Heterosexual interest in homosexual males

Androphilic, ephebophilic, and homosexual pedophilic males were compared on heterosexual interest and arousal potential. The former was measured by the subjects' retrospective reports and the latter by penile responses to pictures of females. The penile responses of the ephebophilic and homosexual pedophilic groups to pictures of physically mature females were not different from those of androphilic males. In the present study as well as in an earlier one, the ephebophilic males responded significantly more to physically mature males than to physically mature females. Homosexual pedophilic males showed little difference in responses to physically mature males and females. In retrospective reports of heterosexual interest and experience and of development of homosexual interest and activities, there were only two differences among the groups: as opposed to androphilic males, a relatively greater number of ephebophilic and homosexual pedophilic males indicated that up to age 15 or later they had felt attracted exclusively to females and that they had been seduced in childhood or early adolescence by a male. These results will have to be replicated before being accepted as reliable. As in some earlier studies, there was a weak but significant correlation of degree of feminine gender identity with age at onset of homosexual interest and with heterosexual interest or experience. A higher degree of feminine gender identity went together with less heterosexual interest and experience and with an earlier onset of homosexual interest and experience.This study was supported by Ontario Mental Health Foundation Grant No. 403 and was carried out at the Alex G. Brown Memorial Clinic of the Ontario Ministry of Corrections, at the Clarke Institute of Psychiatry, Toronto, Canada, and at Atascadero State Hospital, Atascadero, California.     

Clinical patterns among male transsexual candidates with erotic interest in males

Male-to-female transsexuals who reported an erotic interest in males showed different patterns of sexual activity. Sexual history was used to categorize a transsexual sample into three groups: 44% abstained from sexual activity (Inactive group), 19% were sexually active but avoided using their penis in sexual activity (Avoidant group), and 37% were sexually active and derived pleasure from their penis (Pleasure group). The groups were compared for differences in gender identification, developmental patterns, and personality. Transsexuals in the Avoidant group showed patterns of traits and experiences that generally conformed to characteristics of the nuclear transsexual. They were dissimilar from the other two groups on measures of feminine functioning, heterosexual history, and fetishism. Transsexuals who interact with males in ways that are viewed as more classically homosexual shared more in common with the transsexual group which abstained from sexual activity with males. Both groups displayed more masculinity in development and more evidence of emotional disturbance. The implications of these findings for diagnosis and treatment are discussed.     

The clinical profile of male transsexuals living as females vs. those living as males

The clinical profiles of five male groups were compared: transsexuals who live as females (FEM), those who live as males (MAL), homosexual patients (HOP), homosexual controls (HOC), and heterosexual controls (CON). The MAL group showed psychotic features on the MMPI and a greater frequency of suicide attempts than the other groups. Their sexual behavior was incongruous in that they have had substantial sexual contact with men but less often desired sexual contact with men. They also less often desired to handle the penis of an adult man or to kiss him on the lips. They were more likely to find handling another's penis disgusting. However, they showed considerable involvement of their penis in sex relations with men. The FEM group, in contrast, had MMPI profiles suggestive of character disorders and tended to engage in antisocial behavior. Both MAL and FEM groups were similar in MMPI and 16 PF femininity. The HOP group showed overall similarity to MAL but was not as pathological. The HOC and CON groups were similar in being normal but their sexual behavior differed, as expected. The paradoxical behavior of MAL is discussed as well as the parallel of the FEM group's behavior to that of criminals.This study was supported by grants from the Ontario government and the Psychiatry Research Fund, Clarke Institute.     

Heterosexual experience,marital status,and orientation of homosexual males

The penile volume responses of homosexual males to pictures of nude women and men were measured and related to the subjects' marital status and experience of heterosexual intercourse. Single subjects with no experience of heterosexual intercourse and married subjects with a history of intercourse with only their wives showed significantly greater response to pictures of men compared to pictures of women than did single subjects with experience of heterosexual intercourse and married subjects with experience of intercourse with women additional to their wives. It was concluded that extensive experience of heterosexual intercourse with one partner did not reduce homosexual responsiveness as measured by subjects' penile response to pictures of nude men and women. It was further concluded that some homosexual males showed physiological evidence of a degree of bisexuality in addition to the behavioral evidence that they sought heterosexual physical relationships.This investigation was supported in part by the National Health and Medical Research Council of Australia.     

