Literature – Youth & Sexuality
Lecture 1a
Laan, E. T., Klein, V., Werner, M. A., van Lunsen, R. H., & Janssen, E. (2021). In
pursuit of pleasure: A biopsychosocial perspective on sexual pleasure and gender.
International Journal of Sexual Health, 1-21.
ABSTRACT
Objective: Various sources of evidence suggest that men and women differ in their experience
of sexual pleasure. Such gender differences have been attributed to men’s higher innate sex
drive, supported by evolutionary psychology perspectives and gender differences in
reproductive strategies.
Method: This paper presents biopsychosocial evidence for gender similarities in the capacity
to experience pleasure, and for substantial gender differences in opportunities for sexual
pleasure.
Results: We conclude that sexual activity, in most cultures, is less pleasurable and associated
with greater cost for heterosexual women than for heterosexual men, even though they do not
differ in the capacity for sexual pleasure.
Conclusion: Since gender differences in experienced sexual pleasure are not a biological
given, a more critical discourse of sexual pleasure might create awareness of current
inequalities, help lift restrictions for women’s opportunities for pleasure, and could reduce
gender differences in the cost of sex. That would truly serve sexual justice around the globe.
Introduction
The World Association of Sexual Health (WAS) recently adopted sexual pleasure, defined as
“the physical and/or psychological satisfaction and enjoyment derived from shared or solitary
erotic experiences, including thoughts, fantasies, dreams, emotions, and feelings,” as the
cornerstone of sexual health. Sexual pleasure is not just one of the main reasons to engage in
sexual behavior, it is also important for sexual health and sexual rights.
The ”dangers” of sexual pleasure
Western religious traditions have considered sex to be a “dangerous, destructive, negative
force”. To date, public health approaches to sexuality remain largely focused on adverse
health outcomes and concomitant risks.
These deep-rooted ideas that uncurbed sexuality is dangerous probably reinforce many
caretakers’ and parents’ fears that a positive approach to sexual health and sex education will
entice innocent children and adolescents into engaging in sex that they are not yet able to
consent to. Yet research shows that countries that promote abstinence-only sex education or
no sex education usually perform worse on indices of sexual health than countries that
provide comprehensive and positive information about sex to adolescents. In other words, a
positive approach to sexual health and sex education has more benefits than risks.
Health benefits of pleasure
,In a review of 40 studies published since 1990, authors concluded that the experience of
sexual satisfaction, sexual pleasure, and positive sexual self-esteem improves sexual health,
mental health, and physical health outcomes. It promotes overall wellbeing through improved
relationship quality and general life satisfaction.
Findings may give the impression that, for men, sexual pleasure is less important for enjoying
the health benefits of sex than it is for heterosexual women. However, this finding may rather
reflect the fact that, for men, sexual activity is almost invariably associated with sexual
pleasure, such that sexual pleasure does not further contribute to the association between
health and engagement in sexual activity as it does in heterosexual women. Engaging in
sexual activity may be exchangeable to experiencing sexual pleasure for the average man, but
not for women.
The gendered context of pleasure
Experiences of sexual pleasure seem embedded in a gendered context. Around the world,
sexual complaints are more prevalent in heterosexual women than in heterosexual men. In
(religious) traditional cultures sexual pleasure of women is judged to be more dangerous and
undesirable than that of men, or even considered irrelevant, probably because sexual pleasure
of women does not appear to be directly related to reproductive success.
Only those problems that interfere with sexual pleasure of men or with procreative sex are
deemed worthy of complaint or treatment, while sexual issues that are important and
distressing to women (and individuals engaging in non-procreative sex), including a lack of
sexual pleasure, go unnoticed.
Current gender differences in experienced sexual pleasures and displeasures
Pleasure gaps
The most recent study on orgasm differences between women and men of various sexual
orientations confirms findings of earlier studies suggesting that heterosexual sexual activity
benefits sexual pleasure of men more than that of women. They found that men of all sexual
orientations were more likely to orgasm than women.
Very robust data that suggest that penile-vaginal intercourse is rather ineffective to induce
orgasm in women. This is not explained by women simply being less able to orgasm than
men, as women who have sex with women have orgasms in 80–90% of all sexual interactions.
Some have argued that women are not particularly concerned about experiencing orgasm,
which may in itself be interpreted to reflect women being innately less interested in sex. If this
were true, orgasm would be a poor measure of women’s sexual pleasure. However, based on a
series of surveys in Finnish women, authors concluded that the most important single
predictor of sexual satisfaction for women is orgasm. In addition, women who downplay the
importance of orgasm may perhaps do so to reduce cognitive dissonance.
There are other indices besides orgasm that are indicative of substantial gender differences in
pleasure derived from sex.
Painful sex
,The prevalence of pain or discomfort during penile-vaginal intercourse is high among women.
In men, dyspareunia is much less prevalent. Characteristically, heterosexual women with
dyspareunia do not cease sexual activity that is painful for them. They ignore the primary
function of pain as signaling damage to the body. Findings suggest that beliefs that penile-
vaginal penetration is a “natural” sexual act to which men are entitled, justifying a
relationship breakup, are alive and well.
