As a researcher whose work focuses largely on the causes and conse quences of unwanted pregnancy, I may appear to be an unlikely candidate to write a foreword to a book on infertility. Yet, many of the themes that emerge in the study of unwanted pregnancy are also apparent in the study of infertility. Moreover, this volume is an important contribution to the literature on fertility, women's health issues, and health psychology in general, all topics with which I have been closely involved over the past two decades. Neither pregnancy nor its absence is inherently desirable: The occurrence of a pregnancy can be met with joy or despair, and its absence can be a cause of relief or anguish. Whether or not these states are wanted, the conscious and unconscious meanings attached to pregnancy and in fertility, the responses of others, the perceived implications of these states, and one's expectations for the future all are critical factors in determining an individual's response. In addition, both unwanted pregnancy and failure to conceive can be socially stigmatized, evoking both overt and subtle social disapproval. Fur ther, they involve not only the woman, but her partner, and potentially the extended family. Finally, both of these reproductive issues have been poorly researched. Because both are emotionally charged and socially stigmatized events, they are difficult to study. Much of the early literature relied on anecdotal or case reports."

The publication of this volume at this time appears particularly auspi cious. Biological, psychological, and social change is greater during the pubertal years than at any other period since infancy. While the past two decades have witnessed a virtual explosion of productive research on the first years of life, until recently research on adolescence, and particularly on puberty and early adolescence, has lagged substantially behind. This book provides encouraging evidence that things are changing for the better. Considered separately, the individual chapters in this book include important contributions to our growing knowledge of the biological mechanisms involved in pubertal onset and subsequent changes, as well as of the psychological and social aspects of these changes, both as con sequences and determinants. In this regard, the book clearly benefits from the breadth of disciplines represented by the contributors, includ ing developmental endocrinology, adolescent medicine, pediatrics, psy chology, and sociology, among others."

This thirteenth volume in the series addresses an increasingly salient worldwide research, design, and policy issue-women and physical environments. We live in an era of worldwide social change. Some nation-states are fracturing or disintegrating, migrations are resulting from political up heavals and economic opportunities, some ethnic and national animosi ties are resurfacing, and global and national economic systems are under stress. Furthermore, the variability of interpersonal and familial forms is increasing, and cultural subgroups-minorities, women, the physically challenged, gays, and lesbians-are vigorously demanding their rights in societies and are becoming significant economic and political forces. Although these social-system changes affect many people, their im pact on women is especially salient. Women are at the center of most forms of family life. Whether in traditional or contemporary cultures, women's roles in child rearing, home management, and community relations have and will continue to be central, regardless of emerging and changing family structures. And, because of necessity and oppor tunity, women are increasingly engaged in paid work in and outside the home (women in most cultures have historically always worked, but often not for pay). Their influence in cultures and societies is also mounting in the social, political, and economic spheres. In technological societies, women are playing higher-level roles, though still in small numbers, in economic and policy domains. This trend is likely to acceler ate in the twenty-first century.

A useful tool for practitioners, researchers, theorists, and advanced students, Handbook of Sexual Assault analyzes the nature and extent of the problem of sexual offending and classifies the types of offenders according to an empirically developed system. In addition, contributors present the theories of the etiology and maintenance of sexual offending; offer various perspectives and factors relevant to accurate assessment; and detail contemporary treatment procedures.

As we enter the last decade of the twentieth century, the AIDS epidemic looms ever larger and threatening. The specter of upwards of a million deaths in the United States and perhaps many millions worldwide from a sexually transmitted virus shakes our belief in modem medical science, while challenging the foundations of democratic society. Almost ten years into the epidemic, and with an enormous body of basic science research on the Human Immunodeficiency Virus (HIV), we still do not know why AIDS emerged when it did or how to stop its spread. A very humbling experience for scientists, clinicians, public health experts, politicians, and the general public. Yet there are signs that a well coordinated multidisciplinary research program can conquer the epidemic and, perhaps, provide the basis for preventing future epidemics. The HIV family of viruses is now better understood, both in terms of structure and function, than any other virus. Genetically engineered peptides and nucleic acids are being tested as specific treatments or vaccines against HIV infection/disease. Most prom ising are the strides which have been made in understanding those aspects of human behavior which have contributed to the spread of HIV infection and which must be substantially modified if AIDS is to be controlled and eventually eradicated. The basis of that understanding has roots in a diverse set of disciplines which have converged in the work presented in this book."

