other countries, visited the Institute to use its library, learn about ongoing research, and attend lectures. In 1924, Hirschfeld turned the Institute over to the German government; little changed, however, and he continued as director.

Other Hirschfeld "firsts" included cofounding the first sexological society, Ärztliche Gesellschaft für Sexualwissenschaft und Eugenik (Medical Society for Sexology and Eugenics), in 1913, and organizing the world's first international congress on sex research, the International Conference for Sexual Reform Based on Sexual Science, in 1921. During the second congress, in 1928, Hirschfeld helped establish the World League for Sexual Reform, whose goal was to organize an international community promoting social progress through science.

With Nazism looming, Hirschfeld left Germany at the end of 1930, beginning what turned out to be a world tour that included the United States, Japan, China, the Philippines, Indonesia, Ceylon, India, Egypt, and Palestine. During the journey, Hirschfeld was enthusiastically received, lecturing to both academics and the public and observing the sexual attitudes and customs of the places he visited.

On May 6, 1933, while Hirschfeld was still abroad, the Nazis dissolved the Institute, destroying the greater part of the library in a public burning. Two months earlier, Karl Giese, Hirschfeld's secretary and collaborator at the Institute, had secretly left Berlin, probably bound for France, taking with him some of the irreplaceable documents and valuables for safekeeping. The fate of these materials is unknown, but some of Hirschfeld's other papers are now in the archives of the Kinsey Institute for Sex Research in Bloomington, Indiana.

Because it was unsafe to return to Germany, Hirschfeld settled in Switzerland and then Pans, where he established the Institut François des Sciences Sexologiques. Although similar to the Berlin Institute, it lacked the staff and wealth of materials of the original and failed to gain much recognition. In 1934, Hirschfeld dissolved the French Institute and moved to Nice, where he died the following year. He was cremated and buried at the Cauçade Cemetery in Nice.

REFERENCES

Haeberle, E.J. The Jewish Contribution to the Development of Sexology. Journal of Sex Research, Vol. 18 (1982), pp. 305-323.

Hoenig, J. Dramatis Personae: Selected Biographical Sketches of 19th-century Pioneers in Sexology. In J. Money and H. Musaph, eds., Handbook of Sexology, Vol. 1. New York: Elsevier, 1978.

"Wolff, C. Magnus Hirschfeld: A Portrait of a Pioneer in Sexology. New York: Quartet Books, 1986.

Diane Morrissette

HOMOPHOBIA

Defining Homophobia
Research on Attitudes About Homosexuality
The Social Construction of Homosexuality

George Weinberg is credited with coining and popularizing the term "homophobia" in his landmark book Society and the Healthy Homosexual. He used the term to explain the dread felt by heterosexuals when near homosexuals as well as the self-hatred many homosexuals feel in relation to their own sexual orientation. During the 20 years since Weinberg introduced the term, a body of literature has developed that explores and critiques its use. Common usage has expanded the definition to include other negative attitudes about gay and lesbian people. This entry reviews the definitional debates and research findings regarding attitudes about homosexuality and briefly analyzes the role homophobia has played as an emergent concept in the social construction of homosexuality.

Defining Homophobia

In 1967, Churchill used the term "homoerotophobia" to describe a cultural fear of same-sex eroticism and sexuality. Churchill's contention was that negative attitudes about homosexual behavior and people are a reflection of a sex-negative culture, whereby the sex drive is believed to pose a threat to social organization. Weinberg's later explanation of homophobia emerged from Churchill's theory. Homophobia, according to Weinberg,

appears as an antagonism directed toward a particular group of people. Inevitably it leads to disdain of these people, and to the mistreatment of them. This phobia in operation is prejudice, which means we can widen our understanding of it by considering the phobia from the point of view of its being a prejudice and uncovering its chief motives.

There seems to be agreement that for some people a phobic response (as traditionally defined) to homosexuality is present but that this fails to account for or accurately describe the complex ways homophobia is experienced by the majority of people. Nonetheless, homophobia is still the commonly accepted term to describe the range of feelings and attitudes that often result in behaviors such as avoidance, joking and derision, violence and homicide, self-hate, and suicide.

Research on Attitudes About Homosexuality

With his explanation of the psychology of positive and negative attitudes toward homosexual people, Herek provides a brief overview of the literature on reactions to lesbian and gay people. He reports that findings are contradictory about the relationship between sex-role conformity and attitudes toward these groups. The consistent patterns that have emerged in the literature are that persons with negative attitudes toward lesbian and gay people are less likely to have had personal contact with them; they are also less likely to report having engaged in homosexual behaviors or to label themselves lesbian or gay. They are more likely, especially if they are males, to perceive their peers as manifesting negative attitudes; more likely to have resided in areas where negative attitudes are the norm; more likely to be older and less well educated; more likely to be religious, to attend church frequently, and to subscribe to a conservative religious ideology; more likely to express traditional and restrictive attitudes about sex roles or to have more guilt and negativity about sexuality; and more likely to express high levels of authoritarianism and related personality characteristics.

With regard to sex differences, the literature is fairly consistent in terms of the direction and intensity of attitudes. Heterosexuals show a tendency for more negative attitudes toward homosexuals of their own sex than of the other sex, and more negative attitudes are reported by males than by females.

Herek provides his own model for explaining attitudes toward homosexuality. Arguing that attitudes serve psychological needs, he suggests that three major needs are likely to be met by one's attitudes toward lesbian and gay people: (1) experiential, (2) defensive, and (3) symbolic. Experiential attitudes are the result of feelings and ideas associated with past contacts with lesbian and gay people, associations which are used to make generalizations about all gay men and lesbians. Defensive attitudes emerge to help an individual deal with an internal, unconscious struggle or anxiety by projecting it onto lesbian and gay people. Attitudes are likely to function defensively when the individual perceives some similarity between his or her own unconscious conflict and homosexual people. A symbolic function occurs when attitudes express abstract ideological concepts that are integral to one's personal and group identities. Symbolic attitudes express values important to one's concept of self, thereby helping individuals to establish their identity and affirm their notion of the sort of person they perceive themselves to be. At the same tune, attitudes mediate relations to other important individuals and reference groups. In this way, people who think of themselves as "good Christians" may hold negative views toward homosexuality, if that is consistent with their reference group's Christian interpretation of homosexuality. Likewise, people who conceive of themselves as civil libertarians may hold more positive attitudes as a result.

Whereas Herek's model conceptualizes homophobic attitudes with reference to the psychological needs they serve, Ficarrotto's study was designed to understand the independent roles of sexual conservatism and intergroup prejudice in the development of the homophobic personality. He reports that both sexual conservatism and social prejudice are independent and equal predictors of antihomosexual sentiments. Given that people may hold the same attitudes and beliefs for different reasons, Ficarrotto concludes that for some people homophobia may be a function of a set of rigid beliefs and ingrained feelings that sexuality is negative. For others, homophobia might be best explained as a general personality trend toward prejudice. Accordingly, someone who is racist and sexist may also be homophobic, but not all people who hold racist and sexist attitudes are necessarily homophobic.

Homophobia has multiple roots and meanings. Any attempts to change antihomosexual attitudes are going to require a range of interventions that individually and collectively address the distinct psychological needs maintained by these various belief systems. Despite this, there is evidence that some educational programs are effective in promoting more positive attitudes toward homosexuality.

Given the apparent relationship between homophobia and the problems of antigay and antilesbian violence, sexism, and teen suicide, combatting homophobia continues to be an important part of the contemporary lesbian, gay, and bisexual political movements' agendas in the United States.

The Social Construction of Homosexuality

It is important to note the role that Weinberg's use of the term "homophobia" plays in shaping the public discourse regarding homosexuality. Weinberg's focus on antihomosexual attitudes, prejudices, and related discriminatory behaviors is significant in relation to ideological shifts in the social construction of the meaning of homosexuality. Although the meanings ascribed to the homosexual person have varied historically, in Western culture over the past few centuries these varied identities have shared the common element of being devalued. The meanings have included sinfulness, criminality, and sickness.

Within the political climate of the civil rights movement and the second wave of the women's movement in the United States, gay liberation emerged publicly in the late 1960s. Part of the political agenda was to combat the medical model that labeled homosexuality as sick or pathological and refocus on the civil liberties of the individual. As a consequence, lesbian, gay, and bisexual people are now often viewed as members of a minority group with the shared experience of oppression due to prejudice and discrimination. This is in contrast to the popular view of lesbian, gay, and bisexual people as sharing a psychiatric diagnosis with other deviates.

Weinberg's use of medical language to talk about the disease of homophobia and the healthy homosexual is symbolic of the shift altering the socially constructed meaning of homosexuality. Given the Stonewall rebellion in 1969, which symbolized the start of the contemporary gay liberation movement in the United States, and the pressure in the early 1970s on the American Psychiatric and American Psychological associations to remove homosexuality from their lists of mental disorders, Weinberg's work can be seen as contributing to and emerging out of a new perspective.

While sinfulness, criminality, and mental illness are seen as historically ascribed meanings of homosexuality, they still persist in various forms today. This analysis is not intended to suggest that the ideas about homosexuality have been altered entirely with the introduction of the concept of homophobia. Rather, the discourse regarding homophobia has been intricately related to this changing ideology by supporting the conceptualization of lesbian, gay and bisexual people as a sexual minority. There is clearly increased acceptance for framing homophobia, and not homosexuality, as a social problem today, and this is in part a function of the discourse on homophobia initiated by Weinberg.