Violent sex and “scary” sex
Although all individuals are vulnerable to experiences of sexual victimization, sexual assault,
abuse, and harassment are overall still gendered crimes, such that women and girls are more
likely to be victims than men and boys. Members of marginalized groups face substantially
increased vulnerability to sexual victimization. These include individuals with disabilities,
sexual and gender minorities, homeless individuals, individuals engaging in various kinds of
sex work, and members of indigenous populations.
Based on this review, it is justified to conclude that currently women, and particularly
heterosexual women, are less likely to experience sexual pleasure than men, and that for them,
sex may come at a greater cost than for men. This raises the question of whether women have
a lesser capacity for sexual pleasure than men or whether these differences are better
explained by women having fewer opportunities for sexual pleasure.
Aim of this paper
This paper reviews biopsychosocial evidence for gender differences and similarities in (1) the
capacity to experience sexual pleasure and (2) opportunities to experience sexual pleasure,
including societal pressures which facilitate or penalize the attainment and expression of
sexual pleasure. Given that some of the greatest (observed) “pleasure gaps” are between
heterosexual women and heterosexual men, much of the paper will address gender differences
between heterosexual women and men.
Capacity for sexual pleasure
Childhood genital responses and behavior
Evidence is accumulating that women and men do not differ in their biological capacity for
sexual response, as evidenced by observations of genital responses and behavior of girls and
boys from (and even before) birth and onwards. The fact that masturbation is condoned or
even encouraged in boys but not or to a lesser extent in girls can have repercussions on the
use and efficacy of masturbation as a source of pleasure. By the time they are ready to engage
in sex with another person, boys may be equipped with greater knowledge than girls about
what type of genital stimulation is pleasurable to them.
Responsivity to sexual stimuli
In contrast to popular opinion that women are not very responsive to visual sexual stimuli,
women do respond to visual sexual stimuli with genital sexual arousal. Also, the ease with
which women and men become genitally aroused in response to sexual stimuli does not seem
to differ. Male and female brains are also equally responsive to visual sexual stimuli. The
mechanism of arousal is similar in women and men.
Sexual desire
, According to the incentive motivation model, sexual desire is activated by external, sexually
relevant stimuli or mental representations of such stimuli. This conceptualization of sexual
desire contrasts that of many other researchers who, influenced by Freud, Kaplan, and others,
consider sexual desire to be of internal origin, as a drive which is awakened “spontaneously”
through deprivation. As a result, many questionnaires are based on the assumption that sexual
desire is a stable trait, a capacity that one does or does not possess, and which is then often
claimed to be stronger in men than in women. Interestingly, studies using self-report
questionnaires that conceptualize sexual desire as a trait consistently find gender differences
in the stereotypical direction (with men reporting higher desire), whereas studies that have
individuals rate their feelings of sexual desire immediately following exposure to a sexual
stimulus fail to find differences between women and men.
Following the incentive motivation model, gender differences in reported feelings of desire
may be the result of differences in incentive, or sexual context, quality rather than reflective
of innate differences.
Sex drive, “sex” hormones, and reproductive success
In contrast to most animals, in humans neither the ability to engage in sexual activity nor the
motivation to do so is under strong hormonal control. If anything, in women and men the
absence of partnered and solo sexual activity, or the presence of non-rewarding (i.e., non-
pleasurable) sexual activity, seems related to a reduction of the desire to be sexually active,
with sexual abstinence even leading to reduced testosterone levels after prolonged periods of
sexual abstinence.
Even though a certain level of testosterone is required for men’s brains and genitals to be
sensitive to sexual stimuli, normal physiological testosterone levels above that minimum
threshold seem unrelated to levels of sexual desire. The same may be true for women, for
whom testosterone is also thought to be associated with their sexual arousability. Not absolute
but rather relative hormonal levels may allow women and men to be sensitive to sexual
stimulation.
Furthermore, labeling testosterone the “male sex hormone” obscures the fact that, for men,
testosterone is also their most important reproductive hormone. And although estrogens are
thought to be the “female sex hormone,” in reality no good evidence exists that they are
related to women’s sensitivity to sexual stimuli. In sum, the role sex hormones play in male
and female reproduction should not be equated with their role in men’s and women’s
sexuality.
In a similar vein, conflating sexuality with reproduction seems to have led to the widely held
belief that the sexual act that helps humans reproduce (penile-vaginal intercourse), should also
be the most sexually pleasurable. When considering the overwhelming evidence that penile-
vaginal intercourse advances heterosexual men’s orgasms, as discussed earlier, this seems like
a reasonable thought, at least from a male perspective. Labeling the vagina a reproductive
rather than a sexual organ would help women to no longer feel sexually dysfunctional when
they have difficulty becoming sexually aroused, let alone experience orgasm, from penile-
vaginal intercourse without direct or indirect stimulation of their pleasure organ, the clitoris.
Sexual behaviors and attitudes: gender differences or gender similarities?