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Gaither TW, Siapno AED, Kianian R, Vincent N, Williams KC, Piquerias E, Russell MM, Litwin MS. Relationship between pelvic sensations and lifetime exposure to receptive anal intercourse among people with prostates. J Sex Med 2023; 20:1195-1205. [PMID: 37548267 DOI: 10.1093/jsxmed/qdad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Despite the negative stigma on receptive anal intercourse (RAI), this behavior has a positive influence on individuals' sexual and relationship health. No large studies have previously looked at specific sensations experienced during RAI and how these sensations may change with experience. AIM In this study we aimed to quantify commonly reported pelvic sensations during RAI and determine whether their presentation changes with increasing experience of RAI. METHODS An internet survey was conducted on sensations felt during RAI among people with prostates from July 2022-January 2023. The survey content was developed based on a mixed-methods qualitative study and inquired about demographic and sexual histories as well as sensations (pleasure, pain, urinary, and bowel) experienced during RAI. We used descriptive statistics to describe demographic and sexual histories. All data were stratified by lifetime exposure to RAI. OUTCOMES The primary outcomes assessed included the quantification of both the primary sensations experienced during RAI and the associated bother. RESULTS In total, 975 participants completed the survey. The median age was 32 (range 18-78) years. The average age of first participation in RAI was 21 ± 6.6 years. Most respondents were having sex at least once a week (65%). Nine percent of respondents reported fewer than 10 experiences with RAI, 26% reported 11-50 RAI experiences, 32% reported 51-200 experiences, 16% reported 201-500 experiences, and 18% reported >500 experiences. As the number of experiences with RAI increased (from <10 to >500 exposures), the reported frequency of pleasurable sensation increased from 41% to 92% (P < .0001), whereas severe insertional pain and symptoms of bowel urgency decreased from 39% to 13% and from 21% to 6%, respectively (P < .0001). Urinary urgency sensation did not differ by lifetime RAI experience. CLINICAL IMPLICATIONS Lifetime RAI exposure can be readily assessed and correlates not only with pelvic sensation but also many other aspects of sexual health. These results imply that the etiology of dissatisfaction with pleasure or anodyspareunia during RAI may differ by lifetime RAI exposure. STRENGTHS AND LIMITATIONS This is the first study to our knowledge to assess pelvic sensations experienced during RAI among a large sample of individuals. This is a cross-sectional study, and we cannot conclude how pelvic sensations change over time among individuals. Internet-based participants may not be representative of clinical populations. CONCLUSION Lifetime exposure to RAI is positively associated with pleasure and is negatively associated with pain and bowel urgency. Pelvic sensations experienced during RAI appear to be dependent on lifetime RAI exposure history regardless of age.
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Affiliation(s)
- Thomas W Gaither
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Allen E D Siapno
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Reza Kianian
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | | | - Kristen C Williams
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Eduardo Piquerias
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Marcia M Russell
- Department of Surgery, Section of Colorectal Surgery, David Geffen School of Medicine, Los Angeles, CA 90095, United States
- Surgical and Perioperative Careline, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
- School of Nursing, University of California Los Angeles, Los Angeles, CA, United States
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Rind B. Subjective Reactions to First Coitus in Relation to Participant Sex, Partner Age, and Context in a German Nationally Representative Sample of Adolescents and Young Adults. ARCHIVES OF SEXUAL BEHAVIOR 2023:10.1007/s10508-023-02631-5. [PMID: 37286764 DOI: 10.1007/s10508-023-02631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/09/2023]
Abstract
Analysis of a Finnish nationally representative student sample found that subjective reactions to first intercourse (mostly heterosexual; usually in adolescence) were highly positive for boys and mostly positive for girls, whether involved with peers or adults (Rind, 2022). The present study examined the generality of these findings by examining subjective reactions to first coitus (heterosexual intercourse) in a German nationally representative sample of young people (data collected in 2014). Most first coitus was postpubertal. Males reacted mostly positively and uncommonly negatively in similar fashion in all age pairings: boy-girl (71% positive, 13% negative); boy-woman (73% positive; 17% negative); man-woman (73% positive, 15% negative). Females' reactions were more mixed, similar in the girl-boy (48% positive; 37% negative) and woman-man (46% positive, 36% negative) groups, but less favorable in the girl-man group (32% positive, 47% negative). In logistic regressions, adjusting for other factors, rates of positive reactions were unrelated to age groups. These rates did increase, in order of importance, when participants were male, their partners were close, they expected the coitus to happen, and they affirmatively wanted it. Reaction rates were computed from the Finnish sample, restricting cases to first coitus occurring in the 2000s, and then compared to minors' reactions in the German sample. The Finns reacted more favorably, similarly in both minor-peer and minor-adult coitus, with twice the odds of reacting positively. It was argued that this discrepancy was due to cultural differences (e.g., Finnish culture is more sex-positive). To account for the reaction patterns shown in the adolescent-adult coitus, sizably at odds with expectations from mainstream professional thinking, an evolutionary framework was employed.