While defining and analyzing the "problem of homophobia" has contributed to creating a more accepting social environment for lesbian, gay, and bisexual people to live in and make meaning out of their lives, there is still significant resistance to this change in frame of reference. Writing for the right-wing watchdog group Concerned Women for America, for example, Lussier says:

Until recent years, only ethnic groups and the disabled have been considered legal minorities. Members of these groups have no control over the factors that cause them to be a protected class. However, homosexuals who choose to engage in unnatural behavior, are not considered minorities in any legal sense. But if they have their own way, that will change.

Examining the research on homophobia clearly highlights how personal and emotional dimensions of individual psychology—as well as the complex social psychology of intergroup conflict, prejudice, and changing sexual and political ideologies—interface. While many more lesbian, gay, and bisexual people are living open lives based on self-acceptance, self-definition, and affirmation, there still exists a powerful climate of active violence and oppression The dialectic between hate and acceptance continues.

REFERENCES

Aguero, J.E., L. Bloch, and D. Byrne. The Relationship Among Sexual Beliefs, Attitudes, Experience and Homophobia. Journal of Homosexuality, Vol. 10 (Fall 1984), pp. 95-107.

Churchill, W. Homosexual Behavior Among Males: A Cross-Cultural and Cross-Species Investigation. New York: Hawthorn, 1967.

Ficarrotto, T.J. Racism, Sexism, and Erotophobia: Attitudes of Heterosexuals Toward Homosexuals. Journal of Homosexuality, Vol. 19 (1990), pp. 111-16.

Friend, R.A. Choices, Not Closets: Heterosexism and Homophobia in Schools. In L. Weis and M. Fine, eds., Silenced Voices. Buffalo: State Univ. of New York: Press, in preparation.

Herek, G.M. Beyond "Homophobia": Social Psychological Perspective on Attitudes Toward Lesbians and Gay Men. Journal of Homosexuality, Vol. 10 (Fall 1984), pp. 39-51.

Lussier, E. Gay. Activists Press Teachers on Sexual Minorities. Concerned Women for America, Vol. 13 (Aug. 1981), pp. 1, 11-12.

Weinberg, G.H. Society and the Healthy Homosexual. New York: St Martin's Press, 1972.

Richard A Friend

HOMOSEXUALITY

Definitions
The Sexual Aspects of Homosexuality
Psychological Adjustment
Relationship to Other Phenomena
Therapy
Conclusion

In all likelihood, more has been learned about homosexuality in the period since 1970 than at any other time in history. With this explosion of information has come the pleasant problem of interpreting it. But what has been notably lacking in the past 20 years are cogent theories that can make sense of the larger patterns in the data.

In this entry, information about male and female homosexuality is interwoven. Consequently, there is the danger that information about lesbians will be slighted, since there is much more known about male than female homosexuality. Nevertheless, the similarities between the sexes are common enough that much space and effort are saved by such a joint discussion. Readers should keep this caveat in mind.

Definitions

The controversies concerning the definition of sexual orientation are echoed in a similar controversy about the proper definition of homosexuality. The definition we prefer is Money's: "homosexuality" refers to same-sex sexual contact, either (1) as a genital act or (2) as a long-term sexuoerotic status. According to the first aspect of the definition, a homosexual act is any sexual act involving sexual arousal between two members of the same anatomic sex. According to the second aspect, a homosexual person is someone who is able to fall in love only with a person of the same anatomic sex or is able to be sexually aroused only by such a person.

These two aspects of the definition are themselves controversial. Some people believe that only the first aspect is tenable. Kinsey, for example, rejected terms like "a homosexual man" or "homosexuals" and was repeatedly forced to fall back on an unusual construction (i.e., "the homosexual," a noun form, meaning the homosexual as a phenomenon) when he referred to the topic. Even so, he was not able to avoid completely the use of phrases such as "homosexual individuals" or "homosexual males," as is astutely pointed out by Robinson.

Confusion is also generated when the first aspect of the definition is mixed with the second, as happens when it is assumed that people who have had sexual contact with members of their own sex "are" homosexual in orientation. In a free society, but one in which sexual activity is assumed (rightly or wrongly) to reflect a deep intimacy, it is likely that most people who perform consensual homosexual acts are homosexual in orientation. But this is not inevitable, and different segments of society differ in the extent to which acts do indeed reflect intimacy. Homosexual acts by teenage male prostitutes, for example, often do not reflect any underlying homosexual orientation; the same is often true with early adolescent sexual experimentation. In a subculture in which what we now call recreational sex is approved, homosexual acts without homosexual orientation are also more likely. The converse error—for example, after therapy, to assume that the cessation of homosexual acts means a conversion to heterosexuality—is also common.

Social constructionism is a scholarly point of view that asserts, in the case of homosexuality, that homosexuality per se does not exist but is nothing more than a concept constructed by the society in which we live. Social constructionists point out that different societies organize their understanding of homosexual acts in such dizzyingly varied ways that it is futile to try to understand these acts in the light of any assumed essence or underlying "real" phenomenon of homosexuality. For example, other cultures totally lacked our modern construction of homosexuality, as evidenced by the fact that ancient Greece did not have words for "homosexual" and "heterosexual." Although there is important truth in such a point of view, it should not be taken too far. Even in ancient Greece, there was a recognition of our modern categories of heterosexual and homosexual—although it is perfectly true that these categories were not as highly charged emotionally as they are today. Nowadays, we understand that dog lovers tend to have different personality traits than cat lovers; the fact that we do not coin terms for these distinctive tastes ("caniphiles" and "feliphiles," perhaps?) does not mean we deny their existence. Likewise, many writers in ancient Greece clearly understood that there were homosexual and heterosexual persons; it is just that the culture did not attach great emotional or moral significance to these personality types, any more than we do today to dog loving and cat loving. The fact that terms like "caniphile," "feliphile," and even "bipetual" sound bizarre and perhaps stigmatizing underscores the social constructionists' point. Nevertheless, one should not assert that caniphila and feliphilia are nonexistent, nor should one deny the existence of homosexuality and heterosexuality.

The Sexual Aspects of Homosexuality

It used to be a popular stereotype that homosexuals were doomed (a favorite word) to a life of empty one-night stands in a search for that unattainable goal, a long-lasting homosexual partnership. The problem is that if the discussion of homosexuality is allowed to be controlled by the terms "promiscuity" and "monogamy," one will overlook important aspects of the nature of couplehood and relationships in these groups of people.

For example, sexual scientists have often conducted surveys in which homosexual men are asked about the number of sexual partners they have had in their lives. Most of these surveys show that gay men, on average, have more partners, both on a lifetime basis and in the recent past, than demographically comparable heterosexual men. But the distributions that produce these averages are rarely given. In one study, the majority of the sexual partners of a group of gay men were partners of two men in the sample who were male prostitutes. In another study, the majority of the heterosexual encounters in a sample of homosexual and bisexual men were performed by two men.

In the gay community, the most important thing to understand about couplehood and relationships is the extreme diversity of patterns to be seen There are couples who are just as monogamous as many people's mother and father were, quite possibly more so. There are individuals whose promiscuity would startle a Casanova. And there is everything in between.

The second most important thing to understand is that a desire for a committed partner and a desire for a variety of sexual relationships can coexist in the same person—and that the gay community (especially the gay male community) often openly acknowledges this fact. Couplehood has become very popular in the gay community—a fact that is often attributed to the epidemic of acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV). However, this trend would probably have occurred anyway, and it has always been strong among homosexual women. Couples form when the members of the couple mature to certain stages of their lives and when social conditions permit the signs of couplehood (e.g., living together or attending events together) to be displayed. Many therapists believe that a long-term gay male couple will eventually split up unless its members find some way to permit occasional "extramarital" flings, whereas a lesbian couple will eventually split up unless its members find some way to prevent such flings. Others disagree. It is common in Europe today to presume that married heterosexual couples need not stay sexually monogamous throughout life. (Although this is not an unknown point of view in America, it is far less often publicly discussed or assumed.) Likewise, at many times in the past, especially where marriages were arranged or severely constrained by social pressures, it was considered normal that married couples would copulate to produce children but seek sexual excitement outside the couple.

Few things irritate modern homosexuals more than to be asked what she or he does in bed. The irritation arises for two reasons: first, the question may presume that homosexuals are a distinct, weird species whose members can be questioned about anything at all (in contrast to "normal" individuals whose privacy is respected); and second, the question may be designed to ascertain whether that individual performs the male or the female role in bed (as if there were only one of each). Putting aside whether these two motives are as salient as they are thought to be, let us simply note that sexual scientists and readers of encyclopedias are allowed to ask whatever questions they wish in the interests of scholarly inquiry and transmission of knowledge.

