THE LAST 50 YEARS IN THE HISTORY OF HUMAN SEXUALITY AND THE FUTURE
Author: Dr. Jaqueline Brendler
Prior to the last 50 years, we have to mention especially the studies of Sigmund Freud, the father of psychoanalysis, as well as to remember Haverloock Ellis. In 1948, Alfred Kinsey published 'Sexual behaviour in the human male' and, in 1953, 'Sexual behaviour in the human female', based on 12,000 individual interviews that contained data such as that 37% of Americans had had homosexual experiences and 62% of women had experienced masturbation. In 1951, Luis Miramontes (Mexico) invented the nortestosterone pill.
In 1960, the FDA approved the sale of the birth control pill. That caused a separation between reproduction and sexuality and changed the man-woman bond. Pre-marital sex became more frequent and people started thinking about sexuality as a pleasant relational activity. That achievement was one of the pillars of the Sexual Revolution in the 1960s, marked by protest movements among teenagers and young adults, by the re-emergence of feminism, in a world that witnessed the Vietnam War, in which the youth were against the 'system' at the time of 'make love, not war'.
In 1966, Masters & Johnson published 'Human sexual response', after direct observation of over 10,000 sexual intercourses during a 12-year-study. In 1970, they published 'Human Sexual Inadequacy', which described a new approach to treating sexual problems - the figure of the 'sexual therapist' - and reported sexual response as including the stages of excitement, orgasm, and resolution. Even though a penile prosthesis - made of an acrylic rod - was used for the first time in 1950, it was in 1973 that Morales published the utilisation of double, rigid polyethylene prostheses. In that same year, Scott and Bradley reported the use of 4-volume inflatable prostheses. Still in the 1970s, Finney's semirigid prostheses emerged in 1977 as an evolution.
Psychoanalyst, psychologist, and psychiatrist Helen S. Kaplan recognized the stage of desire, and sexual response started including Desire-Excitement-Orgasm-Resolution (D-E-O-R). She published 'New sex therapy' in 1975, integrating the behaviourist theory and the psychoanalytic one, within a sophisticated methodology that allowed the association of lines of treatment, which changed the direction of sexual therapy in the world. In 1976, Julia Heiman, Leslie LoPiccollo, and Joseph LoPiccolo published 'Becoming Orgasmic: A Sexual and Personal Growth Programme for Women'. In the 1970s the media turned into a remarkable force in the Sexual Revolution, and women started having a stronger presence in the labour market, at the same time that nonmarital cohabitation emerged. In 1974, homosexuality ceases to be considered a mental disease, and in 1978 the first baby is born through IVF (in vitro fertilization). In the late 1970s, backward movements 'against abortion' and 'against sexual education' take place in the USA, as well as the herpes epidemic.
Intracavernous injections to treat erectile dysfunction were discovered in 1977. In the 1980s, numerous works were published on the use of papaverine, papaverine and phentolamine, and, at the end of the decade, prostaglandin E1.
Still in the 1980s, the AIDS epidemic emerged as well as the 'risk group'. In 1981, Shere Hite published 'The Hite report on male sexuality' and, in 1983, the first pregnancy from a frozen embryo occurred. In the 1980s, the word 'climacteric' was spread, the term '3rd age' and semen banks multiplied all over the world. John Money is another author to be remembered from the 1980s.
In the 1990s, a large number of women had already achieved their financial independence, which led them to struggle for their other dreams and demand more 'quality' in the bond, thus changing marital relationship. Other women embarked in the dictatorship of orgasm by incorporating the male 'neoliberal' pattern and performance. In 1992, the first ICSI (Intracytoplasmic Sperm Injection) takes place, as an ally in male-caused situation of infertility. HRT (Hormone Replacement Therapy) emerged in the 1990s. AIDS brought the 'risk behaviour' at the same time that a 'serial monogamy', with successive unions, was seen among adults. Also in the 1990s, the Internet became popular, changing strategies of affective and sexual contact and widening the range of possibilities, more in the positive than in the negative sense. DNA tests became easily accessible and paternity was a certainty. GLS movements increased, demanding rights. In 1996, the work 'Is menstruation obsolete?' was published on the possibility of women not to menstruate, challenging old cultural dogmas. Being part of the labour market, women started choosing to get pregnant after 35 years of age, which led to the emergence of 'late motherhood' - an achievement for women.
In the late 1990s, a larger number of (adult and teenage) women started taking sexual initiatives, which caused conflicts within the male universe. In Brazil, teenagers started to 'stay' (ficar - in Brazilian slang) with several partners in the same party.
In 1998, the FDA approved the sale of Sildenafil (Viagra). Its effectiveness allowed more interest in the discussion of healthy and dysfunctional sexuality at all levels of society, modernising the treatment of erectile dysfunction with the use of oral drugs. In 1999, the postcoital pill (levornorgestrel) started to be sold in Brazil.
In 2000, Rosemary Basson described an alternative model for female sexual response, which was distinct from the sequence D-E-O-R thus far equally accepted for men and women, and that became known as 'circular model'. It includes those stages in a more dynamic way. Until 2002, she had published 6 more articles to complement her theory. In 2000 and afterwards, the word Pansexual started to be widely publicized; the term 'melhor idade' (best age) emerged in Brazil, valuing people over 65; and freezing women's eggs proved effective - another advancement in the infertility field. Young men, insecure and willing to have an outstanding sexual performance started to use sildenafil (Viagra).
In 2002, 94 pages of articles on sexual orientation were published on the Archives of Sexual Behaviour 31(1) 2002. The most prominent article was 'How many gay men owe their sexual orientation to fraternal birth order?' by Cantor, J. M. et al. The authors reported that 1 out of 7 gay men owe their orientation to the 'fraternal birth order' effect, which might imply the identification of a genetic locus for homosexuality, after an effect that operates in a pre-natal environment, based on the theory about the progressive immunization of some mothers to antigen H-Y. According to that theory, the number of male foetuses generated by the same mother is important, as they would increase the effect of H-Y antibodies in sexual differentiation of the brain of each male foetus, thus reflecting on their sexual orientation.
In 2003, tadalafil (Cialis) was launched as another powerful oral drug for the treatment of erectile dysfunction. In the USA, the campaign for 'sexual abstinence among teenagers' was intensified and the term 'metrosexual' became popular. In March 2004, Pfizer reported the discontinuation of the study on sildenafil in women.
As for the future, there is a lack of pharmacological studies with dysfunctional women, which should be double-blind and randomized. It would be very important to further clarify the role played by serotonine, acetilcoline, NANC (VIP, NP Y), nitric oxide, the Sympathetic NS, the Parasympathetic, estrogens, and androgens regarding female dysfunctional sexuality. Still about women, there shall be research on neurological and vascular injuries caused by HAS, diabetes, multiple sclerosis, and marrowbone injuries. Another major challenge will be to further study genetics and prenatal environment regarding sexual orientation, not only in homosexuals, and CNS areas related to satisfactory sexuality and sexual dysfunction. Any advancement - whether psychotherapeutic or drug-related - that comes to reduce the time of suffering for those who have some kind of sexual problem will be welcome.
Annals of the 7th Rio Grande do Sul State Meeting on Human Sexuality, May 13-15, 2004, Porto Alegre, Brazil, pages 9-10.