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."

There are few topics in sex research as compelling and confounding to researchers, clinicians, and the general public as that of transsexualism. Upending normative notions of gender, eroticism, and identity, it poses significant scientific and clinical challenges. The book addresses a fascinating and largely unexplored topic within the study of transsexualism: The feelings and desires of conventionally masculine men who are attracted to women yet want to become women themselves. Through a collection and discussion of vivid first-person narratives, the book provides an in-depth examination of these men's unusual propensity to be sexually aroused by the thought of themselves as women and how these men's sexual feelings influence their decisions to seek or undergo sex reassignment. These narratives about autogynephilia by autogynephilic male-to-female (MtF) transsexuals provide the first comprehensive documentation of the erotic ideation that underlies the most common form of MtF transsexualism. The narratives provide empirical evidence for Blanchard's theory of MtF transsexual motivation, and thus are of interest to researchers and theorists studying the phenomenology of MtF transsexualism. The narratives are likely to be eye-opening to psychologists, psychiatrists, physicians, and other professionals who work with MtF transsexuals: Most clinicians probably do not fully appreciate the erotic underpinnings of their clients' condition. A better understanding of their clients' autogynephilic feelings and motivations would enable these professionals to provide more empathetic and effective clinical care.

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.

Mark has eloquently unraveled the mystery behind addictive behavior: when our relationships are not alive and growing, the temptation for various kinds of addictions is unleashed.. ---Dr. Gary Smalley With today s rampant availability of Internet pornography, sexual addiction has become a national epidemic that affects up to 10 percent of Christians. As devastating as any drug habit, it brings heartbreak and despair to those it entangles. But there is help for men and women caught in sexual addiction s downward spiral. This book offers a path that leads beyond compulsive thoughts and behaviors to healing and transformation. Sensitive to the shame of sexual addiction without minimizing its sinfulness, Dr. Mark Laaser traces the roots of the problem, discusses its patterns and impact, and maps out a biblical approach to self-control and sexual integrity. Previously titled Faithful and True, this revision includes an all-new section that deals with sexual addiction in the church. Other important changes reflect cultural trends, incorporate current research, and place a greater emphasis on spiritual growth. This book also addresses the unique needs and issues of female sex addicts. Whether you know someone with a sexual addiction or struggle yourself, Healing the Wounds of Sexual Addiction points the way to understanding, wholeness, and holiness."

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."

Like the lines of a secret map made dimly apparent by the chemical potion brushed on a piece of paper from a child's detective kit, the outlines of what may be a substantial behavioral biology of human life seem to be coming clear. From genetic science at its most molecular to demography with its assessment of the vital experience of massive populations, there is a growing understanding of the various ways in which the human species reveals underlying commonalities of experi ence through the life cycle and over the web of interactions that constitutes the basic matter of social life. At the same time, research has been successful in two super ficially and contradictory directions: first, in showing the enormous variation in human arrangements and consciousness across and with in cultures; and second, in showing the similarity between cultures as far as basic processes of physiology, neurophysiology, and even so ciallife are concerned. But the contradiction only exists in the absence of an understanding of the fact that in a species living under as many ecological, historical, and economic niches as Homo sapiens, cultural variation is what one would naturally expect."

This collection of readings is designed to clarify the relationship between social structures and psychological processes. Our awareness of the need for such a book derives from our extensive experiences in teaching a for mal course for mental health professionals on gender and psychother apy. The material in this anthology emphasizes the clinical implications of the new research and knowledge that has changed our understanding of the psychological development of women and men. Throughout the book, we present ideas that challenge conventional explanations of psy chological distress in women and men and suggest alternative concep tualizations of these processes. As will be evident, our work is informed by and contributes to the growing field of knowledge produced by feminist scholars over the last decade. That this book on gender has more to say about women reflects the existence of a substantial body of research that reconceptualizes women's psychology. The corresponding research on men is still in its formative stages, due in part to the later development of a men's move ment. Although many of the chapters focus on women, we have attempted in our discussion to consider the implications for men. We believe that the fundamental processes explored in this book are relevant to the understanding of both women and men."