The coy answer is that homosexuals do in bed everything that heterosexuals do except penovaginal intercourse. Of course, people who believe that penovaginal intercourse is the sexual act are puzzled by this answer, because there seems to be nothing else to do; but surely most educated adults know about oral-genital intercourse, anal intercourse, mutual masturbation, hugging, kissing, stroking, and so on. On those occasions when questioners are indeed so gauche as to inquire about which person plays the man's role and which the woman's, more may well be revealed about the questioners' behavior than the questionees'. A homosexual, asked such a question, might respond with his or her own question: "You mean I have to choose?" or even "You mean that when you have sex the man always starts it and he always inserts and he's always on top and he always decides when to stop it? Why do all those things have to be done by the same person?" In comparison with gay men's sexuality, lesbian sexuality has been little studied. Of late, this has undoubtedly been due to the AIDS crisis, since it has been deemed important to know what causes some gay men to strongly prefer anal intercourse, the act most likely to transmit AIDS in this population. In spite of the relative lack of research on female homosexuality, we do know that few lesbians can be characterized as taking only a masculine or only a feminine role in sex—a phenomenon that is called butch-femme.

Some studies indicate that lesbian couples have sex less often than heterosexual or gay male couples. Several studies suggest that lesbian lovemaking is relatively more focused on the entire body (hugging, kissing, stroking) and less directly focused on the genitals (cunnihngus, insertion of dildoes), although there are enthusiastic exceptions to this rule. Explicit erotica written by lesbians for lesbians is becoming increasingly popular. In their labs, Masters and Johnson observed couples of all sexual orientations having sex and noted that lesbians were typically better love makers than heterosexual couples were. One interesting fact lesbians, when sucking on their partner's breasts, were usually careful to suck equal amounts of time on each breast (as if they had to be "evened out"); this was not true among the heterosexual men or for homosexual men who sucked on their partner's nipples. Apparently, no attempts have been made to discern larger patterns in lesbians' sexual behavior beyond these kinds of statistical or clinical details.

As mentioned previously, the sex lives of gay men have been intensely studied of late due to the AIDS epidemic. Few gay men can be characterized as taking only a masculine or only a feminine role in sex, although men who prefer anal intercourse often indicate a preference either for the "top" (inserting) role by wearing keys or a bandanna handkerchief on the left side, or for the "bottom" (receiving) role by wearing such items on the right.

Although these preferences are real, they should not be taken too seriously; in large cities in the United States, gay men are for the most part expected to be versatile, not only in top versus bottom roles (if any) but also in the choice of particular acts (e.g., oral, anal, masturbatory). This is less true in foreign countries. Let us finally reemphasize the large segment of the gay male community—perhaps a majority of it—that has no interest in such matters. For example, at a typical young-crowd gay disco, one sees few if any exposed key rings or bandanna handkerchiefs.

Investigators are increasingly seeking, and finding, interesting patterns in gay men's sexual behavior that go far beyond the mere statistical summarization of a Kinsey report (or a "Gay Report"). One study found, for example, that gay men's sexual behaviors cluster naturally into three categories (using a technique termed factor analysis). The first category, engaged in by nearly all gay men, consists of oral-genital acts and affectionate behaviors such as hugging and kissing. The second category, engaged in by a large minority or slight majority, consists mostly of acts involving anal sex (mainly insertive and receptive anal intercourse). The third category, engaged in by a small minority, consists of esoteric acts such as sadomasochistic rituals, "fist fucking" (in which a hand, as it happens not in the form of a fist, is inserted into the rectum), and so on. Notice that there is no evidence in this clustering of an insertor-insertee dichotomy.

The present author would add a fourth category: imaginary acts, engaged in by no gay men but which have entered the public imagination through the process of urban mythmaking. In this illusory category is "gerbiling," an act apparently invented by a right-wing pseudoscientist with a vividly homophobic imagination for a talk show in Philadelphia. Rumors describing hospital admissions for this practice—which supposedly involves receiving sexual pleasure from the death throes of a gerbil inserted into the rectum—have moved from city to city and involved various local weather forecasters and certain movie stars. As one prominent gay newspaper wrote, in an article debunking this pseudopractice, "Show us the X-rays!" The persistence of such rumors tells us less about the sexual practices of gay men than it does about the latent belief on the part of the rumor mongers that gay men as a class are characterized by doing weird, unbelievable things to their rectums. The fact that fist fucking exists, and would provide perfectly adequate fodder for such a belief, simply makes the success of the gerbiling myth all the more remarkable.

Psychological Adjustment

In the 1950s, it was routinely presumed that homosexuality was an extremely deviant activity and the symptom or even cause of a wide variety of psychopathologies. The path-breaking experiments of Evelyn Hooker disproved this extreme view by demonstrating that trained therapists were unable at better-than-chance levels to differentiate between homosexuals' and heterosexuals' psychological test scores if the therapists were blind to the sexual orientations of the subjects. Now, such a differentiation could probably be made if a score for childhood gender nonconformity were included (see below), but even so there would be many exceptions.

In terms of such mainstream psychological problems as psychosis or schizophrenia, however, Hooker's insights remain as valid as ever. Although there are a few psychological problems that homosexuals may have more often than heterosexuals do, these problems signify reactions to social oppression as opposed to any underlying, causative pathology. Interested readers are referred to Gonsiorek's recent extensive review.

Relationship to Other Phenomena

Homosexuality is often thought to be related to other phenomena such as transvestism, transsexualism, or AIDS. In fact, homosexuality is not equivalent to any of them and for the most part these assumed connections are incorrect stereotypes. For example, transsexualism (i.e., the obsessional insistence that one's innermost feelings of being male or female do not match one's genitalia) can occur in men who are sexually attracted to men, in men attracted to women, in women attracted to men, and in women attracted to women. Of course, when one wishes to change sex, it is not immediately clear whether the terms "homosexual" and "heterosexual" should be used in reference to the original or the desired sex.

In the case of transvestism (in which putting on the clothes of the opposite sex is or has been associated with sexual arousal), we must first face the fact that society's standards for female dress are far more flexible than they are for male attire. A man or boy wearing a dress elicits the strongest possible negative reaction, whereas a woman or girl wearing a coat and tie elicits positive or neutral reactions—or negative reactions only in the case where the act somehow challenges the observer's most basic perceptions of sex difference. According to the late Robert Stoller, there are only three reported cases in the entire world literature of women who became sexually aroused by putting on men's clothing. That all three women had bisexual aspects to their lives is an interesting scientific curio, but it merely underscores the fact that essentially no lesbians or bisexuals are transvestites.

More to the point, although there are adult homosexual men who enjoy wearing women's clothes, there are also adult heterosexuals who enjoy the same. While no good empirical data on the matter are available, the consensus of opinion seems to be that the percentage of male homosexual cross-dressers is no higher than that of male heterosexual cross-dressers. In contrast, a great deal of evidence exists that fetishistic cross-dressing associated with sexual arousal occurs far more often, perhaps exclusively, on the heterosexual side.

An interesting fact concerning cross-dressing (whether erotic or nonerotic) has only recently emerged in research: when cross-dressing occurs early in boyhood (anywhere from the age of three to just before puberty), it is often a harbinger of adult male homosexuality, although the desire to cross-dress typically dies out or dies down soon after puberty. When cross-dressing occurs later in boyhood (beginning around puberty), especially if it is associated with sexual excitement, it is often a harbinger of adult heterosexual transvestism.

Sadomasochism (S&M)—the facilitation or achievement of sexual arousal by giving or receiving pain—is often associated in the popular imagination with male homosexuality, presumably because of the existence of so-called leather bars in the male homosexual subculture. The same can be said of a lighter form of S&M, bondage and discipline, in which pain is absent but dominance and submission themes are prominent. Yet here, too, appearances can be deceiving, and these erotic tastes are found on all sides of the sexual-orientanon boundary. For example, the heterosexually directed Joy of Sex often gives suggestions for bondage and discipline to be enjoyed by heterosexual men and women alike, and lesbian S&M interests are not unknown. Fetishism (i.e., interest in objects such as hair or shoes) is found in men of every sexual orientation and rarely in women.

The relationship of homosexuality to bisexuality is contentious and complicated—and probably rather different in men and women. When a man declares himself to be bisexual, he is usually disbelieved by most male homosexuals. The presumption is that such a man is deceiving himself: that he is in all likelihood a gay man who has not yet come to terms with his homosexuality. This presumption, right or wrong, is rooted in the fact that every gay man knows many men who used to call themselves bisexual and now call themselves gay. In contrast, when a woman says she is bisexual, the statement is usually taken quite seriously by homosexual women. For example, the possibility that she may permanently leave a homosexual relationship for a heterosexual one is often taken at face value and not regarded as a sham.

It is a common prejudice that homosexual men are particularly prone to pedophilia (i.e., erotic attraction to children) or to ephebephiha (i.e., erotic attraction to pubescents or younger teenagers). But pedophilia and ephebephiha cut across all sexual-orientation boundaries, and thus parents who entrust their children to the care of adults should bejust as aware of the possibility of same-sex molestation as of opposite-sex molestation. Even if there were average differences by sexual orientation in rates of pedophilia or ephebephila, such studies would be irrelevant to the social-political controversy—just as would a study demonstrating that one or another racial group was more or less prone to pedophilia. After all, it is clear that the large majority of all sexual (and racial) groups are not pedophiles.

Lesbians are rarely accused of pedophilia or ephebephiha, and when they are it is usually as a result of having been identified with the general concept of homosexuality rather than as lesbians per se (a negative halo effect, if you will). There are, of course, essentially no scientific data on the question, as nearly all pedophiles and ephebephiles are men.

