Male Sexuality and Sexual Behavior

Gender and sexuality evolve together and become inextricably intertwined. Parents often interact with their children in different ways depending on the children's sex. Girls may be caressed and patted while boys are tickled and rough-housed.

Sexual values and feelings usually are established and reinforced during childhood. Children between ages 5 and 10 often tell stories that have sexual or romantic themes. Girls are more likely than boys to tell romantic stories and less likely than boys to tell sexually explicit stories. This fundamental difference may explain some of the difficulties in understanding and communication that sometimes occur between men and women.

During adolescence, changes in development cause boys and girls to diverge even more dramatically. Both sexes are going through a major biological event— for girls, menstruation; for boys, the ability to ejaculate. A boy's sexuality is primarily located in his genitals during puberty. Within 2 years of puberty, all but a relatively few boys have experienced orgasm, usually brought on by

Reproductive System masturbation. Girls this age tend to focus more on developing relationships than on their sexuality.

Masturbation

For males, masturbation is touching or massaging their penis for sexual pleasure or to achieve an erection and ejaculation. Male sexual impulses, initially acted out through masturbation, are linked to physiological changes, brought on by increased production of the male hormone testosterone during puberty. At this age, boys are easily aroused. Male adolescents have frequent erections, often without apparent stimulation of any kind.

Masturbation was once considered abnormal. Today it is viewed as a normal, healthy sexual activity that starts in puberty and can continue throughout life. There is no evidence that masturbation causes any physical injury or psychological harm. For many adolescent boys masturbation is their major sexual activity, and many engage in it frequently. For many men, also, masturbation remains a satisfying, if less important, component of their sexuality.

Long-term Relationships

Most people in our society ultimately marry or make a long-term commitment to another person. Sexual commitment inside marriage or an established relationship makes up the larger part of adult sexual experience. Many couples find new and different kinds of satisfaction in long-term sexual relations with the same person: coming to know and understand each other better, learning to make each other happy through sex, and relaxing with and not having to impress the other person. For many men, not having to worry about sexual conquest any longer is a great relief; finally, love and sex can grow closer together.

In a long-term relationship, most couples find that they have sex less frequently than they did when their relationship was new. After childbirth, sleep loss and the demands of parenthood often interfere with sexual intimacy. Anger, depression, drinking too much alcohol, certain medications, and fatigue also can take their toll on your sexual drive. You should not feel pressured by the need to conform to a sexual norm you have heard about regarding the frequency with which you have intercourse. However, if you or your partner want to revitalize your relationship, you can do something to

Maintain the Romance

Keeping a relationship strong requires the effort of both partners. Make your relationship a priority. Have fun together. Enjoy at least part of your leisure time together and create time to be alone with each other.

Maintain the Romance

Keeping a relationship strong requires the effort of both partners. Make your relationship a priority. Have fun together. Enjoy at least part of your leisure time together and create time to be alone with each other.

put some of that old spark back into your sexual relationship. Go out on a date, 141

just the way you did when you first met. Or set aside some time each week to be S exuality together alone. But remember that the number of times per week you and your partner have sex is not as important as the quality of your lovemaking. If you feel that you or your partner may have a more serious sexual problem, talk to your doctor, who can refer you to a sexual therapist.

Relationships

You can benefit from forming and maintaining a close, stable, long-term relationship. Nurturing your relationship with your partner can make you happy— and it also can keep you healthy.

Homosexuality and Bisexuality

Men who are sexually attracted to other men are called homosexual. Women who are sexually attracted to other women are called lesbians. The term "gay" is often used to describe homosexual men and women. Bisexuality is sexual attraction to both men and women.

No one is sure what causes homosexuality, or what causes heterosexuality, for that matter. No particular hormonal, biological, or psychological influences have been identified with certainty as substantially contributing to a person's sexual orientation. Most scientists believe that a person's sexual orientation is established in childhood, through genetic or environmental influences or a combination of both. It is not a choice. Therefore, the term "sexual preference" is inaccurate.

Scientific research indicates that parents have very little influence on their children's sexual orientation.

Evidence also shows that children who are raised by homosexual parents are no more likely to grow up to be homosexual than are children raised by heterosexuals. Like heterosexuals, most gay people realize their sexual orientation during adolescence. Some, however, realize it much later, even after leading a married life.

