Archive for March, 2009


Monday, March 30th, 2009

Vs. minors

A sixteen-year-old male and three friends were swimming nude and saw a fourteen-year-old boy on the opposite bank fellate a fifteen-year-old boy. The parties joined forces and finally all males were fellated by the youth. There was some horseplay, but the extent of force was questionable.

Vs. adults

A homosexual party at the twenty-nine-year-old offender’s home led to heavy drinking and excessive noise. Neighbors complained and the four men and the host were arrested. It was claimed by the offender that there was no overt sexual behavior prior to the arrest. Thus, four of the cases involved three copartners, three of them included four males in addition to the offender, and there was one offense in each of the highest categories of five, six, and seven copartners. The ten accounts given above do not appear, however, to portray generally planned behavior. On the contrary, one feels it to be very much a matter of chance and accident that the particular situation built up. The offenses are typified by the picture of young, aimless males driving around in a car, with an eye out for a potentially willing female if they can find one. A lone male of these ages might well have lacked confidence to attempt a pickup and a sexual approach, but numbers often breed a sense of courage. It will be noted that in these ten cases of group behavior the young offender is in strong evidence. This is understandable, since such group social patterns are typical of younger males.

In fact, if one records the ages of the 92 males at the time they committed the offenses involving copartners, and compares their median age with that of the remaining males at the time of their offenses, it is clear that the offenders who operate in pairs or in larger units are consistently younger than the other offenders in their group. This is no real surprise, since studies of nonsex offenses tabulated on the basis of age and multiparticipation show the same trend, but it is of interest to find here a consistent pattern.

In summary, coparticipation in sex offenses is atypical, and when present it is most likely to be found in heterosexual offenses committed by younger males. It is rarely present in our sample of homosexual or incest offenses.



Monday, March 30th, 2009

Since there is among males a very high correlation between arousal from seeing females and arousal from thinking of them, we have combined the answers to these two questions. The variation in response is great: at one extreme are the incest offenders vs. children and the control group, very few of whom (4 and 10 per cent respectively) reported little or no response, while at the other extreme are the heterosexual offenders vs. adults (41 per cent) and the homosexual offenders vs. adults (35 per cent). The fact that the heterosexual offenders vs. adults have the largest percentage of persons reporting little or no arousal from thinking of or seeing females, and the heterosexual offenders vs. minors have the third largest percentage (31 per cent) may at first seem paradoxical, but is simply explained. Persons with high frequencies of heterosexual coitus are relatively sated and hence respond to heterosexual stimuli less intensely. In addition to being heterosexually quite active, the majority of men in these two offender groups were interviewed very early in the history of the research, when these questions were dealt with rather summarily and no cognizance was taken of anything other than current status. No more than half of any other group were interviewed in this early phase. Also, and more importantly, these two groups rank first and fourth in the proportion of persons rated as feeble-minded or with below-average intelligence. Dullness correlates with lack of response to noncontact stimuli. Among the six groups with fewest individuals reporting little or no response are the three aggressor groups, whose members could scarcely have been moved to commit their offenses without some visual or imaginative arousal, and the control-group individuals who probably owe their position to a combination of relative sexual deprivation and better education, these two factors being generally associated.

Turning to the other extreme—the category of strong and/or frequent response—we find, as we expected, that the peepers lead with 38 per cent. At first glance the rest of the percentages seem rather meaningless, but in actuality die groups occupying both ends of the range do so for known reasons. The high end of the range (37-38 per cent) is occupied by our three youngest groups: peepers, prison, and aggressors vs. minors. Youth, intensity, and frequency of response we know to be highly correlated. The only other group in this range is the control group whose members we have just described as relatively well-educated (i.e., more imaginative) and sexually deprived. At the other end of the range, with less than one fifth of their members reporting strong arousal, we find at the bottom our oldest and second oldest groups, third from the bottom our most homosexual group, and fourth from the bottom the sated (or even burned-out) heterosexual offenders vs. adults. In brief, strong responses to heterosexual noncontact stimuli are positively correlated with youthfulness, sexual deprivation, and higher education and are negatively correlated with old age, homosexuality, and satiation.