Physical attractiveness phenomena permeate society with somber ramifica tions. Correspondingly, practical applications of physical attractiveness phenomena are extensive. The consequence is that almost every person can benefit from knowledge about research on physical attractiveness. Such research material provides valuable information for persons established in their careers, as well as those preparing for a career. Similarly, parents at all stages of their life cycle should be cognizant of how physical attractiveness impacts the psychological and physiological development of children. Because no one is isolated from physical attractiveness phenomena, knowledge of this material should be imperative for everyone. This book consolidates research that specifically addresses physical attractiveness. The first summary was a classic review presented over 10 years ago (Berscheid & Walster, 1974). Since then the research literature has continued to grow, but no comprehensive review has again been published. Even though research summaries have been presented in a compilation of psychological abstracts (Cash, 1980), and in a discussion of stereotyping literature (Adams, 1982), the study of physical attractiveness phenomena is due for a comprehensive account and an analysis of the extensive, divergent research."

In the 1960's marked changes occurred throughout the world in philosophies and policies related to man's role in life. These changes, prompted predominantly by extensive increases in knowledge and popula tion density, have produced increased pleasures as well as problems. The rising number of people and improved methods of communication and transportation have caused more relationships among people, with their pleasures, competitions, jealousies, conflicts of interest, oppressions, and crimes. Large assortments of drugs have been developed and are easily obtained. There are drugs to speed us up, slow us down, make us sleep, change our perspectives on life, promote propagation of life or prevent it, prolong life or terminate it, and modify the course of life in many ways. Also, numerous mechanical devices have been developed that influence the propagation of life, the termination of life, and the manner in which we live. Many people have changed their overall goals in life, and in par ticular have experienced major changes in attitudes and policies applying to sexual activity, marriage, birth control, abortion, welfare, children, old people, criminals, economics, social status, careers, education, euthanasia, and suicide. There also has been marked enlightenment concerning the effect of the chemical and physical status of the brain upon normal and abnormal thinking and behavior."

I have long been awe-struck by authors' claims that their books had been in the making for 5, or 10, or even 15 years. I now have a better appreciation ofthe work involved in bringing a book to press. The seeds of this project have had a long germination. The impetus for this book began more than 10 years ago when I was a graduate student in clinical psychology. Having an interest in human sexuality-and in theories on the forms of sexual attraction specifically-I was perplexed by various perspectives on this subject. Disciplines of thought that I encountered medicine, evolutionary biology, developmental psychology, gay/lesbian theory, social constructionism, anthropology, Marxism, Christianity, and others-perceived the issue so differently, so strongly, with almost no overlap. I was fascinated that the question ofhow and why one is attracted to either one or both sexes could elicit such conviction and divergent points of view. There seemed to be no easy way to resolve these differences. Still, what frustrated me most in my readings were several conceptual problems among the two prominent proponents of contemporary sexuality theory scientists and social constructionists. One ofmy first frustrations with biomedical and social scientists who write about sexuality was that they often define sexual attraction in strict behavioral terms, as completed observable sexual acts--observable in the sense that such acts or their consequences are seen by others.

Sperm Wars turns the conventional thinking about the biology of sex on its head. Evolutionary biologist Robin Baker argues that human sexuality follows certain laws, and all of those laws are governed by one thing: sperm warfare. In the interest of promoting competition between sperm to fertilize the same egg, evolution has built men to conquer and monopolize women while women, without ever knowing they are doing it, seek the best genetic input on offer from potential sexual partners. In this book, Baker reveals, through a series of provocative fictional scenes, the far-reaching implications of sperm competition: ten percent of children are not fathered by their "fathers;" less than one percent of a man's sperm is capable of fertilizing anything (the rest is there to fight off all other men's sperm); "smart" vaginal mucus encourages some sperm but blocks others; and a woman is far more likely to conceive through a casual fling than through sex with her regular partner. From infidelity, to homosexuality, to the female orgasm, Sperm Wars turns on every light in the bedroom. Two decades after its initial publication, this classic of popular science will still surprise, entertain, and even shock.