An estimated 3 to 10 percent of American men have been involved exclusively in homosexual relationships throughout their lives. A much higher percentage of people have reported experimenting in same-sex activities during adolescence, although they identify themselves as adult heterosexuals. Although a significant number of people have bisexual feelings, a small percentage actually act on those feelings. Most homosexuals adjust well to their sexual identity, even though they often must overcome disapproval and prejudice. This adjustment can be stressful and may lead to emotional and physical health problems. Homosexual teenagers in particular may feel confused and isolated from friends and family, and they may fear rejection.

Relationships

You can benefit from forming and maintaining a close, stable, long-term relationship. Nurturing your relationship with your partner can make you happy— and it also can keep you healthy.

142 For some homosexuals and heterosexuals, frequent sexual activity with dif-

The ferent partners is a common practice throughout life. People with multiple sex

Reproductive partners run the risk of developing a variety of sexually transmitted diseases

System (STDs; see page 180).

Health Concerns of Gay and Bisexual Men The biggest health concern among sexually active gay men is contracting STDs including the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Men who have sex with men make up the largest category of people infected with HIV in the United States. The risk of HIV transmission is greater for a person who is receiving anal sex because the lining of the rectum is delicate and can be easily torn, allowing easy entrance of the virus into the bloodstream. Condoms are essential to reduce the risk of transmitting HIV

Sexually active gay men are also at increased risk for infection with hepatitis B (see page 191). This bloodborne virus can be transmitted through unprotected sex. Although condoms provide some protection, the best way to avoid hepatitis B is to be immunized. The vaccine is given in a series of three injections. Immunization against hepatitis B is recommended for all sexually active gay and bisexual men.

Anal cancer is more likely to occur in gay men than in heterosexuals. The increased risk is thought to be related to a higher risk of infection with the human papillomavirus (HPV; see page 184), a sexually transmitted virus that can cause precancerous skin changes. Men at risk for anal cancer should have regular examinations by their physician to detect the early signs of this form of cancer. Men who participate in anal sex are also at risk for urinary tract and gastrointestinal infections; when bacteria in the rectum enter the urethra, the infection can spread up the urethra into the urinary tract and into the intestines.

Drug and alcohol abuse affect a large percentage of gay men. Nearly one third of homosexual men and women abuse drugs or alcohol, while only 10 to 12 percent of the heterosexual population abuses drugs or alcohol. Drinking alcohol and abusing other drugs, such as cocaine and marijuana, not only endanger a person's health by increasing the risk for disease but also increase the chances that a person will engage in other risky behaviors, such as unprotected sex.

Societal discrimination, issues surrounding AIDS, and the lack of emotional support from family or friends can create psychological problems that weigh heavily on gay and bisexual men. Even though openly gay people are more accepted than ever before in the United States, some state laws still ban homosexual activity. Physical or verbal abuse and harrassment are relatively common experiences for gay men and women.

Without some level of acceptance and support from family members and friends, teenagers who are struggling with their sexual orientation may become depressed, turn to drugs, or run away from home, usually to large cities, where their problems are intensified. Suicides among homosexual teenagers are two to 143

three times more likely than among heterosexual teenagers of similar age. Many S exuality homosexual and bisexual teenagers use drugs such as alcohol, marijuana, and cocaine and crack. Drug abuse not only harms teenagers directly but also increases their risk of engaging in unsafe sex and developing STDs, including HIV.

Many homosexual men may also face the stress of living in an unaccepting society, hiding their sexual orientation from those around them, and dealing with loneliness and isolation. Gay men may have difficulties finding partners and establishing meaningful relationships. The threat of AIDS also takes its toll on the emotional health of gay men in the United States. Many gay men have to deal with the deaths of partners and friends who die of AIDS, as well as pressure from some people who may blame the homosexual community for the disease. All of these issues contribute to high levels of depression, suicide, and drug abuse among gay men.

Some homosexuals may hesitate to seek medical care because they fear rejection by physicians. If you are gay or bisexual, look for a doctor you are comfortable with and who understands your healthcare needs. In many large metropolitan areas, special clinics are dedicated to meeting the healthcare needs of the local gay community.

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