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Jahnke S, Schmidt AF, Hoyer J. Pedohebephilia and Perceived Non-coercive Childhood Sexual Experiences: Two Non-matched Case-Control Studies. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:340-374. [PMID: 35549946 PMCID: PMC10041574 DOI: 10.1177/10790632221098341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Research on the link between childhood sexual abuse experiences (CSAE) and pedohebephilia is limited by its focus on events that the respondents rate as abusive. We asked 199 German-speaking (Study 1) and 632 English-speaking (Study 2) men with and without self-reported pedohebephilia to complete the Childhood Trauma Questionnaire (CTQ) and scales to assess perceived non-coercive childhood sexual experiences with adults (PNCSE-A), and peers (PNCSE-P, only Study 2). A substantial number of participants with PNCSE-A disagreed with all items of the CTQ Sexual Abuse subscale (e.g., 35% and 26% of pedohebephilic men in Studies 1 and 2, 38% of teleiophilic men in Study 2). While pedohebephilic men reported more CSAE than teleiophilic men, the effects for PNCSE-A did not consistently point in the expected direction. In Study 2, conviction status for sexual offenses among pedohebephilic men was linked to higher rates of CSAE, PNCSE-A, PNCSE-P, physical neglect, and physical abuse. Pedohebephilic men in Study 2 also reported more PNCSE-P than teleiophilic men. Our results highlight the importance of assessing different (positive or neutral) perceptions of CSAE. Better controlled designs (e.g., matched case-control studies) are needed to substantiate whether and how perceived non-coercive childhood sexual experiences relate to pedohebephilia and sexual offending.
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Affiliation(s)
- Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, Norway
| | - Alexander F. Schmidt
- Institute of Psychology, Social & Legal Psychology, Johannes Gutenberg-Universität Mainz, Germany
| | - Jürgen Hoyer
- Institute for Clinical Psychology and Psychotherapy, Technische Universitä Dresden, Germany
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Lassri D, Wasser O, Tener D. Lover, Mentor, or Exploiter: Retrospective Perspectives of the Older Person Following Sexual Relationships with Adults During Adolescence. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:987-999. [PMID: 35075600 DOI: 10.1007/s10508-021-02233-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 06/14/2023]
Abstract
Sexual relationships between an adolescent and an older person are considered controversial and in many countries are conceptualized under the legal definition of statutory relationship/rape. Despite the consensus regarding their potential negative implications, little is known about how adolescents perceive and construct them. To address this lacuna, the current exploratory study examined how individuals who have experienced sexual relationships with an adult while growing up perceived the older person and the meaning they ascribed to the age gap (M age gap, 7.78 years; range, 2-18 years). A qualitative thematic methodology was incorporated in analyzing in-depth semi-structured interviews with 28 individuals (M age, 29.89 years) who had experienced sexual relationships with an (at least 2 years) older person during adolescence (M age, 14.78 years). Participants described five different perceptions of the older persons: romantic partner; sexual partner; authority figure; complex/unstable figure; and exploiter. Subsequent analysis, focusing on the role participants assigned to age when describing these different images of older persons, shed additional light on their subjective perceptions; namely, for each image, age had a particular meaning. This paper may contribute to the understanding of individuals' experiences of sexual relationships with an older person by emphasizing the complexity of such relationships, as reflected in the participants' construction of the older person's image, potentially providing important information that can inform best practice for professionals working with this population. Findings highlight the need to address diversity and ambiguity rather than the uniform dichotomy that characterizes the legal framing of automatically constructing these relationships as statutory. Further implications for research, policy, and practice are discussed.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt Scopus, 91905, Jerusalem, Israel.