Acoustic and perceptual implications of the transsexual voice

Two experiments are described concerning voice characteristics of male-to-female transsexuals. In the speech production experiment isolated words and longer utterances were realized in a male and female mode by subjects. Speech samples were analyzed as to a number of acoustic parameters and compared intraindividually. It appeared that, in spite of anatomical constraints, subjects were able to realize a number of vocal characteristics that are known to add to a feminine voice quality in the female speaking mode. In the second experiment, consisting of a perceptual task, male and female versions of some speech samples were presented pairwise to a panel of listeners who were able to identify the intended speaker sex mode. Perceptual results thus corroborate the acoustic findings.     

A comparison of Nocturnal Penile Tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties

The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erectile dysfunction; (iii) high risk for erectile dysfunction (organic and psychogenic); (iv) psychogenic dysfunction; reactive to erotica; and (v) psychogenic dysfunction; nonreactive to erotica. Subjects participating in this study underwent a comprehensive medical and psychological screening to place them in each subgroup. The penile circumference response to erotic stimuli used in conjunction with NPT response appeared useful in differentiating subgroups of erectile dysfunction and suggested the need for further diagnostic refinement in this area. The majority of vasculogenic dysfunctional subjects experienced greater erection responses during exposure to erotic stimulation than during NPT; several of these subjects achieved almost full erections in waking states but were practically flaccid at night. The discussion covers diagnostic and therapeutic implications.     

Physical and hormonal evaluation of transsexual patients during hormonal therapy

The optimal hormonal therapy for transsexual patients is not known. The physical and hormonal characteristics of 38 noncastrate male-to-female transsexuals and 14 noncastrate female-to-male transsexuals have been measured before and/or during therapy with various forms and dosages of hormonal therapy. All patients were hormonally and physically normal prior to therapy. Ethinyl estradiol was superior to conjugated estrogen in suppression of testosterone and gonadotropins but equal in effecting breast growth. The changes in physical and hormonal characteristics were the same for 0.1 mg/d and 0.5 mg/d of ethinyl estradiol. The female-to-male transsexuals were well managed with a dose of intramuscular testosterone cypionate of 400 mg/month, usually given 200 mg every two weeks. The maximal clitoral length reached was usually 4 cm. Higher doses of testosterone did not further increase clitoral length or suppression of gonadotropins; lower doses did not suppress the gonadotropins. Based on the information found in this study, we recommend 0.1 mg/d of ethinyl estradiol for the noncastrate male-to-female transsexual and 200 mg of intramuscular testosterone cypionate every two weeks for the noncastrate female-to-male transsexual.     

Penile responses of rapists and nonrapists to rape stimuli involving physical violence or humiliation

The sexual arousal profile of a subgroup of rapists with a history of low-level physical violence during their offenses was assessed. Twenty subjects participated: 10 rapists and 10 nonrapists. Stimuli consisted of audiotapes with the following five thematic contents: mutually consenting sexual activities; rape involving physical violence; rape involving humiliation; physical aggression without sexual activities; neutral. Penile responses were recorded during stimuli presentation using a mercury-in-rubber strain gauge. Data showed no differences between both groups for the rape stimuli involving physical violence. For the rape stimuli involving humiliation, however, the penile responses of the two groups differed. With those stimuli the average penile response of the rapists was higher than that of the nonrapists. Therefore, for this subgroup of rapists the association between sexual activities and humiliation presents a higher erotic value than the association between sexual activities and physical violence. Implication of these results as to the discriminant validity and classificatory accuracy of phallometry in rapists is discussed.     

Voluntary control of penile tumescence among homosexual and heterosexual subjects

Voluntary control of erectile responses represents a major threat to the validity of penile plethysmography. This study was designed to determine whether individuals can mimic a sexual orientation that differs from their actual sexual orientation. Since the presumed mechanism underlying voluntary control of penile tumescence involves a shift in attentional focus, a recall test was employed to assess the relationship between the ability to influence erectile responses and recall of critical test stimuli. Homosexual and heterosexual subjects were exposed to sexual materials under standard and faking instructions. The faking instructions consisted of asking subjects to suppress erectile responses to preferred stimuli and to enhance penile tumescence in the presence of nonpreferred stimuli. Across groups, results revealed some degree of suppression of erections but no significant enhancement of erections. Self-reported cognitive arousal under both conditions was consistent with erectile data. However, subjects' perceived control over erectile responses tended to be greater than their actual performance. No significant differences in recall were obtained. The recall procedure appears to interfere with subjects' ability to control erectile responses. Implications for clinical applications of penile plethysmography are summarized with suggestions for future research.     