In the popular imagination today, male homosexuality is inevitably associated with AIDS. Of course, there is no denying that gay male culture has been irrevocably affected by the AIDS epidemic, at least in the major cities where AIDS has to date taken so much of its toll, and that coming out as gay also means coming to terms with, and deciding whether to take responsibility for, the necessity for safer sex if one chooses not to remain celibate. This association can also have a pathological tinge, as when a female-to-male transsexual who is sexually attracted to men writes that he considers his AIDS diagnosis to be the quintessential confirmation of his (male) homosexuality, or when a gay man uninfected with HIV insists that symptoms, perhaps of a common cold, are in fact evidence that he has AIDS. Such cases are, of course, rare, but their very extremeness helps to put the more common patterns in perspective.

The negative halo effect applies with special force to the popular image of lesbians and AIDS. Many lesbians are involved in the fight against AIDS and in making sure that lesbians modify their sexual behavior to slow any possible spread of the disease in their community. But this is not the result of elevated levels of the disease in comparison with either heterosexual women or homosexual men. Quite the contrary: lesbians have extremely low rates of AIDS, and a confirmed report of lesbian-to-lesbian sexual transmission would astonish AIDS researchers. Yet many times in popular discourse, people have assumed that lesbians are somehow associated with AIDS in an infectious way. Whether it be a state legislator arguing in favor of a bill denying homosexual women (and men) the right to be foster parents on the basis of AIDS exposure or an estranged husband arguing in court that his wife's lesbianism would expose their children to AIDS, there is scarcely a better documented example of the nonrational genesis of prejudice.

Therapy

Although far more common in the past, it is still not rare for some homosexuals to approach psychotherapists with the request to convert their homosexual orientation into a heterosexual one. In a similar vein, it is apparently still the case that homosexual adolescents are more likely to try to commit suicide than heterosexual adolescents because their homosexual feelings seem socially unacceptable, even shameful. This is not a surprise, given the severely antihomosexual attitudes of society, especially the teenage segment.

Although there is still substantial controversy on this matter, it is now widely regarded as unethical, for a variety of reasons, to offer "therapy" to change a sexual orientation. First and foremost, it does not work. There is a long and shameful list of therapists who have made attempts, only to abandon them, sometimes quietly and sometimes with open discussion. For example, a former president of the Association for the Advancement of Behavior Therapy, Gerald Davison, not only founded such a therapeutic school ("Playboy therapy") but also repudiated it on many occasions after deciding that it did more harm than good and that it would not have been ethical even if it had worked. Another behavior therapist, Kurt Freund, abandoned his form of aversive therapy for homosexuality after a genital measurement device (called a plethysmograph) showed that the "cured" ex-homosexuals remained sexually aroused by images of naked men.

This unfortunate sequence of events is now being repeated in the claims that homosexuality can be cured by religious conversion or other spiritual methods. "Ex-homosexuals" have been followed by "ex-ex-homosexuals," and there is even a sordid turn of events: on more than one occasion, the men involved in founding and running ex-homosexual ministries have used their followers as sexual partners. Although one cannot, of course, claim that all or even most such ministries are self-deceptive or manipulative, it is chilling to hear managers of such enterprises admitting that homosexuals do not in fact acquire a heterosexual orientation through their programs. It is claimed that the most that can be hoped for is abstinence from homosexual contacts, and perhaps some mild degree of heterosexual arousability—just as an alcoholic cannot be truly cured of the underlying disease of alcoholism. These apologists might pay more attention to Freund's conclusions:

Almost 20 years ago I started a therapeutic experiment.... [t] his was a long-term study, and these marriages [of homosexuals] were followed up for many years. Virtually not one "cure" remained a cure. The patients had become able to enjoy sexual intercourse with females as well [as males], though much less than with males, but there was no true, lasting change in sexual preference.... Many patients admitted this only much later than they themselves had clearly noted this fact.

Conclusion

This is an exciting time for research in homosexuality. Researchers who attended college during the early heyday of campus social groups for gay students acquired the knowledge that gay people are far more ordinary than most of the psychological and psychiatric theories of their professors would have had them believe. Now that they have advanced in their careers and acquired the ability to conduct their own studies, they have begun to address several of the fundamental questions about sexual orientation that earlier generations had deemed unimportant or too controversial. One of these questions concerns biological and hormonal predispositions to particular sexual orientations, but this is far from being the only new avenue of research. Social constructionism, for example, has breathed new life into many controversies relating to homosexuality and challenged its very existence as a definable phenomenon. A great deal of important work on the psychological and social aspects of male homosexuality is being conducted as part of the effort to fight AIDS. Unfortunately, an effect has been the continuing neglect of research on lesbianism. For this and for many other reasons, much work remains to be done.

REFERENCES

Davison, G.C. Constructionism and Morality in Therapy for Homosexuality. In J.C. Gonsiorek and J.D. Weinrich, eds., Homosexuality: Research Implications for Public Policy. Newbury Park, Calif.: Sage, 1991.

Freund, K.W. Should Homosexuality Arouse Therapeutic Concern? Journal of Homosexuality, Vol. 2, No. 3 (1977), pp. 235-40.

Gonsiorek, J.C. The Empirical Basis for the Demise of the Illness Model of Homosexuality. In J.C. Gonsiorek and J.D. Weinrich, eds.. Homosexuality: Research Implications for Public Policy. Newbury Park, Calif.: Sage, 1991.

Robinson, P. The Modernization of Sex: Havelock Ellis, Alfred Kinsey, William Masters and Virginia Johnson. New York: Harper & Row, 1976.

James D. Weinrich

HOMOSEXUALITY AND LESBIANISM: CROSS-CULTURAL PERSPECTIVES

Problems of Definition
India
Asia
Native Americans
New Guinea
Conclusion

Homosexuality in some form has always existed. In modern industrial societies, it is estimated that between 5 percent and 10 percent of the population is homosexual. In some societies, such as ancient Greece, male homosexuality was not only practiced but also institutionalized as an integral part of the social structure. In most Western cultures, however, homosexuality was less openly practiced, and much of our information about the phenomenon is derived from legal records. Women rarely appeared in these documents because their relations with other women were seen as friendships and thus encouraged. This is very different from the treatment received by men who were suspected of homosexuality. Historically, European men were expected to avoid close interaction patterns with other men, in contrast to the sometimes ardent interactions of women. Generally, the Judeo-Christian tradition taught that all nonprocreative sexual acts were intolerable but punished sodomy, or anal sex, most severely.

The behavior of male homosexuals was seen as deviant, but what constitutes deviant behavior differs cross-culturally as well as throughout history. Even terms such as "homosexuality" and "homosexual" are modern, originating in the late 19th and early 20th centuries. The sparsely written history of homosexuality is not indicative of the millions of lives lived by homosexuals, but reflects the earlier bias against homosexuality and the fear that studying homosexuality would prove risky in public opinion.

As physicians became interested in homosexuality in the 19th century, they classified homosexuality (as well as prostitution and masturbation) as a disease. Thus, they were inclined to find a cause and a cure for the disease of same-sex love. In 1974, the American Psychological Association removed homosexuality from the category of pathological illness. However, there are still people today who feel that homosexuals can be "treated" and "cured" and turned to a heterosexual life.

In the United States, slow acceptance of homosexual couples is seen not only in the recent view of them as "normal" by psychological standards but also in the prevailing laws, which do not fully sanction same-sex marriages. These marriages, often performed in community churches, are not considered legally binding, so same-sex spouses are denied the tax and insurance benefits granted to heterosexual spouses. Some countries do recognize homosexual marriage and confer on the partners the same rights and obligations that heterosexual couples have. Denmark is one such Western country.

Acceptance is even more common in non-Western societies. In Mombasa, for example, 50 percent of Swahili women live independently of financial support from their husbands and often have lives of their own. There is a strong lesbian subculture that consists of lesbians earning good wages in the business world and living together as couples. This is not seen as problematic because many of them are reasonably wealthy and can support their "wives." There is also a growing number of lesbian salons, or meeting places, where they discuss social issues, the arts, and daily life. These function in much the same way as the salons seen in Paris in the 1930s and 1940s.

These kinds of homosexual arrangements cross-culturally are of great interest to anthropologists, although there has frequently been a reluctance to formally publish information about them. Anthropologists who did write openly about variable sexual lives often found their work censored. For example, in the 1930s and 1940s, the anthropologist E.E. Evans-Pritchard, who worked among the Azande tribe of West Africa, wrote that he found homosexuality practiced by both men and women. His reports, however, were kept from the public by the Anthropological Society until the early 1970s when they were finally published openly.

Writing on homosexuality is generally about men. This is true cross-culturally. The reason may be that men's roles in society have been viewed as more important than women's or that most early anthropological work was done by men.

Problems of Definition

One of the great obstacles in gay and lesbian studies cross-culturally is the absence of a universal word defining male and female homosexuality and the behaviors or attitudes that characterize someone as such. "Lesbian" as a term describing sexuality did not exist until the late 19th century. The term "homosexual" does not exist even today in some parts of the world. Not all people who have engaged in homosexual behavior are homosexuals. Many people all over the world go through a stage of experimentation when they are learning about their sexuality. In most societies, a single, or even several, homosexual encounters do not mean that one is a homosexual. In some cultures, such as New Guinea's, premarital sexual behavior between men is encouraged and considered the normative pattern.