Families are undergoing dramatic changes in our society. Our tradi tional views are being challenged by new family arrangements. These new family arrangements are forcing redefinitions of what consti tutes a family and raising significant issues regarding the potential developmental consequences for children in these families, if such exist. Moreover, the ramifications of redefined families and their bear ing on children's development extend into the legal, political, and societal arenas. This book focuses on the relationships between di verse family arrangements and children's development, as well as on legal and social implications. Our interest in this area emanates from our experience in directing the Fullerton Longitudinal Study. In the course of this investigation, we observed families undergoing transformation, most commonly in maternal employment and marital status. Our initial research on the role of maternal employment in children's development provided the scientific foundation for our interest. Just as we feel that maternal employment and dual-earner families should be comprehensively re searched regarding their relationships to children's development, we also believe that other contemporary family arrangements should receive extensive attention in the developmental literature. Hence, the idea for this book emerged.

In a review written in 1979, I noted that there was a paucity of research examining the effects of maternal employment on the infant and young child and also that longitudinal studies of the effects of maternal em ployment were needed (Hoffman, 1979). In the last 10 years, there has been a flurry of research activity focused on the mother's employment during the child's early years, and much of this work has been longi tudinal. All of the studies reported in this volume are at least short-term longitudinal studies, and most of them examine the effects of maternal employment during the early years. The increased focus on maternal employment during infancy is not a response to the mandate of that review but rather reflects the new employment patterns in the United States. In March 1985, the Bureau of Labor Statistics reported that 49.4% of married women with children less than a year old were employed outside the home (Hayghe, 1986). This figure is up from 39% in 1980 and more than double the rate in 1970. By now, most mothers of children under 3 are in the labor force."

Methodological problems have hampered researchers' efforts to understand and control AIDS since the beginning of the epidemic. This practical book addresses these problems by using actual health research case studies to develop strategies regarding design and sampling, measurement, and analysis and modeling issues. Researchers working on both biological and behavioral aspects of the disease will find this work a singularly effective tool to improve their study designs.

Sexual Orientation in Child and Adolescent Health Care serves as a resource for child health care professionals including pediatricians, family physicians, nurses, pediatric psychologists, child and adolescent psychiatrists, and social workers. The issues of sexuality and sexual orientation now generate great interest among those who treat children. This volume describes the effects of stigmatization on non-heterosexual physicians, patients, and students, and discusses a variety of clinically relevant topics including the development of sexual orientations, children of gay or lesbian parents, young children with gender atypical behavior, and the healthcare needs of gay and lesbian adolescents. The last two chapters describe methods for improvement in medical education and medical care, and provide extensive resources available to professionals and consumers.

Rough-and-tumble play provided one of the paradigmatic examples of the appli- tion of ethological methods, back in the 1970's. Since then, a modest number of - searchers have developed our knowledge of this kind of activity, using a variety of methods, and addressing some quite fundamental questions about age changes, sex diff- ences, nature and function of behaviour. In this chapter I will review work on this topic, mentioning particularly the interest in comparing results from different informants and different methods of investigation. Briefly, rough-and-tumble play (or R&T for short) refers to a cluster of behaviours whose core is rough but playful wrestling and tumbling on the ground; and whose general characteristic is that the behaviours seem to be agonistic but in a non-serious, playful c- text. The varieties of R&T, and the detailed differences between rough-and-tumble play and real fighting, will be discussed later. 2. A BRIEF HISTORY OF RESEARCH ON R&T In his pioneering work on human play, Groos (1901) described many kinds of rough-and-tumble play. However, R&T was virtually an ignored topic from then until the late 1960's. There was, of course, a flowering of observational research on children in the 1920s and 1930s, especially in North America; but this research had a strong practical o- entation, and lacked the cross-species perspective and evolutionary orientation present in Groos' work.

What are the differences between the sexes? That is the question that Ann Oakley set out to answer in this pioneering study, now established as a classic in the field. To answer it she draws on the evidence of biology, anthropology, sociology and the study of animal behaviour to cut through popular myths and reach the underlying truth. She demonstrates conclusively that men and women are not two separate groups: rather each individual takes his or her place on a continuous scale. She shows how different societies define masculinity and femininity in different and even opposite ways, and discusses how far observable differences are based on biology and psychology and how far on cultural conditioning. Many books have discussed these vital issues. None, however, have drawn on such an impressively wide range of evidence or discussed it with such clarity and authority. Now newly reissued with a substantial introduction which highlights its continuing relevance, this work will continue to inform and shape dialogues around sex and gender for a new generation of scholars and students.

Over the past decade, the AIDS pandemic has propagated so widely and exerted such a dev astating impact that one may properly ask the question, Why not concentrate all AIDS efforts on disease control alone? Why link AIDS with women's reproductive health? What is the scientific basis for this linkage? And how might AID~ control and women's health objectives be promot ed simultaneously? These questions constitute the principal themes addressed in this monograph. The 15 chapters in this volume are intended to provide state-of-the-art reviews of key interac tions between AIDS and women's reproductive health for an audience of scientists and policy makers in the AIDS and population fields. Impetus for this monograph comes in pan from what we perceive to be an inadequate global response, thus far, to AIDS and women's health ;>roblems. A common platform has failed to emerge among the disparate professional communities working in the areas of AIDS, STDs, and family planning. As a result, endeavors in these fields have been isolated, and opportunities for joint action have been missed. An enormous and, as yet, unharnessed potential exists for power ful interdisciplinary collaborations that could strengthen policies and programs against these pressing health problems of humankind.

