Harold I. Lief

Orgasm in the postoperative transsexual

The dearth of information regarding orgasm in postoperative transsexuals prompted the authors to study its prevalence. The sample consisted of 14 male-to-female (M—F) and 9 female-to-male (F—M) postoperative transsexuals. The relationship of orgasm to sexual and general satisfaction was explored via a specially designed questionnaire. Orgastic capacity declined in the M—F group and increased in the (F—M) group. Despite the decrease in orgasm in the M—F group, satisfaction with sex and general satisfaction with the results of surgery were high in both groups. General satisfaction of 86% replicates other studies. Frequency of sex increased by 75% in the M—F group and by 100% in the F—M group. A phalloplasty does not appear to be a critical factor in orgasm or in sexual satisfaction. The general conclusion is reached that it is possible to change ones body image and sexual identity and be sexually satisfied despite inadequate sexual functioning.

The sex knowledge and attitude test (SKAT)

The Sex Knowledge and Attitude Test (SKAT) was designed to measure knowledge, attitudes and degree of experience in a variety of sexual behaviors, and to be used as a teaching and research instrument. The SKAT has been administered to over 35,000 students, approximately two-thirds of whom have been medical students. SKAT has served two major objectives: to measure changes in knowledge and attitudes after a course or program in human sexuality and to demonstrate the deficiencies of medical and nursing education in preparing health professionals to aid patients with sexual problems. Additional types of research using the SKAT are suggested.

Retractors of false memories: The evolution of pseudo-memories

The formation of pseudomemories and the subsequent methods used by subjects to eventually distinguish between true and false memories are the primary foci of this study. A survey instrument was distributed to 100 “retractors” after an initial telephone interview with False Memory Syndrome Foundation (FMSF) staff. Forty respondents (40% of the subjects) who returned the questionnaire comprise our study population. The survey inquired about personal and family information, events surrounding the subjects accusations of sexual abuse, childhood history, and the subjects reflections on his or her experience. The process of the development of pseudomemories is highlighted. Subjects also described their feelings and experiences in open-ended questions, including their subjective experience as memories evolved, factors influencing thoughts, feelings and doubts, the process of questioning memories, the process of restoring relationships with family members, and uncertainties about views of memories currently held. We focus on the evolution of pseudomemories, especially the influence of the therapist; we explore the nature of therapy, one that makes an ill patient much worse and that eventually becomes so onerous that patients who still have some remaining reality-testing flee from therapy.

A New Measure of Adolescent Sexuality: SKAT-A

Risky sexual behaviors among adolescents have become a critical public health concern as the specter of AIDS has spread to the general population. This paper summarizes efforts by the authors to develop the Sex Knowledge and Attitude Test for Adolescents (SKAT-A), a comprehensive adolescent sexuality scale. The SKAT-A has three main sections: knowledge, attitudes, and behavior. A principal component factor analysis indicates the presence of four subscales in the attitude scale: Sexual Myths, Responsibility, Sex and Its Consequences, and Sexual Coercion. The behavior section contains 43 questions concerning sexual behavior and experience. The results of test-retest and internal reliability assessments indicate that the subscales possess adequate temporal stability and internal consistency. An assessment of concurrent validity was also completed. Future efforts include the development of a sexual risk-taking scale and a interactive computer software package.

Clinical profile of experience with 130 consecutive cases of impotent men

Abstract A review of the evaluation and treatment of 130 consecutive patients seen in a multidisciplinary impotency evaluation center is presented.

Reproductive Hormone Levels and Sexual Behaviors of Young Couples During the Menstrual Cycle

The classic studies of Kinsey and his coworkers (1948, 1953) and of Masters and Johnson (1966) provided a major stimulus for the scientific investigation of human sexual behavior. Since those pioneering efforts, a number of reports have appeared concerned with physiological (Masters and Johnson, 1970), behavioral (Fisher, 1973) and social (Chesser, 1957) determinants of human sexuality.

Sex Education in Medicine

Remarkable changes have taken place in the sex education of medical students and physicians in the last 18 years. This chapter describes the changes that have occurred since 1960, the present status of sex education for health professionals, and future prospects.

Ego-dystonic homosexuality.

The patient coming in with a dysphoria over his or her homosexual feelings, fantasies or behavior must be given the choice of working through the homophobia or the heterophobia. With the first choice, treatment is directed toward decreasing shame over the homosexual orientation and integrating the patients social role and personal identity. If a move toward greater heterosexuality is chosen, techniques range from psychoanalysis to time-limited psychodynamic psychotherapy to behavioral techniques. Behavioral techniques may involve in vitro or in vivo desensitization. Issues in selecting the appropriate form of therapy are sometimes subtle and complex, and ethical issues frequently beset the therapist. The patient must be kept fully informed of his or her options, and the choice and the goals of therapy must be arrived at by both patient and therapist.

From refusal to reconciliation: family relationships after an accusation based on recovered memories.

In following families who reported to the False Memory Foundation between 1992 and 2001 that a member had charged them with incest, a survey questionnaire (with a 42% return rate) was sent to some 4,400 families. These data demonstrate that 99% of these accusers were white, 93% were female, 77% were graduates, 86% were in psychotherapy, and 82% accused their father. Such accusations were rare events before 1985 but then grew exponentially in frequency, peaking in the 2-year period from 1991 to 1992, with 579 accusations. Thereafter, such accusations steadily declined so that in 1999 and 2000, only 36 accusations occurred. The accusers can be differentiated in the manner with which they reconciled with the situation: 56% refused all family contact, 36% returned but did not discuss the accusation, and 8% retracted completely. These data give evidence of a time-limited craze of therapy-induced incest accusations that has now dissipated.

The relationship of sexual adjustment and related sexual behaviors and attitudes to marital adjustment

Abstract This paper examines the extent of relationship between sexual adjustment and marital adjustment for 30 married couples followed for 3–6 months. Sexual adjustment was assessed by means of the LoPiccolo-Steger Sexual Interaction Inventory, and two other measures termed a Couple Interaction Scale (CI) and a Couple Compatibility Ratio (CCR). Marital adjustment was assessed by means of the Locke-Wallace Marital Adjustment Scale (L-W MAS) and a clinically-devised instrument based on the extent of support between the marital partners. The two marital adjustment instruments agreed closely. A high degree of association was obtained between most of the sexual adjustment measures and the two marital adjustment measures; using the most reliable of these measures, it is estimated that sexual adjustment contributed between 40 % and 55 % of the variance in marital adjustment. This association was not due to a specific stage of. the human sexual response cycle of desire, excitement, orgasm and gratification. Int...