Physical and hormonal evaluation of transsexual patients: A longitudinal study

The physical and hormonal characteristics of 60 male-to-female transsexuals and 30 female-to-male transsexuals were measured before or during treatment with commonly used forms and dosages of hormones. Only two patients (both female-to-male) had either a congenital defect in hormonal production or abnormal genital development. Patients were seen at 3- to 6-month intervals for an average of 18 months. The response to therapy was examined over time; physical parameters, hormonal concentrations, liver function tests, lipids, and glucose were measured. Three patients were changed from ethinyl estradiol to conjugated estrogen because of liver enzyme elevations. Ethinyl estradiol (0.1–0.5 mg/day) was equal to conjugated estrogen (7.5–10 mg/day) in its ability to suppress testosterone and gonadotropins and to promote breast growth. Maximum breast growth required 2 years of therapy. During treatment with testosterone, female-to-male transsexuals had a significant mild elevation of cholesterol and triglyceride. The female-to-male transsexuals receiving testosterone cypionate, 200 mg every 2 weeks, ceased to have menstrual periods and became progressively masculinized. A mean maximal clitoral length of 4.6 cm which achieved by 1 year of therapy. Based on the data generated by this study, we recommend as hormonal therapy 0.1–0.5 mg/day of ethinyl estradiol or 7.5–10 mg/day of conjugated estrogen for male-to-female transsexuals, and intramuscular testosterone cypionate, 200 mg every 2 weeks, for female-to-male transsexuals.This study was made possible by support from the Department of Pediatrics.     

Sexual fantasies of heterosexual and homosexual men

Heterosexual men and homosexual men rated how arousing different sexual fantasies were and how often they had used these fantasies over the previous year. Within each group, sensual and genital same-orientation fantasies were more arousing than either public-sex or dominance-submissive fantasies, which in turn were more arousing than aggressive-sex fantasies. For both heterosexual and homosexual men the extent to which a fantasy was arousing correlated with the person's experience of the activity depicted in the fantasy. The frequency of use of a fantasy correlated positively with its arousal level but not always subtantially so. The results are discussed in the context of the mediating role of fantasy in human sexual arousal.     

Psychosocial development of heterosexual,bisexual, and homosexual behavior

Relationships with overt adult Kinsey Scale scores (K) indicate that early sexual experiences are most closely related to K, followed in order by gender related and familial variables. A developmental model emphasizing social learning is presented. Interviewees were 7669 American white males and females.Elevated K (more homosexual scores) was found for females who had few girl companions at age 10 and few male companions at 16, had learned to masturbate by being masturbated by a female, had intense prepubertal sexual contact with boys or men, found thought or sight of females, but not males, arousing by age 18, had homosexual contact by age 18, higher K at 17, and higher first-year homosexual behavior frequency.Elevated K (more homosexual scores) was found for males who reported poorer teenage relationships with their fathers, had more girl companions at age 10, fewer male companions at 10 and 16, avoided sports participation, learned of homosexuality by experience, learned to masturbate by being masturbated by a male, had intense prepubertal sexual contact with boys or men, had neither heterosexual contact nor petting to orgasm by age 18, found thought or sight of males, but not females, arousing by age 18, had homosexual contact by age 18, higher K at ages 16 and 17, and had higher first-year homosexual behavior frequency.Behavioral bisexuals, those scoring between 2.0 and 4.0 on the K scale on the basis of overt behavior (0.7% of females, 1.2% of males), reported more arousal to heterosexual stimuli than did exclusive heterosexuals.     