- Research Department of Clinical, Educational and Health Psychology, UCL, and Haruv Institute, Jerusalem, Israel.
| | - Ortal Wasser
- Silver School of Social Work, New York University, New York, NY, USA
| | - Dafna Tener
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt Scopus, 91905, Jerusalem, Israel
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Rind B. Reactions to Minor-Older and Minor-Peer Sex as a Function of Personal and Situational Variables in a Finnish Nationally Representative Student Sample. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:961-985. [PMID: 35018515 DOI: 10.1007/s10508-021-02224-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 06/14/2023]
Abstract
Felson et al. (2019) used a large-scale nationally representative Finnish sample of sixth and ninth graders to estimate the population prevalence of negative subjective reactions to sexual experiences between minors under age 18 and persons at least 5 years older and between minors and peer-aged partners for comparison. They then accounted for these reactions in multivariate analysis based on contextual factors. The present study argued that focusing exclusively on negative reactions short-changed a fuller scientific understanding. It analyzed the full range of reactions in the same sample, focusing on positive reactions. For reactions in retrospect, boys frequently reacted positively to minor-older sex (68%, n = 280 cases), on par with positive reactions to boy-peer sex (67%, n = 1510). Girls reacted positively to minor-older sex less often (36%, n = 1047) and to girl-peer sex half the time (48%, n = 1931). In both minor-older and minor-peer sex, rates of positive reactions were higher for boys vs. girls, adolescents vs. children, when partners were friends vs. strangers or relatives, with intercourse vs. lesser forms of sexual intimacy, with more frequent sex, and when not coerced. Boys reacted positively more often with female than male partners. In minor-older sex, partner age difference mattered for girls but not boys, and the minor's initiating the sex (14% for girls, 46% for boys) produced equally high rates of positive reactions. Most of these factors remained significant in multivariate analysis. The frequency of positive reactions, their responsiveness to context, the similarity in reaction patterns with minor-peer sex, and the generalizability of the sample were argued to contradict the trauma view often applied to minor-older sex, holding it to be intrinsically aversive irrespective of context.
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Boydell V, Wright KQ, Smith RD. A Rapid Review of Sexual Pleasure in First Sexual Experience(s). JOURNAL OF SEX RESEARCH 2021; 58:850-862. [PMID: 33871295 DOI: 10.1080/00224499.2021.1904810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While researchers have thoroughly studied the who, what, and when of first sexual experiences, we know much less about how people construct, experience, and proceed (or not) with sexual pleasure in these experiences and beyond. To address this knowledge gap, the Global Advisory Board for Sexual Health and Wellbeing (GAB) coordinated a rapid review of published peer-reviewed research to determine what is currently known about sexual pleasure in first sexual experiences. We found 23 papers exploring this subject and its intersections with sexual health and sexual rights. The results reveal significant gaps in erotic education, gender equity, vulnerability and connection, and communication efficacy; and highlight important domains to consider in future research. Our findings draw out the key features of pleasurable first sexual experience(s), namely that individuals with the agency to formulate their definition and context of what pleasure means to them are more likely to experience pleasure at first sex. This finding points to promising ways to improve first sexual experiences through erotic skills building and through addressing knowledge gaps about having sex for the first time among disadvantaged groups.