Human identity, including sexual identity, is the product of cultural surroundings and historical situations. One may be willing or desirous of homosexual experimentation, but it may never happen due to these surroundings. This means that one can be a homosexual and never engage in sex with a member of the same sex. Sexual acts do not determine one's sexuality. It is the self-identifying process that brings sexuality to light. It has been said that the way to identify a lesbian or gay man has become a personal matter: "you are one only if you consider yourself one."

Lesbian relationships may have been more difficult to define cross-culturally and historically because of the state of women's relationships in general. Historically, women have often been encouraged to have intimate relationships with other women. These "romantic friendships" were not seen as a threat to or an acceptable replacement for male-female relations. Cross-culturally, it seems that these friendships were meant to aid women in passing time while men were away, thus reducing demands on men, and in the process these friendships became an economic benefit, providing help with household work and child care. However, not all of these friendships remained platonic.

In the West, for example, many women did not define themselves as lesbians because of the negative connotations of the word. They would freely admit to some that they were in love, physically and emotionally, with another woman but add that they were not lesbians. This is one of the main problems in identifying and studying homosexuality cross-culturally.

If a Western term is applied to a behavior and related beliefs, and this term has no approximate equal in another culture, the process of communicating about the behavior is difficult. An anthropologist may use the term "lesbian" to describe an observed relationship in which two women live together, share a bed and chores, and raise their children together. However, what if the women would not consider their relationship lesbian in nature? Similarly, many women who have had physical love relationships with other women would not define themselves as lesbians.

Historically around the globe, if women did realize that their happiness was to be found only by living romantically with another woman, they had to make life changes to do so. First, they had to find ways of being economically independent from the support of a man. Once a woman could support herself, she could find other women who desired the same life; this led to the beginnings of a lesbian subculture, as seen in Mombasa. There are also many situations in which women who love one another can do so while remaining in culturally acceptable living arrangements.

India

In India, for example, there is a varied population of lesbians. Many are devotees of the various Hindu or Sikh goddesses. The spiritual and physical aspects of their relationships are very important. Here, where homosexual acts between women are not mentioned in the law, homosexual acts between men are illegal. In 1987, however, two policewomen were fired for marrying each other but were not prosecuted.

Most of the writing on lesbians in India is about older, economically independent, educated urban Indian women or foreigners living in India. Many of these women had been sent abroad to a university, and it was in this context that they had their first chance to act on their inner erotic feelings without the direct danger of their families finding out. Many of these Indian women were involved in relationships with other women lasting through their college years. Their desire to return to their homeland, however, eventually took them back to their families and away from their lovers. Some of these relationships, probably, did not involve genital sex, but they were still considered lesbian relationships because of the intense erotic and emotional feelings involved.

When these Indian women who have lesbian relationships abroad return home, they ordinarily marry men their families have chosen for them. Marriage is expected; family structure is often the only hope for social security; a woman living alone is seen as suspect, and it is often difficult to secure housing. Some women will try to find help through women's groups or return to a women's school, but many will work within their culturally acceptable social groups.

Employment opportunities and independent living patterns are not as abundant for women around the world as they are for Western women. That is why it is difficult to find lesbian relationship forms when they exist within common family units. Because Indian culture places a high value on family tradition, these women have intense fears that their behavior would publicly dishonor their families. Their arranged marriages often last a lifetime, and the women describe their husbands as good men with whom they have little in common. The women are available to their children and for occasional intercourse with their husbands. These lesbians, however, are able to skillfully combine monogamous same-sex relationships with their obligations as wives.

In India, mothers-in-law and daughters-in-law are expected to be a great support to one another and to spend time together shopping and cooking. In cases in which a lesbian lives in the same city as her mother-in-law, she may have to explain her close female friend who appears to offer the support that normally a mother-in-law would provide. Many Indian lesbians, however, seem to manage well within the prevailing cultural expectations.

Lovers in India often see each other daily if possible. They may go for a walk or to an exhibition or a women's meeting, and finally spend the rest of the afternoon together in their private quarters separate from their husbands. Female couples whose jobs are controlled by a schedule may meet when convenient at an urban hotel.

Lesbian women in India often report feeling that they embody the qualities of both men and women in their relationships with other women. The butch-femme classification found among Western lesbian couples seems to be much less prevalent. As mentioned earlier, the self-definition of these women differs from Western beliefs. "Lesbian" is not an unfamiliar concept or word, but often these women see themselves as simply women who have and always will love other women. In some conversations, these women may make no distinction between heterosexual and homosexual relations. They may speak of chapti, or lesbianism, but there is no Hindi or Urdu equivalent for the word "lesbian." Often they say that emotions and acts of love are gender free.

Some Western lesbians and feminists might not feel comfortable using "lesbian" to describe these Indian women, since they remain married and continue to live in relationships that are based not on personal choice but cultural expectation. However, it is important to remember the cultural variability of homosexual patterns.

Asia

In China, historically, male homosexuality was tolerated without the threat of severe punishment. A far worse offense was celibacy. Chinese history, fiction, legends, and other written works, as well as oral communication such as jokes and slang, contain a great deal of information on male homosexuality. Many Chinese men from the southeastern provinces went to sea, engaging in fishing expeditions and trades. While they were away, their friendships would often include sexual relations and some loving partnerships. The men would visit young boys when they went into port, and some paid a "bride price" in order to "marry" these young boys.

The women left behind sometimes turned to one another, some taking vows to be lifelong spinsters and never to marry. Others would go through elaborate rituals to "marry" and engaged in sexual pleasures freely. These marriage rituals are not unlike those found around the world. It seems that telling not only one's partner, but also friends and perhaps family, that there is a firm commitment involved in one's relationship is important to most people, whether they are heterosexual or homosexual.

In China, in both men's and women's cases, homosexual relations are often disguised as conventional family relations, such as brothers or sisters. This has been one acceptable way in which lovers could live together and maintain a common household.

Homoerotic fiction has existed in China for centuries. Lesbianism in Asia can be traced back to as early as 520-480 B.C.E., when Buddhist nuns in India wrote lesbian love poetry. Rulers of Chinese states have been the subjects of legendary homoerotic tales of their loves. One emperor, Ai-di, who loved a young man, Tung Xian, cut off his sleeves, upon which the latter was sleeping, so he could arise without awakening his lover. The term duan-xiu ("cut sleeves") thus became another expression for homosexual love.

Many novels came out during the Ming and Quing periods in China that contained elaborate accounts of homoerotic behavior. Because many men were used to portray women in Chinese theater (as in Shakespearean), they were often the objects of male desire. In early Chinese poetry, it is often difficult to determine if the object of a man's love is a woman or another man. Many reviewers of later and more moralistic times rewrote the poems to make clear that the erotic desire was a heterosexual one.

As is the case in many urban areas, first homosexual experiences for Chinese youths often occur at their same-sex boarding school. These schools do not have a higher incidence of homosexuals attending them; they simply provide an environment that makes same-sex loves less traumatic for those who are so inclined. In 1982, the People's Republic of China Criminal Law Code did not expressly prohibit homosexual activities.

Native Americans

The two most popular institutionalized same-sex practices are gender-reversed homosexuality and age-structured homosexuality. In gender-reversed homosexuality, the individual adopts the dress, social roles, gestures, occupation, and sexual behavior of the opposite sex. The Native American berdache is the best known of this tradition.

Berdache occurred in at least 113 different tribes. In two-thirds of those cultures, there were only male berdache, whereas in the other third there were both male and female berdache. Thus, a biologically normal Indian male would take on the berdache role, simulate menstruation and pregnancy, and dress as a girl (later as an older woman). For males, the gender reversal resulted in their feminization and was a lifelong role.

Women who were berdache (sometimes called nadles) were respected due to their behavior in their occupation (e.g., skilled hunter or rider), and they were allowed to have marital partners of the same sex, if desired. This type of gender reversal was also found in Brazil, where an explorer encountered many women hunting with the men, each accompanied by another woman she had brought along as her "wife."

New Guinea

Only males have been found to participate in age-structured homosexuality. Males of different ages, never equals, engage in ritualized homosexual practices for years. This activity usually occurs in adolescence and is similar to ancient Greek homosexual practice. The age-structured form has occurred in many places around the world but is best known in New Guinea.

In New Guinea, this type of homosexual behavior co-occurs with warriorhood cults of masculinity, sexual antagonism between boys and girls, and strong restrictive behaviors about sexual practices. Sambia males undergo ritual initiation procedures that fully institutionalize same-sex erotic contact between young boys and unmarried youths. This practice focuses primarily on the beliefs held by their culture concerning the power of semen transmission. Semen is a growth stimulant in the eyes of many tribal cultures. Among the Sambia, ingesting semen is believed actually to secure a boy's maturation. They believe that the male body alone cannot spontaneously produce semen. Thus, males need to take in semen to produce their own for both inseminating their future wives and acting as donors to younger boys.

In Sambia culture, only oral intercourse is permitted for semen transmission, and there has been no record of masturbation to orgasm. Homosexual contacts between females are believed to be absent; however, most of the studies have been done by men, who may have had difficulty uncovering female sexual practices. Approximately 5 percent of Sambia males continue to engage exclusively in homosexual sex after adolescence.