Until recently, studies of women's health received scant research attention in the context of the overall magnitude of research conducted on health. Even for health issues that affect both men and women, most research has been limited to male subjects, leaving a large gap in our knowledge base concerning women's health. Finally, the decade of the 1990s is ushering in a shift in this inequity. In 1990 the U.S. National Institutes of Health issued a compelling report citing the lack of sufficient research on women's health as a major gap in our knowledge, and a mandate has been issued to add women as study subjects in research or to document why they have not been included. Such directives will undoubtedly lead to a much-needed burgeoning of research activities in the area of women's health as we approach the twenty-first century. Despite limited research resources, however, there have been steady, scientifically rigorous voices in the wilderness for the last several years, and many of the best investigators are represented in this volume. These workers have led the vanguard in exploring psychosocial factors that are likely to differentially affect women's and men's health. For example, women and men engage in social roles that often differ, if not in quantity, then certainly in quality. Sex differences in role expectations, environmen tal qualities, role burdens related to the domains of work and family, and abilities to adapt to and cope with stressful situations may have a distinctive impact on health."

This book offers a genealogy of the medicalisation of sexual appetite in Europe and the United States from the nineteenth to twenty-first century. Histories of sexuality have predominantly focused on the emergence of sexual identities and categories of desire. They have marginalised questions of excess and lack, the appearance of a libido that dwindles or intensifies, which became a pathological object in Europe by the nineteenth century. Through a genealogical approach that draws on the writings of Michel Foucault, A Genealogy of Appetite in the Sexual Sciences examines key 'moments' in the pathologisation of sexuality and demonstrates how medical techniques assumed critical roles in shaping modern understandings of the problem of appetite. It examines how techniques of the patient case history, elixirs and devices, measurement, diagnostic manuals and pharmaceuticals were central to the medicalisation of sexual appetite. Jacinthe Flore argues that these techniques are significant for understanding how a concern with 'how much?' has transformed medical knowledge of sexuality since the nineteenth century. The questions of 'how much?', 'how often?' and 'how intense?' thus require a genealogical investigation that pays attention to the emergence of medical techniques, the transformation of forms of knowledge and their effects on the problematisations of sexual appetite.

Integrating behavioral, psychoanalytic, and biological perspectives into a unique multi-modal approach, the authors present a new diagnostic and treatment methodology which is flexible enough to account for individual variations in sexually perverse disorders. Alongside this methodology, they highlight the key issues concerning these disorders to provide the general practicing clinician with a practical guide for treating the sexually deviant patient.

The search for artificial means of enhancing sexual experience is timeless and can even be found in the opening passages of Genesis (3:7) where Adam and Eve discovered sex as they took a bi te of the forbidden fruit: "And the eyes of them both were opened, and they knew that they were naked. " While others may interpret the "opening of their eyes" as simply an awareness of male and femaleness, John Milton and others regarded the forbidden fruit as an aphrodisiac and in Paradise Lost, described in greater detail what happened: "But the false fruit For other operation first displayed Carnal desire infiarning. He on Eve Began to cast lascivious eyes; she hirn As wantonly repaid; in lust they burn. " Not only did Milton regard the "forbidden fruit" as an aphro disiac, he also identified it as an apple, and an apple it has re mained until this day. Sexual behavior has always been one of the most fascinating and attention-arresting activities in human history and there has been no decrease in the fascination and curiosity it still arouses in the human psyche. 1 2 Introduction As timeless as the topic of sexual behavior is that of aphro disiacs. For example, after the "forbidden fmit," the Bible specifi cally identified mandrake as an aphrodisiac (Genesis 30:14-17): "And Reuben went, in the days of wheat harvest, and found mandrakes in the field, and brought them to his mother, Leah."

Research has traditionally shown high schools to be hostile environments for LGBT youth. Boys have used homophobia to prove their masculinity and distance themselves from homosexuality. Despite these findings over the last three decades, The Declining Significance of Homophobia tells a different story. Drawing on fieldwork and interviews of young men in three British high schools, Dr. Mark McCormack shows how heterosexual male students are inclusive of their gay peers and proud of their pro-gay attitudes. He finds that being gay does not negatively affect a boy's popularity, but being homophobic does. Yet this accessible book goes beyond documenting this important shift in attitudes towards homosexuality: McCormack examines how decreased homophobia results in the expansion of gendered behaviors available to young men. In the schools he examines, boys are able to develop meaningful and loving friendships across many social groups. They replace toughness and aggression with emotional intimacy and displays of affection for their male friends. Free from the constant threat of social marginalization, boys are able to speak about once feminized activities without censure. The Declining Significance of Homophobia is essential reading for all those interested in masculinities, education, and the decline of homophobia.