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Affiliation(s)
| | | | - Robert D Smith
- Global Health Centre, The Graduate Institute, Geneva (IHEID)
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Rind B. First Sexual Intercourse in the Irish Study of Sexual Health and Relationships: Current Functioning in Relation to Age at Time of Experience and Partner Age. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:289-310. [PMID: 32430871 DOI: 10.1007/s10508-020-01721-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
The Irish Study of Sexual Health and Relationships, based on a nationally representative sample of Republic of Ireland adults in 2004-2005, was used to examine adult adjustment in individuals who had their first sexual intercourse as a minor with an adult. Participants were classified into one of four groups based on their age at first intercourse and their partner's age: minors under 18 with peers; minors under 16 with adults; minors 16 to 17 with adults; and adults with adults. Adjustment (health, general relationships, satisfaction with most recent sexual partner, self-confidence, education and career achievement, and sexual problems) was compared across groups separately by gender. The vast majority of cases involved postpubertal heterosexual coitus. Overall, minors involved with adults were not significantly less well adjusted than adults involved with other adults on a majority of measures, effect size differences in adjustment were mostly small, and mean adjustment responses consistently indicated good rather than poor adjustment. Sex differences in first-intercourse characteristics and reasons for engaging reliably occurred for all age groups. In general, males compared to females were more willing, wanted more to lose their virginity, felt more ready for it, did it more often on the spur of the moment, and were less often involved in a relationship or in love when it occurred. Sex differences were greatest for boys versus girls under 16 with adults. Mediation and moderator analyses were also performed. Results were discussed in relation to competing perspectives on the effects of minor-adult sex.
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Reactions of Boys and Girls to Sexual Abuse and to Sexual Encounters with Peers. J Youth Adolesc 2019; 48:1869-1882. [PMID: 31478119 DOI: 10.1007/s10964-019-01111-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
Abstract
To understand the etiology and consequences of child sexual abuse it is important to study the victims' subjective reactions to such incidents. Because researchers have not been able to survey children about sexual abuse, not much is known about how subjective reactions are related to gender, age, age difference, and the social relationship between the offender and victim. The present study fills this gap using data gathered from a large, nationally representative sample of Finnish children ages 11 to 17 (N = 32,145). Analyses of abuse are based on a sample of 1520 children (78% girls), while analyses of peer sexual experiences are based on a sample of 3551 children (55% girls). Multivariate analyses adjusted for the use of coercion, the intimacy of the sexual experience, and other incident characteristics. It was hypothesized that, as a result of sex differences in sexuality and attitudes toward deviant behavior, girls are more sensitive than boys to age and age difference. Three findings supported the hypothesis: (1) girls were more likely than boys to have a negative reaction to sexual encounters regardless of the age difference; (2) for girls, age was negatively associated with the likelihood of a negative reaction, but age had no effect for boys; and (3) girls reacted negatively to age difference while boys did not. However, girls did not react more negatively unless the offender was at least eight years older. The results highlight the susceptibility of adolescent boys to encounters with older women. They further suggest that ignoring the role of the victim limits understanding of the vulnerability of young people to sexual abuse.
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Prino LE, Longobardi C, Settanni M. Young Adult Retrospective Reports of Adverse Childhood Experiences: Prevalence of Physical, Emotional, and Sexual Abuse in Italy. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1769-1778. [PMID: 29380089 DOI: 10.1007/s10508-018-1154-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 01/05/2018] [Accepted: 01/15/2018] [Indexed: 06/07/2023]
Abstract
This study sought to understand the prevalence of childhood abuse in Italy using an instrument developed by the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) and adapted to the Italian context. The study participants were 312 young adults, 106 males (34%), and 206 females (64%), aged 18-24 years, from various northwest Italian universities and workplaces, using an ISPCAN Child Abuse Screening Tool retrospective questionnaire (ICAST-R). With reference to comparative data from other countries, the Italian context reveals a high incidence of emotional abuse (62%) followed by physical abuse (44%) and sexual abuse (18%). While males reported more physical abuse, females reported more exposure to sexual and emotional abuse. Moreover, the validity of the ICAST instrument was evaluated. The internal consistency for the three subscales was similar to the findings of previous studies, with Cronbach's alphas ranging from 0.51 for emotional abuse to 0.59 for sexual abuse. We observe that children undergo forms of emotional and physical maltreatment for disciplinary purposes, and for this reason, such abuse is excused. Greater prevention measures should be adopted in this direction. Finally, our study has contributed to the validation of the ICAST-R instrument for use in the Italian context.