Again, Western vocabulary and criteria make it difficult to define this behavior. The Sambia themselves do not have a noun category for either "homosexual" or "heterosexual." They do not even recognize that someone can be either exclusively homosexual or exclusively heterosexual throughout his or her entire life. The Sambia see no necessary contradiction in a person's engaging in sex with both females and males as long as this is done at the appropriate stage of life and in an acceptable manner.

A main difference to note in this regard between the United States and Sambia is that the definition of sexual preference in the United States, especially homosexual preference, focuses on the individual and disregards social surroundings and cultural variations. Moreover, the idea of sexuality begins with a conception of sexual orientation as natural attraction to the opposite sex. This notion is quite different from thought patterns in other cultures in which there may be more fluidity in sexual preference from one life stage to the next, as in the case of the Sambia, or more culturally acceptable ways of living beyond one's sex, as with the berdache.

Conclusion

The cases presented here are by no means exhaustive and mark only a few examples of homosexuality across cultures. They have been used to illustrate the global and cross-cultural existence of and variability in gay and lesbian lives. Because the gay liberation movement has been based in the West, most critical, in-depth studies have focused on gay and lesbian couples living in Europe or the United States. As more scholars, both homosexual and heterosexual, begin to free up their definitions of homosexuality, a growing number of cross-cultural studies of same-sex partners can be expected. Such an effort is important not only for historical and anthropological studies, but for a generally increased awareness of the variety of successful sexual partnerships found around the world.

REFERENCES

Allen, J. Lesbian Philosophies and Culture. New York: State Univ. of New York Press, 1990.

Bullough, V., and B. Bullough. Sin, Sickness and Sanity. New York: New American Library, 1977.

Greenberg, D.F. The Construction of Homosexuality. Chicago: Univ. of Chicago Press, 1977.

Herdt, G., ed. Ritualized Homosexuality in Melanesia. Berkeley: Univ. of California Press, 1984.

Murray, S.G. Male Homosexuality in Central and South America. San Francisco: Gai Saber Monograph, 1987.

Pink Book Editing Team. Second ILGA Pink Book. Utrecht: Interfacultaire Werkgrouep Homostudies, 1988.

Ross, M.W., ed. Homosexuality, Masculinity, and Femininity. New York: Harrington Press, 1983.

Salvatore, L.J., and R.P. Peteren, eds. Historical Perspectives on Homosexuality. New York: Haworth Press, 1981.

Xiaomingxiong. History of Homosexuality in China. Hong Kong: Samhasha and Pink Triangle Press, 1984.

Liesl L. Gambold

HORMONES: THE ENDOCRINE SYSTEM

Fetal Sexual Development
Hormonal Control of Sexual Maturation
Gonadal Steroids and Sexual Maturation
Male Reproductive Function
Female Reproductive Function

From the moment of conception to maturity, sexual development depends on a complex interaction of genetic and dynamic hormonal interrelationships that regulate hypothalamic, pituitary, and gonadal function. The development of neuroendocrine function in relation to growth and sexual maturation of both the female and the male throughout the life cycle is covered here. This discussion focuses on the normal patterns; the various changes, abnormalities, problems, and treatment modalities involving the neuroendocrine system are covered under such topics as castration, compulsion, gender, infertility, impotence, menopause, menstruation, pheromones, physical disabilities, pregnancy, and transsexualism.

Fetal Sexual Development

The sequence of embryonic and physiologic changes that control the sexual differentiation of the fetus begins with fertilization. The sex of the embryo is genetically determined at the instant of fertilization, with the XX karyotype conferring female sex and the XY karyotype conferring male sex.

The embryo has indifferent gonads that can become either testes or ovaries. In the absence of a Y chromosome, the indifferent gonads differentiate into ovaries nine to ten weeks after conception. At about 18 to 20 weeks, the internal and external female genitalia develop, establishing female genital sex. The presence of the Y chromosome causes the indifferent gonads to differentiate into testes at six to eight weeks. Shortly afterwards, testicular Leydig cells begin to secrete testosterone, which stimulates the development of internal and external male genitalia, establishing male genital sex.

In the human fetus of either sex, the fetal gonad is affected by three gonadotropins: placental chorionic gonadotropin (hCG) early in gestation, and later by follicle stimulating hormone (FSH) and luteinizing hormone (LH), both secreted by the fetal pituitary. Fetal serum hCG peaks around the tenth week of gestation and stimulates testosterone secretion by the testes of the male fetus. Unlike the testis, the fetal ovary is only minimally affected by the early appearance of hCG. Growth and function of the fetal ovary is more dependent on the later appearance of the pituitary gonadotropins.

Hormonal Control of Sexual Maturation

The hormonal relationship of the hypothalamic-pituitary-gonadal axis becomes established by two years of age in either sex, functioning quietly until the onset of puberty. In childhood, the negative-feedback response of this axis is extremely sensitive to the small amounts of circulating gonadal steroids, contributing to the low levels of gonadotropins secreted from the pituitary.

Adolescence generally refers to the time between the onset of puberty and the completion of physical maturation. During adolescence, maturation of the gonads is accompanied by accelerated growth, development of secondary sex characteristics, and attainment of reproductive capability manifested by spermatogenesis in the male and ovulation in the female. In anticipation of the onset of puberty, serum concentrations of pituitary FSH rise between the ages of 6 and 8, and at approximately 10 years of age there follows an increase in the secretion of LH by the anterior pituitary. The secretions of LH and FSH are believed to be controlled via the hypothalamus by a single gonadotropin releasing hormone (GnRH). The elevated serum levels of LH and FSH stimulate the growth of the gonads to their adult size, stimulate gametogenesis, and greatly increase the secretion of gonadal steroids. The gonadal-steroid secretion initiates the first physical signs of sexual maturation with development of secondary sexual characteristics. In the female, this includes breast development (thelarche), pubic hair growth (pubarche), axillary hair growth (which usually follows pubarche), somatic growth acceleration, and finally the menarche, or initiation of menses. In the male, a deepening voice; pubic, axillary, and facial hair growth, testicular and phallic enlargement; and somatic growth acceleration indicate sexual maturation. This process generally begins between the ages of 8 and 13 in females, and occurs about two years later in males, with full development over a three-year period. The order of appearance of pubertal features varies greatly among individuals.

In women, release of the gonadotropins occurs on a cyclical basis, creating the reproductive or menstrual cycle. In men, the release is relatively steady, although there are a number of pulses of gonadotropin release in a 24-hour period.

Gonadal Steroids and Sexual Maturation

In females, there are two major reproductive steroids, estradiol (an estrogen) and progesterone (a progestin). The most frequent first sign of female sexual maturation is breast budding, which occurs in response to the increased pubertal levels of estrogen. Both the mammary glands and the adipose tissue of the breast are stimulated to increase in size by estrogen. Increases in body fat and its characteristic deposition, a broader pelvis, and a shorter period of growth of long bones are also effects of estrogen. Progesterone is primarily involved in the menstrual cycle, which is discussed later on.

The major steroid secreted in males is testosterone, although the testes also secrete small amounts of estrogen. Testosterone is responsible for the development of male secondary sexual characteristics. Testosterone helps to initiate the growth spurt of male adolescence and also ultimately ends that growth spurt by stimulating closure of the epiphyses of the long bones. It causes enlargement of the larynx, which deepens the male voice, generally coinciding with the growth spurt. Testicular enlargement occurs, followed by phallic enlargement 12 to 18 months later. Testosterone stimulates growth of muscles and is probably responsible for the higher hematocrit level of men. Gynecomastia, or development of breast tissue, is a normal male response during early puberty, probably due to the higher ratio of estrogen to testosterone secreted by the testes during early and mid-puberty. Testosterone stimulates the growth of facial, body, and pubic hair, and it is a contributing factor in male pattern baldness. It is also required for spermatogenesis and plays an important role in the establishment of sexual interest, or libido.

The adrenal cortex of both sexes also produces small amounts of androgen as a by-product of synthesis of aldosterone and cortisol. The major androgen produced is dehydroepiandrosterone (DHEA). Although a weaker androgen than testosterone, DHEA plays an important role in female sexual development. This adrenal androgen is primarily responsible for the growth of pubic and axillary hair in women and also contributes to the female adolescent growth spurt. DHEA, along with a small amount of androgen secreted by the ovaries, also appears to be responsible for female libido, rather than the "female" sex hormones estrogen and progesterone.

Male Reproductive Function

In the male, the hypothalamus secretes gonadotropin releasing hormone in pulsatile bursts throughout the day. One effect of GnRH is to stimulate the pituitary to increase secretion of the gonadotropins FSH and LH. Pituitary FSH controls spermatogenesis, which occurs in the Sertoli cells. Inhibin is then selected by the Sertoli cells, exerting a negative-feedback control and diminishing the amount of FSH released by the pituitary.

Biosynthesis and secretion of testosterone, the primary male androgen, are carried out by the Leydig (interstitial) cells. Pituitary LH is primarily responsible for stimulating the Leydig cells' secretion of testosterone. Testosterone then acts as an inhibitor of both GnRH secretion from the hypothalamus and LH secretion from the pituitary, another example of a hormonal negative-feedback loop.

Levels of testosterone rise throughout puberty and reach their maximum value by about the age of 20. These relatively high testosterone levels are maintained until the fourth decade, when they begin a gradual decline. The degree of decrease in testosterone levels varies widely from one individual to the next. This decreasing level of testosterone is often compared to the menopausal period of female development.