The author has written an unusually fresh work, applying a biopsychosocial approach to the diagnosis and treatment of a wide range and degree of disorders. The book will provide mental health professionals and graduate students with a trustworthy, sophisticated introduction to sexual health and its problems.

aiaiaiai ai By providing empirical data and multidisciplinary considerations, the book increases awareness of child sex offender suicide among the various entities which come into contact with this population of offenders. This book attempts to bring awareness of this potentially high risk population to better inform the law enforcement, corrections, and mental health communities of the unique risk factors for suicide among CSOs and provide a more effective crisis response. The Federal Bureau of Investigation (FBI) Behavioral Analysis Unit III- Crimes Against Children reviewed and analyzed 106 male Child Sex Offenders (CSO) who committed suicide during the course of a child sex crime investigation. Of the 106 CSOs, 79% were child pornography traders/collectors, 43% were child molesters, 21% were travelers, and 18% were child pornography producers. Analyses also revealed that nearly all were Caucasian and the majority were married, employed, and died via self-inflicted gunshot wound.Of particular interest was that in 26% of the cases, the offender killed himself within 48 hours of his awareness of the investigation; and in nearly half of the known cases, the offender had past/current military service and a criminal history. In addition, 68% left a suicide note, which is substantially higher than the general suicide population. Analysis of the notes revealed common aspects and themes including cognitive distortions, burdensomeness, shame, and self-blame. The most frequently cited reason for the suicide in the note was the child sex crime investigation.

The odd reader (here in England "odd" means occasional) may be interested in how a book comes about. Members of the SIECUS Board of Directors were planning a Festschrift and dinner for Mary Calderone on the occasion of her 75th birthday. One planning idea was to have a booklet, filled with brief essays from prominent sex educators, distributed between the roast beef and the ice cream. My reaction was that such "souvenirs" find their burial place in the same dusty drawer as the program from the high school prom and ticket stubs from South Pacific. I suggested a more lasting, noticeable "monument," a "proper" (as the English say) book which would draw contributions from both SIECUS and non-SIECUS scholars. 1 was too clever to be trapped as editor (in a 1974 preface, I had written "I swore 1 wouldn't edit another book"). And so I seduced Lorna Brown (into being editor). I contacted a few potential con tributors, suggested a few others, convinced Leonard Pace at Plenum Press that this was a worthwhile venture, and left the country. To my amaze ment, six months after settling in Cambridge, England, the rough draft of the book arrived along with areminder from Lorna that during the se duction I had promised to write an Introduction."

Early embryonic loss is a continuing social and economic global problem. In human populations the estimates of interruptions early in pregnancy range from 35-60%. In animal husbandry (swine, ruminants) fully 30% of pregnancies fail to survive early events of gestation. The futility associated with this persistant high risk is even more unsettling because of advances made in assisted reproductive technology which, although this very selective methodology has added to our knowledge of embryo-endometrial interactions, has resulted in a birth rate of only 14%. These studies have instigated comparisons of the live relative contributions of the embryo and the uterus to the outcome of pregnancy. These analyses have shown that we have learned significantly less about the role of the uterus in deciding the outcome of either natural or assisted pregnancies. In 1979 a quotation by George Corner was used to set the tone of a meeting that was devoted to discussion of the cellular and molecular aspects of implantation. In spite of the proliferation in research activity which occurred in the following 15 years our real understanding of the embryo transfer process has fallen short of our expectations. We use the Corner quotation, once again, to preface this symposium so that we may recall that the fundamental nature of the process which regulates embryo-endometrial interactions still escapes us.

When is it timely to publish a synthesis of previously published and original materials from a specific discipline? I believe it to be timely when one has a sufficient amount of high-quality material covering the critical areas of that topic, when the previously published material is scattered over a wide range of journals and books, and when there is no single book that synthesizes the discipline. The treatment of sexual dysfunction emerged to the front lines of health delivery only during the past decade with the pioneering work of William Masters and Virginia Johnson. In spite of the rash of sex clinics and sex therapists that followed, preciously little solid research has been conducted on the various strategies of therapy, the means of assessing complex interpersonal sexual relation ships, and the manner by which clinical change is objectively assessed. No one reader can keep pace with the multitude of jounials that publish key material by sophisticated investigators. And no one investigator can cover these salient areas alone with his or her original work in a single volume. The critical papers have now been written. Ten were written specifically for this volume and thirty-three have previously appeared. This volume laces them together into a coherent pattern. Thus, the time for a synthesis in sexual dysfunction."