Monday, March 30th, 2009

Premarital coitus with companions constituted a substantial proportion of the total sexual outlet for the members of most groups, but reached or exceeded the 50 per cent level among only three, namely, the heterosexual offenders vs. minors and adults and the prison group.

In most groups the proportion tended to increase with age into the thirties, but this is not true of the homosexual offenders, whose percentages are remarkably stable (from sixteen to thirty) and relatively small. The control group and the prison group both attain their largest proportions between twenty-six and thirty, after which a decrease is noted. This decrease seems the result of various combined factors, the first of which is that after thirty the confirmed bachelors tend to avoid emotional entanglements and rely somewhat more heavily on prostitutes for their sexual needs. This seems the case with the heterosexual-offender groups, the aggressors vs. adults, and the exhibitionists. Secondly, with increasing age the still unmarried males contain an increasingly higher percentage of persons with homosexual interest, which obviously tends to reduce the importance of coitus. This is the case with all three homosexual-offender groups. The two control groups show both forms of selectivity operating, with prostitution being the more important.

The proportion of total outlet found in premarital coitus with prostitutes is trivial during the early teens (1 per cent or less) and increases slowly thereafter. The control and prison groups demonstrate this trend best since their numerical size permits meaningful calculations into the fifth decade of life: in their late twenties the members of these two groups were having about 1 orgasm in 10 with a paid female partner; in their early forties about 1 in every 3 or 4.

As we have mentioned elsewhere, confirmed bachelors have a distinct tendency to turn more and more to prostitutes. Prostitutes are available on fairly short notice, there is no irritating uncertainty about whether or not they will agree to coitus, there is no time-consuming courtship, no emotional entanglement, the expense is no greater, and prostitutes usually compare favorably with nonprostitutes in physical beauty and bodily activity. The absence of affectional ties is no serious argument against coitus with prostitutes in the minds of many males, particularly males from the lower socioeconomic level who view sexual activity and love as two quite separate phenomena which are not necessarily related. In fact, some men of the double-standard school feel that sex and love are mutually exclusive-one loves and respects one’s wife or fiancee and, hence, spares her as much as possible the degradation of sexual activity. This attitude is now less common in the United States, but lingering traces of it still bolster the incidence and frequency of prostitution. Note that the three incest groups rank first, second, and third in the proportion of total outlet derived from prostitution between twenty-one and twenty-five, the same age-period in which most of them were marrying.



Monday, March 30th, 2009

In the process of learning to socialize with others, which plays an important role in subsequent sexual fife, physical health can be of great importance. Questioning each man in our sample, seeking to discover if frequent or protracted illness had interfered with his early life, we found that in general from 70 to 80 per cent reported good childhood health, 10 to 15 per cent fair health, and only 5 to 10 per cent poor health. The healthiest were those in the sex-offender groups who had been involved with females aged twelve and older. The control and prison groups are similar to most sex-offender groups, while the homosexual offenders report the poorest health, particularly the homosexual offenders vs. adults (the most homosexually oriented of all homosexual groups). They had the fewest, 55 per cent, who reported good health, and the most, 16 per cent, who reported poor health. In contrast, the heterosexual offenders vs. adults reported 84 per cent with good health and 5 per cent with poor health.

All this would lead one to envision a picture wherein the heterosexual offenders were outdoors with rosy cheeks happily playing with many other children while the homosexual offenders remained indoors alone with their medicine. This, as we shall see, is a false picture. Insofar as we may generalize from our data, only in extreme cases does poor health seriously interfere with socialization with other children. A sickly child may refrain from violent sports, but this does not preclude his having many companions of both sexes. However, ill health may prevent a boy from becoming a part of, and identifying with, what one may call “boy culture” with its early elements of roughness, courage, and other traditional masculine attributes of our culture.



Monday, March 30th, 2009

Of all the groups, the peepers included the fewest members who had petted (91 per cent). Those with petting experience tended to begin at a relatively late date, the median peeper having his first postpubertal experience at sixteen years of age—the third oldest median age. This late start accounts for the small number who petted before they were sixteen, but within the following age-period 16—20 some 90 per cent (a figure neither high nor low in comparison to other groups) engaged in heterosexual petting.