This book is based on a case study about Stella, l'amie de Maimie a Montreal sex workers' rights organization, founded by and for sex workers. It explores how a group of ostracized female-identified sex workers transformed themselves into a collective to promote the health and well-being of women working in the sex industry. Weighed down by the old and tenacious whore symbol, the sex workers at Stella had to find a way to navigate the criminality of sex work and sex workers, in order to do advocacy and support work, and create safer spaces for sex workers to engage in such advocacy. This book focuses on sex workers, but the advocacy challenges and strategies it outlines can also apply to the lives of other marginalized groups who are often ignored, pitied, or reviled, but who are seldom seen as fully human.

A little over 12 years ago I wrote a small volume entitled Infertility. It seemed to me at that time that significant advances in the field called for the publication of such a volume. The following is from the preface to that volume: During the past 15 years considerable progress has been made in the field of infertility diagnosis and management. It is perhaps a paradox that much of this increased knowledge has come about because of Western medicine's preoccupation with the search for a means to control reproduction. As a result, we have achieved new insights into the physiologic mechanisms involved in reproduction, and we have found better methods for measuring physiologic changes in reproductive health and disease. To these advances can be added improvements in the utilization of endoscopic and surgical techniques, in the diagnosis and treatment of infections and endometriosis, and in the treatment of hormonal disorders. During this period, too, through workshops and conferences and in journals and texts, these latest advances have been made available to physi cians, an outstanding example being the two volumes of Progress in Infer tility, edited by Drs. Jan Behrman and Robert Kistner. As necessary as these publications are, they do not offer an overall view of infertility diag nosis and management."

Throughout my clinical training and practice, I have been surprised by the number of times that sexual issues have emerged as an unexpectedly central feature in my work with older adults. I can vividly remember my own internal reaction on hearing one of my elderly female patients tell me that she was date raped a few years after the death of her elderly husband-when she was 68 years old. I can see in my mind's eye the blood splattered on the floor of an inpatient unit from an elderly man who smashed his arm through a window, furious that his antidepressant medication made it impossible to climax through masturbation. On a much less dramatic but equally important note, I think about the elderly amputee who told me softly about his fears of resuming sexual activity with his wife of 25 years. I also think about the elderly woman whose inability to take herself shopping to find fashionable, comfortable clothes to fit over her hunched shoulders and large breasts helped precipitate a serious depression. In sum, I learned early on that elderly sexuality is not just about how many times a week someone makes love. It is my hope that sharing these experiences and introducing the related theories, research, and interventions will assist other clinicians in dealing with these often challenging and clinically demanding situations. Without my patients, this text would not have been possible.

In the decade-and-a-half since I coedited Transsexualism and Sex Reassignment (Green & Money, 1969), remarkable changes have occurred with Harry Ben jamin's "transsexual phenomenon" (1966). Formerly, when writing about this condition in scientific journals, it was necessary to define the term transsex ualism. Now the lay public recognizes it. Even the American Psychiatric Asso ciation acknowledges it as a "disorder," with its inclusion in the Third Edition of its Diagnostic and Statistical Manual (1980). Although this "elevation" to the status of mental illness may seem a Pyrrhic victory, it is a recognition of the legitimacy of transsexual ism as a source of human suffering. The controversy that surrounded the decisions in the early patient cases to perform sex-change surgery has largely dissipated. The cries of "collusion with delusion," principally from psychoanalysts, have quieted. The dire predictions of psychosis and/or suicide following surgery as the "last psychic defenses are cut away" have almost never been realized. By contrast, many postoperative patients consider the surgery to have been life-saving. Medical centers worldwide have incorporated programs for evaluating and treating persons requesting sex reas signment. Elaborate guidelines for patient management have been developed by an international organization of health care professionals (Harry Benjamin Inter national Gender Dysphoria Association, 1981). Harry Benjamin's child has come of age."