As testosterone levels decrease, so too does their negative-feedback inhibition on both the hypothalamus and pituitary. This creates a coincidental rise in gonadotropin levels in an effort to stimulate the aging testes to produce more testosterone. In response to diminishing levels of testosterone, target tissues up-regulate their testosterone receptors, cushioning the effects of the lowered levels of androgen. This promotes maintenance of functioning of accessory structures and also helps maintain a level of sexual interest. Spermatogenesis, which is mostly independent of testicular function and levels of testosterone, continues throughout the male life span following puberty.

Female Reproductive Function

The ovaries of the sexually mature female undergo regular cycles, beginning with maturation and ovulation of a follicle. A period of time follows during which hormones secreted by the remnant of the ovulated follicle create a uterine environment receptive to implantation of an embryo. The maturing follicle also functions as an endocrine organ, secreting estradiol, the main source of estrogen in women who are not pregnant. During ovulation, the mature follicle bursts, releasing an ovum into the body cavity, from which it is swept by the fimbriae into a Fallopian tube, where it may be fertilized.

As a follicle matures, it becomes an active endocrine tissue. Just as in the male reproductive system, the hypothalamus secretes GnRH, stimulating the anterior pituitary to secrete both LH and FSH. Both LH and FSH are needed for ovarian cycles. LH stimulates the thecal cells of the mature follicle to supply the granulosa cells of the follicle with androgen, which is converted by the granulosa cells to estradiol and secreted into the blood. Granulosa cells also secrete inhibin, which acts in a negative-feedback relationship as an inhibitor of anterior pituitary release of FSH. LH secretion is not affected by inhibin. Estradiol is responsible for the regulation of LH levels by a negative-feedback loop involving both the hypothalamus and the anterior pituitary. LH secretion does not always behave as if it were regulated by negative feedback, however; the surge of LH that causes ovulation occurs even though estradiol levels are rising. This surge can be explained by the fact that the anterior pituitary responds differently to rising levels of estradiol than it does to moderate, nonfluctuating levels. At moderate, steady levels of estradiol, the anterior pituitary predominantly shuts off its LH secretion by means of negative feedback. When estradiol levels rise rapidly to high levels, as they do during the follicular phase, the pituitary is actually stimulated to secrete a surge of LH.

In the final stage of follicular maturation, the follicle is called a graafian follicle and visibly bulges from the surface of the ovary. Occasionally, more than one graafian follicle is matured and ovulated. If both are fertilized, this multiple ovulation may lead to fraternal twins. Fraternal twins are genetically different and may be of different sexes.

The surge of LH that follows the rise in estrogen level at this time is coupled with a smaller increase in FSH. The rise in FSH level is considerably smaller due to the continued effects of inhibin on the anterior pituitary. The ovum is released from the graafian follicle about 12 to 24 hours after LH has reached its peak concentration. This is called the ovulation phase of the menstrual cycle and occurs 14 days prior to the onset of menstruation.

The ovum is then swept up by fimbriae and carried toward the uterus by the ciliary activity and smooth-muscle contractions of the Fallopian tube. An ovum can be fertilized for only 10 to 12 hours after ovulation. Spermatozoa can survive for up to three days in the female reproductive tract, allowing for a relatively brief span of time in which fertilization can occur during each menstrual cycle.

The female endocrine system relating to pregnancy is a complex interaction of hormones secreted by the corpus luteum, placenta, uterus, and pituitary. The hormones of pregnancy, labor, and lactation include estrogen, progesterone, placental somatomammotropin, oxytocin, relaxin, and prolactin. (Hormones of pregnancy, labor, and lactation are not covered in this entry.)

Following ovulation, the remnant of the follicle becomes a secretory organ called the corpus luteum, which maintains the receptivity of the uterus to a pregnancy by secreting estrogen and progesterone. If pregnancy does not occur, the corpus luteum degenerates approximately 14 days later, and the resultant decrease in levels of estrogen and progesterone causes the uterine endometrium to be shed, initiating menstruation.

The average menstrual cycle lasts 28 days, with a normal range from 21 to 35 days. The first menstrual day is numbered as day 1 and marks the beginning of the follicular phase of the ovarian cycle. Ovulation, which occurs approximately on day 14 of the 28-day cycle, marks the transition from the follicular phase to the luteal phase of the ovarian cycle. During the luteal phase of the cycle, the presence of progesterone secreted by the corpus luteum modifies the responsiveness of the pituitary to the high levels of circulating estrogen, preventing recurrent surges of LH. During the luteal phase, the negative-feedback system again predominates, and LH and FSH remain at relatively low levels. The estrogen and progesterone secreted by the corpus luteum also interact to convert the uterine endometrium into a structure specialized to receive an embryo. The endometrium thickens and becomes a secretory organ, secreting uterine milk, a carbohydrate-rich fluid capable of nourishing the embryo until implantation in the uterine wall occurs.

It is not uncommon for ovulating women to complain of a complex of symptoms during the last week of the menstrual cycle. This symptom complex, known as premenstrual syndrome (PMS), does not occur in children, pregnant women, or anovulatory women. The symptoms may include breast tenderness, bloating, edema of the extremities, and mood swings. Symptoms abate with the onset of menstruation. No specific etiology for PMS has been found, although progesterone secreted by the corpus luteum is strongly suspected to play a significant role.

The cycles of estrogen and progesterone secretion by the ovaries continue throughout the woman's sexually mature years until the menopausal transition, which usually takes place between 45 and 55 years of age. Menopausal transition is characterized by longer cycles and irregular bleeding. These irregular cycles can persist for months or years before complete amenorrhea occurs. During this time, the ovaries undergo an obliterative endarteritis that leads to a reduction in ovarian size and the replacement of the secretory parenchyma with connective tissue. As the ovaries become less able to secrete steroids in response to gonadotropins, the negative-feedback loop disintegrates and gonadotropin levels rise. Thus, as with the testes, the effect of aging is seen at the ovaries rather than the pituitary or hypothalamus. As gonadotropin levels rise and estrogen levels decline, the woman may experience a variety of signs and symptoms of menopause, including sweating, hot flashes, and a reduction in the feminization that occurred at puberty, such as diminishing fat deposits and atrophy of the breast, vulva, and vagina. Prolonged estrogen deficiency is a risk factor for a decrease in bone calcification, leading to the development of osteoporosis. It is increasingly common for women of menopausal years to take estrogen and progesterone supplements to reduce the effects of the failing ovaries.

REFERENCES

Alexander, S.E., S. Aksel, R.R. Yeomon, and J.M. Hozelton. Gonadotropin and Ovarian Hormone Dynamics in Luteal Phase Defects. American Journal of Obstetrics and Gynecology, Vol. 166 (Feb. 1992), pp. 652-57.

Bagatell, C.J., R.H. Knopp, W.W. Vale, J.E. Rivier, and WJ. Bremner. Physiologic Testosterone Levels in Normal Men Suppress High-Density Lipoprotein Cholesterol Levels. Annals of Internal Medicine, Vol. 116 (1992) pp. 967-73.

Enningham, G.R., W.B. Schill, and E.S.E. Hafex, eds. Regulation of Male Fertility. The Hague: Martinus Nijhoff, 1980.

Hershman, J.M. Endocrine Pathophysiology, 3d ed. Philadelphia: Lea & Farbiger, 1988.

Schauf, C., D. Moffett, and S. Moffett. Human Physiology: Foundations and Frontiers. St. Louis: Mosby, 1990.

Tsatsoulis, A., S.M. Shalet, and W.R. Robertson. Bioactive Gonadotropin Secretion in Man. Clinical Endocrinology, Vol. 35 (1991), pp. 193-206.

Uzych, L. Anabolic-Androgenic Steroids and Psychiatric-related Effects: A Review. Canadian Journal of Psychiatry, Vol. 37 (1992), pp. 23-28.

Wilson, J.D., et. al. Harrison's Principles of Internal Medicine. 12th ed. New York: McGraw-Hill, 1991.

Janice Fulton

HUMOR AND SEX

Throughout the history of world humor, no topic has been more pervasive than sex. Within parameters dictated by each society, humor generally is the most socially acceptable avenue for expressing sex-related fears, confusion, and aggression that cultural constraints otherwise forbid. Sexual humor can be used as an instrument for sublimation, seduction, release, or even education. At a single stroke, it can provide both sexual and comic pleasures.

Folklorist Gershon Legman observes that sexual folklore is almost always humorous, even though it deals with serious fears and problems of life. He likens this type of sexual humor to whistling in the dark. He sees humor as performing the important mental health function of absorbing and controlling anxieties felt in connection with sex-related topics such as venereal disease and castration or with scatological themes such as defecation. It has been suggested that, as societies become more educated and refined, they tend to increase repression of direct sexual expression, and therefore obscene humor becomes more important as a safety valve.

Sexual humor can be a covert way of socializing individuals to the norms of sexual behavior expected within a group and thus maintaining those norms. Some experts feel that this approach is more successful than the use of threats. The resulting sharing of understanding tends to bond individuals in the "in" group together and to differentiate them from outsiders.

In his book Jokes and Their Relation to the Unconscious, Sigmund Freud suggests that sex-oriented jokes enable the satisfaction of lustful instincts, even by individuals who are faced with some obstacle such as an inability to deal with open discussion of sex. The kinds of sexual jokes a person tells and enjoys can reflect facets of his or her sexual makeup such as a suppressed tendency toward violent sexual behavior or exhibitionism. They also can serve as a protective mechanism that denies the seriousness of a sexual problem that is troubling the teller.