The accumulative incidence, the percentage with petting experience by a given age, gives a somewhat different picture. By age twelve one third, a moderate figure, had petted; by age fourteen the peepers are in the lower part of the rank-order with 41 per cent; and by age sixteen they are still in the lower third of the rank-order with 65 per cent. However, by age eighteen they have risen to a middle position with 88 per cent. This is what we saw in the age-specific incidence figures which showed little activity between puberty and age fifteen and a moderate amount between ages sixteen to twenty.

Relatively few of the peepers achieved orgasm from petting during any five-year age-period up to age twenty-five; thereafter the incidences are moderate. The accumulative incidence of petting to orgasm reached a maximum of 25 per cent by age twenty-three, also a moderate figure. Because our sample of peepers is not large and since few of them reached orgasm through petting in any age-period, we have not calculated their frequencies.

Since the peepers did not get along well with girls in their preadolescent years, one is prepared for the fact that at ages sixteen to seventeen they had the fewest female companions and friends. No less than one quarter reported none at all. The control group, which can scarcely be considered as consisting of Don Juans, had only 15 per cent of its members in this unfortunate situation. Conversely, the peepers had the fewest members (29 per cent) who reported having had numerous female companions.

With this in mind, one would expect to find that they had had the fewest petting partners. However, our sample of peepers seems to consist of two disparate subgroups, one being the inhibited deprived group, as anticipated, but the other being a sexually more successful and rather promiscuous group. At any rate, the peepers have a curious bimodal distribution in numbers of petting partners: they rank second (9 per cent) among those with no partners, high among those with one partner (9 per cent), and in the successive categories of larger numbers of partners their positions in the rank-orders are middle to low. In the ultimate category of over 100 partners only one peeper (2 per cent—the second lowest percentage recorded) is represented, whereas the control group has 15 per cent. The average (median) peeper had petted with 14 females, the fourth smallest number reported. Yet amazingly enough in the category of 51 to 100 partners the peepers rank first with 22 per cent, a proportion considerably in excess of any other group and one that can scarcely be explained away as a vagary of small sample size.

The more sexually restrained subgroup of peepers reduced the percentage of peepers who had engaged in premarital genital manipulation with females: 82 per cent had this experience, a rather small proportion. On the other hand, the sexually active subgroup seems to have raised the percentages of peepers involved in cunnilingus and heterosexual fellation to middle positions in the various rank-orders. In any case, the peepers are not distinctive for mouth-genital contact with females except with regard to extramarital and postmarital partners.

With these females some 28 per cent of the ever-married peepers had cunnilingus, a percentage earning them first place in this particular rank-order.



Friday, March 27th, 2009

When to start the medications is also a topic of much discussion and controversy. Before the development of protease inhibitors, initiation of antiretroviral medications was considered when the T-helper-cell count fell below 500. Use of medications was not recommended earlier in the course of the infection for fear that once they were necessary (when the T-helper-cell count began to fall and the consequent risk of opportunistic infections began to rise), they might no longer be effective. AZT, ddl, and ddC, when used as monotherapy, often become ineffective after six to twelve months because of the development of resistance. Combination therapy offers longer suppression of the virus and can decrease the likelihood that resistance will develop. Combining 3TC with AZT will prevent resistance to the AZT from developing, so that combination is now preferred over the use of either drug alone. The protease inhibitors are even more effective in combination with the anti-retrovirals in maintaining T-cell count and decreasing viral load. The use of two antiretrovirals with a protease inhibitor (a strategy called triple therapy) has also been tried, and it is now the preferred regimen for many patients because of its increased effectiveness.



Friday, March 27th, 2009

For a child born to a mother who is infected with hepatitis B, the same combination of vaccine series and immune globulin is given, usually within twelve hours of birth. This treatment has a high rate of success in preventing the child from becoming infected with hepatitis B, decreasing the likelihood of infection from 80 percent to 5-15 percent. All pregnant women should be tested to determine their hepatitis B status, so that their newborns can be tested and treated if they have been exposed.