Behavioral interventions for the primary prevention of HIV infection among homosexual and bisexual men

Behavioral intervention is the most urgent priority in preventing the further spread of HIV. To maximize the efficacy of AIDS prevention and to most efficiently allocate resources, it is imperative that variables contributing to preventive behavior change be accurately identified, and interventions be critical evaluated prior to widespread dissemination. We review studies regarding homosexual/bisexual men in terms of: 1) epidemiological trends in HIV transmission; 2) models of behavior change organized around the initiation, consolidation, and maintenance of change, and; 3) preventive intervention outcomes. We conclude with recommendations for effective primary prevention programs.Peggy L. Peterson is affiliated with the School of Social Work, Social Development Research Group, University of Washington. Address correspondence and reprint requests to: 146 North Canal St., Suite 211, XD-50, Seattle, WA 98103.David G. Ostrow is affiliated with the University of Michigan.David J. McKirnan is affiliated with the University of Illinois at Chicago.     

Treatment of homosexual and heterosexual sexual dysfunction in male-only groups of mixed sexual orientation

Males complaining of erectile and ejaculatory dysfunctions were treated in a structured therapy program. Twenty-one males of heterosexual, homosexual, or bisexual orientation were divided into five groups, with two male therapists for each group. Patients were those usually considered difficult to treat in that 16 had a primary sexual dysfunction with an average duration of 6 years. Extensive evaluations were made before therapy, at the completion of therapy, and at 2-months follow-up. Pre-therapeutic, post-therapeutic, and follow-up measurements indicated that the program was highly successful.     

EEG responses to visual erotic stimuli in men with normal and paraphilic interests

Contingent negative variation and evoked potentials to visual erotic stimuli were recorded from 8 brain sites in a sample of 62 right-handed men aged 20–50, half of whom declared paraphilic interests and half claimed normal heterosexual interests. To quantify erotic preferences, a variance quotient (VQ) was calculated from scores on the Wilson Sex Fantasy Questionnaire using the formula VQ = Impersonal + Sadomasochistic fantasies/Intimate + Exploratory fantasies. Stimuli consisted of 57 paraphilic slides (depicting fetishistic and sadomasochistic themes), 57 heterosexual erotic slides (explicit pictures of nude women, coitus, and oral sex), and 57 neutral slides (landscapes and street scenes). The P600 response appeared to be the best indicator of erotic preferences, but the locus of maximum arousal was different for paraphilic and heterosexual stimuli. The primary brain site for heterosexual arousal was P4 (right parietal), where there was a –.34 (p < .01) correlation between VQ and P600 (i.e., nonvariant males showed greater responses to normal erotic stimuli at this location). For paraphilic stimuli, there was a correlation of .26 (p < .05) between the VQ and P600 response at the F3 (left frontal) site (i.e., paraphilic men showed greater responses to paraphilic stimuli than normal men at this brain location). Dividing the sample into groups of 23 paraphilics and 23 heterosexual controls on the basis of their VQs showed that normals differentiated between stimulus types more at the P4 than paraphilics. Theoretical and clinical implications of these findings are discussed.     

Effects of medroxyprogesterone acetate on subjective arousal,arousal to erotic stimulation,and nocturnal penile tumescence in male sex offenders

Three chronic pedophiliac sex offenders were treated individually with medroxyprogesterone acetate (MPA) over a minumum of 3 months. Genital and subjective response to erotic stimulation, nocturnal penile tumescence, self-reporting of sexual urges, and testosterone levels were recorded repeatedly throughout the study. A single-subject reversal design was used and medication was administered through a double-blind procedure. The results showed that self-report of arousal outside of a laboratory setting was unreliable as a measure of the drug effect. In a laboratory setting, however, there appeared to be a significant reduction in the report of arousal to erotic stimuli while genital arousal decreased only slightly. Reversal of these responses occurred in only one subject during a final placebo phase. Nocturnal penile tumescence was significantly decreased during MPA administration and appeared to be related to decreases in total testosterone.     

