The elaborate sex positions featured in the “Kama Sutra” may send some giggling, but these ancient Hindu texts called the Tantras introduced techniques to improve and enhance people’s sex lives around 300 A.D. These Eastern expressions of sexual and emotional connection were revitalized more than 1,600 years later during the American sexual revolution and continue to play a widely influential role in Western sexual health. The social changes involved in putting the “Kama Sutra” on bookstores’ shelves opened the public’s eyes to the concept of sexual health itself, sparking a rapid evolution of sexual literature, therapy and other self-help procedures.
According to Men’s Journal, a health and fitness magazine, Alfred Kinsey was among the first to publicly suggest that couples had sex for purposes other than procreation. He founded the Kinsey Institute for Research in Sex, Gender and Reproduction in 1947 and shortly thereafter published “Sexual Behavior in the Human Male” in 1948, followed by “Sexual Behavior in the Human Female” in 1953. These books shocked the American public, costing Kinsey most of his financial backing ; however, they opened the doors for new sex researchers to further develop the idea of sex as a social act.
William Masters and Virginia Johnson were among the first pioneers of sexual health research, starting in 1957 in St. Louis, Miss. They published two revolutionary books, “Human Sexual Response” and “Human Sexual Inadequacy,” in 1966 and 1970, respectively, evaluating and analyzing sexual health and, for the first time, pleasure.
“Sex therapy as a field really became more credible after Masters and Johnson,” said Michael McGee, a certified sex educator and professor at Fairleigh Dickinson University.
Masters and Johnson said sexual problems were — often unsuccessfully — addressed using individual, multiyear psychotherapy sessions before 1970. That year, they introduced what is now considered to be the standard procedure for sex therapy: Couples meet with a male-female therapist team during a session in an attempt to overcome sexual dysfunctions such as premature ejaculation and impotence.
Sex therapy is not always the first step, however, especially if the underlying causes of the problem are purely physical. Potential patients are often referred to a physician or psychologist; only if they cannot fix the problem do people generally go to see a sex therapist.
“We need to evaluate what is going on first before we can find the appropriate resource,” said Christine Peterson, a gynecologist at Student Health. “We have a reading list that we direct patients to, but sometimes the patient will tell us, ‘I understand this information but I’m still having problems.’” Peterson said when this happens, she will “absolutely” recommend a sex therapist.
Yvonne Fulbright, sexology author, defines sex therapy as a place where couples have the opportunity to talk about sexual issues in a safe environment, receive education about how the body functions sexually and learn sex exercises to perform outside the office. Postmodern sex therapy sessions involve addressing an array of underlying causes for sexual dysfunction, especially regarding the couples’ emotional connections and willingness to address them. This focus is illustrated through a widely popular emphasis on sensate focus, a practice in which the act of sexual intercourse is intricately linked with the sexual experience on both a physical and emotional level.
Around 1970, Masters and Johnson also introduced the idea of sex surrogates, or trained therapists who engage with their patients in sexual acts rather than simply talking about problems. R.J. Noonman expanded on this definition in his 1984 thesis about the role of sex surrogates, distinguishing them from prostitutes because of what he calls “intent:” prostitutes focused on achieving an orgasm, whereas sex surrogates focused on sexual healing, spending most of their time talking about and enhancing the “cognitive, emotional and sensual worlds” of a patient.
“There are not many people who practice that due to all kinds of ethical and legal issues,” McGee said, “however it is an enormously valuable service for people with certain issues.” McGee said people who can benefit from these services vary from severely disabled patients who long to explore their sexuality to those who have suffered a traumatic experience that interferes with their capacity to function sexually.
“They [sex surrogates] are highly trained and work closely with a therapist,” McGee said. “There are a high range of professional standards of practice that professional surrogates are bound by.”
These programs have proven successful in some clinics, such as the Riskin-Banker Sex Therapy Center in Orange County, Calif., which is nationally known for its Surrogate Sex Therapy program.
Masters’ and Johnson’s research sparked an flood of both heterosexual and homosexual literature and self-help books, one of which is “The Joy of Sex: A Gourmet Guide to Lovemaking” by Alex Comfort, published in 1972. It was the first major book on sexuality brought to the public’s attention in the United States, selling more than 8 million copies, according to Barnes & Noble. It focuses on sexual intimacy and pleasure, rather than the science and physiology behind physical acts, which was the focus of most of sexual literature of that time.
Just as the social changes during the 1960s and 1970s set the stage for the sexual revolution of that time, increased awareness of HIV/AIDS also played a major role in establishing the popular outlook on sexual health. “The Joy of Sex” was revised to discuss the disease, and much of the academic literature, such as Noonman’s thesis, was updated to include discourse about the way AIDS infiltrated sexual health practices.
The Internet also has influenced the way sexual health is discussed. The fourth edition of “The Joy of Sex” is to be released in the United States in January 2009, and according to The Huffington Post Web site and blog, it will contain a significant amount of new material focusing on sex in a new age of technology, addressing issues such as Internet pornography and cybersex.
Additionally, multiple self-help Web sites have been launched to help people not only ask sex questions they would have otherwise had to ask a physician, psychiatrist or therapist, but also to help guide them toward those resources.
While times have certainly changed since the sexual revolution, McGee said he recently attended a conference where one paper discussed that people still feel self-conscious about sex.
“Even though we live in a society when there is a lot of sexuality in popular culture, people still feel a lot of shame, guilt and fear of going in for sexual help,” McGee said. “If they can talk about their questions with someone who doesn’t judge them or exacerbate these feelings, that experience can be enormously helpful.”
From Kinsey’s social exclusion for his revolutionary research to the open advertising of sex surrogate therapy, the social perception of sexual health has and will continue to grow with the waves of social change.
Read More
U.Va. Health sees a spike in COVID-19 cases
By Emily Horn | September 4, 2023U.Va. Health ended their vaccination requirements in August, and masks were made optional in most hospital areas in early April.
U.Va. Cancer Center harnesses $12 million grant to support opportunities for undergraduates, ongoing research and new center
By Ellen Wu | January 12, 2023The grant provides an opportunity to establish the Center for Systems Analysis of Stress-Adapted Cancer Organelles, which seeks to find the cause of cancer in individual organelles.
U.Va. Health's rural neurology clinics receive a $500,000 grant to fund research and patient care
By Shrinidhi Kittur | January 12, 2023Established in the rural towns of Tazewell, Abingdon and Wise, the clinics have been providing patient care to otherwise underserved populations for decades.