Besides vaccination, the other method to help prevent the transmission of hepatitis B through sexual contacts is to use condoms or other barriers for oral, anal, and genital intercourse if a partner’s status for hepatitis B (and other STDs) is not known. However, since condoms can break or may be used improperly, they should not be relied on as the sole means of preventing infection. Women who have sex with other women can transmit the virus through oral sex and exchange of vaginal secretions. Dental dams or plastic wrap may decrease the risk of infection in such cases.

All partners of these found to be infected with hepatitis B should be immunized.



Friday, March 27th, 2009

Chlamydia is the most common bacterial sexually transmitted disease in the industrialized world. Estimates are that between four and six million people are infected each year with chlamydia in the United States, but this may be an underestimate. Many people are symptom free and are never diagnosed or reported. Studies have shown that between 3 and 5 percent of men and women in general medical clinics and about 15-20 percent of men and women attending STD clinics are infected. Studies of symptom-free people in various areas of the country have found that between 5 and 50 percent of those tested are infected with chlamydia. About half of those infected are teenagers, and about one-third are between twenty and twenty-four years old.

Even though chlamydia is a common infection of adolescents and young adults in the United States, any sexually active person can become infected. Younger women are more likely to become infected with chlamydia if exposed because the anatomy of the cervix makes them vulnerable.

Because many people have chlamydia without experiencing any symptoms, it is an infection that is frequently passed between sexual partners unknowingly. People of any sexual orientation can become infected with chlamydia, although it appears to be more common among those who have opposite-sex partners. Women who have sex with other women may be the least likely to become infected, although there is a small possibility of infection if they share sex toys. Routinely screening those at high risk for chlamydia is the only way to halt the spread of this epidemic.



Friday, March 27th, 2009

Most studies have found transrectal ultrasound to be a rather mediocre predictor of the presence of cancer that has penetrated the prostate wall, and to be downright poor in finding cancer that has reached the seminal vesicles. In two studies, only 30 percent of tumors that had spread to the seminal vesicles could be found by ultrasound. One investigation, of thirty men undergoing radical prostatectomy, found ultrasound’s sensitivity in spotting cancer that had worked its way beyond the prostate wall was a measly 5 percent. Another study, comparing ultrasound and pathological staging in 121 men, found ultrasound’s overall accuracy in staging was only 66 percent—better, but still not reliable enough. And a multicenter study of 230 men found that ultrasound correctly staged 66 percent of locally advanced cancer and only 46 percent of the cancers confined to the prostate.

Ultrasound’s main difficulty is its inability to “see” microscopic cancer spread. So, to sum up: No definitive decision about a man’s course of treatment should be made on the basis of ultrasound alone, and ultrasound readings shouldn’t be the cause of a man’s exclusion from surgery that could potentially cure his disease.



Friday, March 27th, 2009

Now, let’s take a quick look at the reproductive system:

Sperm and testosterone, the male hormone, are made in the testicles. Testosterone is the substance that makes the prostate grow at puberty; it also stimulates the prostate to manufacture its secretions. Sperm travel from the testicles to the twisting, winding epididymis, a convoluted “greenhouse” where they mature.

The epididymis connects to the vas deferens, a hard, muscular cord that winds all the way from the scrotum into the body and down to the back of the prostate. At this point, the seminal vesicles, which produce 70 percent of the fluid for semen, connect to the vas deferens to form the ejaculatory ducts, which run into the center of the prostate. When a man ejaculates, sperm rocket from the epididymis through the vas deferens and out of the ejaculatory duct, where they’re mixed with the fluids from the prostate and seminal vesicles.

To make sure that the semen doesn’t “back up” into the bladder, a muscular valve slams shut in the bladder neck, forcing the semen out the urethra in the penis. Soon after ejaculation, the semen coagulates. A substance called prostate-specific antigen (PSA), which is made by the prostate, then acts on the semen, causing it to become liquid again.

To understand what can go wrong with the prostate, it will probably help to study the illustrations in this chapter and the rest of the book (the illustration in the Glossary shows the male urinary and reproductive systems together). The prostate encircles the urethra like a fist holding a straw—therefore, when its transition zone enlarges, in benign prostatic hyperplasia (BPH), this compresses the urethra and causes urinary problems. Finally, by understanding how PSA is secreted from ducts in the prostate, you’ll be able to see why PSA levels increase when these ducts become obstructed, as they do in prostate cancer.