马鞍山市女性性服务工作者和男男同性恋人群VCT需求调查

目的：了解艾滋病高危人群自愿咨询检测（VCT）需求和利用情况,探讨推动VCT工作开展的策略。方法：选择不同场所的女性性服务工作者（CSW）143人,男男同性恋者（MSM）37人作为调查对象,对其VcT需求和利用情况进行问卷调查。结果：CSW和MSM人群最近12个月接受VCT的比例分别为17．48％和54．05％,差异有统计学意义（X^2=20．97,P〈0．001）。两人群对VCT服务需求是一致的,但对于VCT咨询的内容、提供VCT服务的地点、机构类型,VCT机构服务时间、咨询的形式等,两人群的需求存在差异。结论：目标人群对VCT需求和利用存在差异,应加强对目标人群VCT的指导,并根据目标人群的特征提供不同的VCT服务模式,提高VcT服务的可及性。     

A comparison of high-risk sexual behaviour and HIV testing amongst a bar-going sample of homosexual men in London and Edinburgh.

BACKGROUND: This study compared high-risk sexual and HIV testing behaviour amongst homosexual men recruited from gay bars in London and Edinburgh. METHODS: A cross-sectional survey monitoring high-risk sexual and HIV testing behaviour using a self-completed questionnaire was conducted in November and December 1996. RESULTS: Two thousand, three hundred and ninety-seven questionnaires were returned (1,366 recruited in London and 1,031 in Edinburgh), with a response rate of 77%. A larger proportion of men surveyed in London had had unprotected anal intercourse (UAI) with one or more male partners in the previous year (35%) than in Edinburgh (30%). Men recruited in Edinburgh were less likely to have had an HIV test (54%) than men in London (63%). In both surveys, 25% of men who reported UAI with partners of the same HIV status as themselves also reported never having had an HIV test. CONCLUSIONS: The observed dissimilarities in the HIV epidemic in the two cities may be accounted for by the differences in self-reported high-risk sexual and HIV testing behaviours between the two populations. A large proportion of men in both cities continue to engage in high-risk sexual behaviour suggesting continued transmission of HIV in these populations. Thus, there is a continued need for innovative and relevant health promotion amongst homosexual men in the UK.     

Validity and ethics of penile circumference measures of sexual arousal: A reply to McConaghy

McConaghy (1989) argued that the validity of penile circumference responses (PCRs) is at best unestablished and that penile volume responses (PVRs) have been demonstrated to be clearly superior indices of sexual arousal and orientation. In his critique, McConaghy stated that (i) penile erection has been incorrectly identified with sexual arousal, (ii) that PCRs have not been shown to accurately discriminate between divergent patterns of sexual arousal (including paraphilias), (iii) that the methodologies used to compare the two types of transducers are inappropriate, and (iv) that PCRs should not be used for diagnostic and treatment decisions. In this paper, McConaghy's criticisms are reviewed in the context of the existing literature on the subject. Although PCRs and PVRs involve different methodologies, they generally yield results that bear more similarities than differences. Furthermore, there is an extensive and growing literature on the use of PCR measures with various paraphilias. Several of McConaghy's arguments should be considered tentative while others are clearly unsubstantiated. Most of McConaghy's concerns over the validity and uses of PCR measures are empirical questions. Suggestions for future research are offered.     

Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males

Two studies were undertaken to confirm the previous findings that homosexual men in general tend to have a later than expected birth order and that extremely feminine homosexual men also tend to have a higher than expected proportion of brothers (i.e. a highersibling sex ratio). Subjects in Study 1 were Dutch, adult and adolescent, biological male patients with gender dysphoria (persistent and recurrent desires to belong to the opposite sex), who were undergoing treatment with feminizing hormones. These comprised 83 patients who reported sexual attraction to other males (the homosexual group) and 58 who reported sexual attraction to females or equal attraction to males and females (the nonhomosexual group). Subjects in Study 2 were Dutch adolescent male patients at another hospital. The homosexual group consisted of 21 gender-dysphoric homosexual teenagers referred to a gender identity clinic for children and adolescents. The control group were 21 adolescent males referred to the child psychiatry department of the same hospital for reasons other than gender identity disorder, homosexuality, or transvestism. These were individually matched to the homosexual subjects on age and sibship size. In both studies, the homosexual group had a significantly later average birth order than the comparison group. In Study 1, the homosexual group had a significantly elevated sibling sex ratio; this was not tested in Study 2 because of its small sample size. These studies add to the mounting evidence that late birth orders are common to all homosexual samples and that elevated sibling sex ratios are an additional characteristic of extremely feminine ones.