"Blue" humor can be used by one member of a partnership to seduce the other. The response of the other partner can be taken as a gauge of his or her readiness for further overt sexual activity.

Children begin telling "dirty" jokes at an early age, and sexually suggestive games are common among children in many cultures. According to Legman, a reason for this is that the hardest thing for a child to cope with in his or her environment is the fact of the parents' copulation. On the one hand, children are told to look to their parents as role models, and on the other that the sex act is forbidden to them. They are made to feel uncomfortable discussing their questions and anxieties about their bodies with adults, so they sublimate by whispering sexual innuendos about their teachers and sharing jokes in the school yard.

Sex-related joking relationships usually are confined to members of the same generation. Sharing such a joke with your mother's old college friend, for example, would be considered in poor taste. Joking relationships within a given culture also are circumscribed by its marriage customs and sexual taboos. For example, few cultures consider it appropriate for parents to share sexual humor with their children because of prevailing taboos against incest. When sexual humor is shared by a group, the participants usually are all the same sex. In Sicily, for instance, groups of women commonly entertain themselves in this manner, with the married women imitating men.

Apte has studied joking relationships in many cultures and developed these theoretical propositions comparing the roles of men and women: The two sexes show unequal status, with men generally restricting women's public participation in humor as a means of showing their superiority. Men are intimidated by the idea of sexual equality because of its potential for disrupting this social order. As women age, and especially after they pass menopause, they often gain more freedom to share publicly in sexual humor and obscene language, even to the extent of being allowed to compete with men.

Writing on national styles of humor, Ziv divides American sexual humor into four categories: innocent, where surprise is the key element; innuendo, the most common; hostile; and sex-related humor that reflects cultural attitudes. Widely used on television talk shows, innuendo also is employed on bumper stickers that derive their humor from implied meanings of "it." Ziv observes that innuendo has the advantage that a listener can pretend not to understand. Current examples of humor that reflects cultural attitudes are the books and essays that tell what "real" men and women do and do not do.

Sexually oriented themes occur in the earliest humorous literature. Early Hebrew writings contain parodies on profligacy. In ancient Greece, the epigram was often the vehicle of choice; well-known Greek epigrammatists included Anaxandriades, Aristophon, and Alexis. Sexual innuendos are common throughout Greek literature and often reflect prevailing misogynistic attitudes.

In the Middle Ages, the fabliaux of the jougleurs were the most common form of comic literature, and dozens of examples survive. Although they were highly sexual in content, they were recited freely in mixed groups and were very popular as after-dinner entertainment. Later, Voltaire's epic poem, Maid of Orleans, parodied the life of Joan of Arc and featured a series of sexually oriented jokes.

Almost everyone in contemporary English-speaking society has a favorite obscene joke cast in the form of a limerick:

The limerick's an art form complex
Whose contents run chiefly to sex;
It's famous for virgins
And masculine urgin's
And vulgar, erotic effects.

The great Greek comic poet Aristophanes is believed to have written the first limericks around the fourth century B.C.E. Modern limericks also owe something to a 16th-century English verse form called Poulter's measure. The Oxford English Dictionary quotes an 1898 reference as stating: "Who applied this name [limerick] to the indecent nonsense verse first it is hard to say." However, it was around that time that the term first came into common usage in England. Except for a few written in French, limericks rarely occur in other languages.

Obscene limericks have been popular for more than a century. Alfred Lord Tennyson is said to have written them as a relief from the stress of more serious writing, but they were destroyed immediately after his death. Algernon Swinburne wrote them and did obscene parodies of some of Edward Lear's most beloved limericks, but they rarely are included in anthologies of his work. Such diverse writers as George Bernard Shaw, Eugene Field, Robert Louis Stevenson, Morris Bishop, and Ogden Nash also were limerick aficionados. The true, "unlaundered" limerick of today is distinguished by its sexual or scatological subject matter, obscene language, close adherence to the prescribed poetic form, and clever word play; it usually has a surprise twist at the end.

Though sexually oriented humor can incite destructive behavior and preserve the dominance of one sex over the other, it also can be used as an instrument for reducing stresses related to sexual function and for informing individuals of the sexual attitudes and behavior that are expected by their society.

REFERENCES

Apte, M.L. Humor and Laughter: An Anthropological Approach. Ithaca, N.Y: Cornell Univ. Press, 1985. (Note: comprehensive bibliography.)

Baring-Gould, W.S. The Lure of the Limerick. London: Panther Books, 1970.

Chapman, A.J., and N.J. Gadfield. Is Sexual Humor Sexist? Journal of Communication, Vol. 26 (1976), pp. 141-53.

Fine, G.A. Obscene Joking Across Cultures. Journal of Communication, Vol. 26 (1976), pp. 134-40.

Freud, S. Jokes and Their Relation to the Unconscious. Translated and edited by J. Strachey. New York: W.W. Norton, 1960.

Goldstein, J.H., and P.E. McGhee. The Psychology of Humor. New York: Academic Press, 1972.

Highet, G. The Anatomy of Satire. Princeton, N.J.: Princeton Univ. Press, 1962.

Janus, S.S., C. Janus, and J. Vincent. The Psychosexuality of Stand-up Comedy, Journal of Psychohistory, Vol. 14 (Fall 1986), pp. 133-40.

Legman, G. The Hornbook: Studies in Erotic Folklore and Bibliography. New Hyde Park, N.Y.: University Books, 1964.

Legman, G. Rationale of the Dirty Joke, First Series. New York: Grove Press, 1968.

Levine, J., and F.C. Redlich. Motivation in Humor. New York: Atherton, 1969.

Wells, C. An Outline of Humor. New York: G.P. Putnam's Sons, 1923.

Ziv, A. National Styles in Humor. New York: Greenwood Press, 1988.

Alice P. Stein

HYMEN

The hymen is a membrane, found only in human females, that covers the opening of the vagina at birth. It usually begins to erode shortly after birth and continues to do so throughout childhood and adolescence. Some females are born with a partial or no hymen. At maturity, a young woman may have remnants of hymeneal tissue that form a ring around the vaginal opening. The tissue may also stretch across the opening and vary in size, shape, thickness, and pattern of perforation. The perforations allow for the passage of menstrual fluids and usually permit the insertion of a finger or a tampon. Some females have an imperforate hymen composed of tough fibrous tissue. Such a hymen is not usually detected until menstruation begins; it does not allow for the passage of fluid. The condition can be corrected easily by minor surgery performed in a physician's office.

For a tissue that is not known to function physiologically in any way or to have any evolutionary value, the hymen has been a source of psychological stress in almost all cultures. A common name for the hymen is "maidenhead." Further, a woman who has lost her maidenhead is "deflowered." These terms imply the supposed importance of the presence of the tissue when determining virginity. Because virginity at the time of penetration on the wedding night is prized in so many cultures, the presence of the hymen takes on an importance of its own. In some cultures, the bloody bed sheets are paraded before a waiting audience to prove that the bride was a virgin. If the bride does not have an intact hymen, she may be returned to her parents in disgrace, subjected to public ridicule, starved, tortured, mutilated, or put to death, often by stoning. However, brides and grooms have been known to use the blood of animals or to prick their own fingers to provide the bloody "proof" needed. The deflowering of a virgin sometimes had magical connotations. Certain males and females used special instruments such as horns or stone phalluses to perform ritual deflorations before the wedding night. In some medieval cultures, it was the right of the lord of the manor to deflower the virgins before they were married. Because some men pride themselves on having intercourse with virgins, some prostitutes are quite adept at becoming "virgins" again and again by the use of chicken blood. Indeed, plastic surgeons in some countries (i.e., Italy, Japan) reconstruct hymens for "new virgins" who want to conceal their previous sexual histories from new husbands.

Actually, the presence or absence of a hymen is no indication of the virginity of the female. A physician cannot usually tell if a woman is a virgin, even with a pelvic examination. The hymen may have completely eroded before maturity, or it may have been broken in any number of ways. For example, young girls in rural Egypt, when going to and from the fields, ride astride small donkeys; thus their hymens are often broken. A girl in this situation must then go to the village midwife and get a certificate that explains how her hymen was lost so that when her husband wraps a piece of cloth around his forefinger and inserts it into her vagina on their wedding night, she can use the certificate to prove that she has not had previous intercourse. The hymen may also be broken as a result of vigorous exercise or masturbation. Further, in some women, the hymen is so elastic that it may stretch without breaking during intercourse, and thus a woman may not be a virgin even though she has an intact hymen.

Many women (and men) expect the first intercourse to be painful because they fear the breaking of the hymen (or the taking of the "cherry"). Most such pain, however, results because the female is anxious and unprepared or the attempt at penetration is clumsy or forcible. Thus, first intercourse is traumatic or untraumatic depending on the preparation and understanding of the individuals rather than on the breaking of the hymen.

REFERENCES

Masters, W.H., V.E. Johnson, and R.C. Kolodny. Human Sexuality. 3rd ed. Glenview, Ill.: Scott, Foresman, 1988.

Reinisch, J.M. The Kinsey Institute New Report on Sex. New York: St. Martin's Press, 1990.

James D. Haynes