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Affiliation(s)
- Laura Elvira Prino
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Claudio Longobardi
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy.
| | - Michele Settanni
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
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Rind B. Reactions to First Postpubertal Female Same-Sex Sexual Experience in the Kinsey Sample: A Comparison of Minors with Peers, Minors with Adults, and Adults with Adults. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1517-1528. [PMID: 27783171 DOI: 10.1007/s10508-016-0876-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 08/05/2016] [Accepted: 09/26/2016] [Indexed: 06/06/2023]
Abstract
This study examined reactions to first postpubertal same-sex sexual experience in the Kinsey female same-sex sample (consisting of females with extensive postpubertal same-sex experience) as a function of participant and partner ages. As such, it complemented the Rind and Welter (2016) study, which examined the same in the Kinsey male same-sex sample. Data were collected by Kinsey interviewers between 1939 and 1961 (M year = 1947). Girls under 18 (M age = 14.9), whose sexual experience was with a woman (M age = 26.3), reacted positively just as often as girls under 18 (M age = 14.1) with peers (M age = 15.0) and women (M age = 22.7) with women (M age = 26.3). The positive-reaction rates were, respectively, 85, 82, and 79 %. In a finer-graded analysis, younger adolescent girls (≤14) (M age = 12.8) with women (M age = 27.4) had a high positive-reaction rate (91 %), a rate reached by no other group. For women (M age = 22.2) with same-aged peers (M age = 22.3), this rate was 86 %. Girls with peers or women had no emotionally negative reactions (e.g., fear, disgust, shame, regret); women with women rarely did. Results contradicted prevailing clinical, legal, and lay beliefs that minor-adult sex is inherently traumatic and would be distinguished as such compared to age-concordant sex. The findings are discussed in terms of the time period in which the sexual experiences occurred.
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Rind B, Welter M. Reactions to First Postpubertal Male Same-Sex Sexual Experience in the Kinsey Sample: A Comparison of Minors With Peers, Minors With Adults, and Adults With Adults. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1771-1786. [PMID: 27178172 DOI: 10.1007/s10508-016-0719-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 01/06/2016] [Accepted: 02/12/2016] [Indexed: 06/05/2023]
Abstract
Rind and Welter (2014) examined first postpubertal coitus using the Kinsey sample, finding that reactions were just as positive, and no more negative, among minors with adults compared to minors with peers and adults with adults. In the present study, we examined first postpubertal male same-sex sexual experiences in the Kinsey same-sex sample (i.e., participants mostly with extensive postpubertal same-sex behavior), comparing reactions across the same age categories. These data were collected between 1938 and 1961 (M year: 1946). Minors under age 18 years with adults (M ages: 14.0 and 30.5, respectively) reacted positively (i.e., enjoyed the experience "much") often (70 %) and emotionally negatively (e.g., fear, disgust, shame, regret) infrequently (16 %). These rates were the same as adults with adults (M ages: 21.2 and 25.9, respectively): 68 and 16 %, respectively. Minors with peers (M ages: 13.3 and 13.8, respectively) reacted positively significantly more often (82 %) and negatively nominally less often (9 %). Minors with adults reacted positively to intercourse (oral, anal) just as often (69 %) as to outercourse (body contact, masturbation, femoral) (72 %) and reacted emotionally negatively significantly less often (9 vs. 25 %, respectively). For younger minors (≤14) with adults aged 5-19 years older, reactions were just as positive (83 %) as for minors with peers within 1 year of age (84 %) and no more emotionally negative (11 vs. 7 %, respectively). Results are discussed in relation to findings regarding first coitus in the Kinsey sample and to the cultural context particular to Kinsey's time.
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