Physiological Mechanisms of Sexual Behavior and Motivation

Much of what we know about the physiological mechanisms that underlie sexual behavior and motivation comes from animal research. As you’ve learned, the hypothalamus plays an important role in motivated behaviors, and sex is no exception. In fact, lesions to an area of the hypothalamus called the medial preoptic area completely disrupt a male rat’s ability to engage in sexual behavior. Surprisingly, medial preoptic lesions do not change how hard a male rat is willing to work to gain access to a sexually receptive female (Figure 1). This suggests that the ability to engage in sexual behavior and the motivation to do so may be mediated by neural systems distinct from one another.

Animal research suggests that limbic system structures such as the amygdala and nucleus accumbens are especially important for sexual motivation. Damage to these areas results in a decreased motivation to engage in sexual behavior while leaving the ability to do so intact (Figure 2) (Everett, 1990). Similar dissociations of sexual motivation and sexual ability have also been observed in the female rat (Becker, Rudick, & Jenkins, 2001; Jenkins & Becker, 2001).

Figure 2. The medial preoptic area, an area of the hypothalamus, is involved in the ability to engage in sexual behavior, but it does not affect sexual motivation. In contrast, the amygdala and nucleus accumbens are involved in motivation for sexual behavior, but they do not affect the ability to engage in it.

Although human sexual behavior is much more complex than that seen in rats, some parallels between animals and humans can be drawn from this research. The worldwide popularity of drugs used to treat erectile dysfunction (Conrad, 2005) speaks to the fact that sexual motivation and the ability to engage in sexual behavior can also be dissociated in humans. Moreover, disorders that involve abnormal hypothalamic function are often associated with hypogonadism (reduced function of the gonads) and reduced sexual function (e.g., Prader-Willi syndrome). Given the hypothalamus’s role in endocrine function, it is not surprising that hormones secreted by the endocrine system also play important roles in sexual motivation and behavior. For example, many animals show no sign of sexual motivation in the absence of the appropriate combination of sex hormones from their gonads. While this is not the case for humans, there is considerable evidence that sexual motivation for both men and women varies as a function of circulating testosterone levels (Bhasin, Enzlin, Coviello, & Basson, 2007; Carter, 1992; Sherwin, 1988).

Kinsey’s Research

Before the late 1940s, access to reliable, empirically-based information on sex was limited. Physicians were considered authorities on all issues related to sex, despite the fact that they had little to no training in these issues, and it is likely that most of what people knew about sex had been learned either through their own experiences or by talking with their peers. Convinced that people would benefit from a more open dialogue on issues related to human sexuality, Dr. Alfred Kinsey of Indiana University initiated large-scale survey research on the topic (Figure 3). The results of some of these efforts were published in two books—Sexual Behavior in the Human Male and Sexual Behavior in the Human Female—which were published in 1948 and 1953, respectively (Bullough, 1998).

Figure 3. In 1947, Alfred Kinsey established The Kinsey Institute for Research, Sex, Gender and Reproduction at Indiana University, shown here in 2011. The Kinsey Institute has continued as a research site of important psychological studies for decades.

At the time, the Kinsey reports were quite sensational. Never before had the American public seen its private sexual behavior become the focus of scientific scrutiny on such a large scale. The books, which were filled with statistics and scientific lingo, sold remarkably well to the general public, and people began to engage in open conversations about human sexuality. As you might imagine, not everyone was happy that this information was being published. In fact, these books were banned in some countries. Ultimately, the controversy resulted in Kinsey losing funding that he had secured from the Rockefeller Foundation to continue his research efforts (Bancroft, 2004).

Although Kinsey’s research has been widely criticized as being riddled with sampling and statistical errors (Jenkins, 2010), there is little doubt that this research was very influential in shaping future research on human sexual behavior and motivation. Kinsey described a remarkably diverse range of sexual behaviors and experiences reported by the volunteers participating in his research. Behaviors that had once been considered exceedingly rare or problematic were demonstrated to be much more common and innocuous than previously imagined (Bancroft, 2004; Bullough, 1998).

Among the results of Kinsey’s research were the findings that women are as interested and experienced in sex as their male counterparts, that both males and females masturbate without adverse health consequences, and that homosexual acts are fairly common (Bancroft, 2004). Kinsey also developed a continuum known as the Kinsey scale that is still commonly used today to categorize an individual’s sexual orientation (Jenkins, 2010).

Masters and Johnson’s Research

In 1966, William Masters and Virginia Johnson published a book detailing the results of their observations of nearly 700 people who agreed to participate in their study of physiological responses during sexual behavior. Unlike Kinsey, who used personal interviews and surveys to collect data, Masters and Johnson observed people having intercourse in a variety of positions, and they observed people masturbating, manually or with the aid of a device. While this was occurring, researchers recorded measurements of physiological variables, such as blood pressure and respiration rate, as well as measurements of sexual arousal, such as vaginal lubrication and penile tumescence (swelling associated with an erection). In total, Masters and Johnson observed nearly 10,000 sexual acts as a part of their research (Hock, 2008).

Based on these observations, Masters and Johnson divided the sexual response cycle into four phases that are fairly similar in men and women: excitement, plateau, orgasm, and resolution (Figure 4). The excitement phase is the arousal phase of the sexual response cycle, and it is marked by erection of the penis or clitoris and lubrication and expansion of the vaginal canal. During plateau, women experience further swelling of the vagina and increased blood flow to the labia minora, and men experience full erection and often exhibit pre-ejaculatory fluid. Both men and women experience increases in muscle tone during this time. Orgasm is marked in women by rhythmic contractions of the pelvis and uterus along with increased muscle tension. In men, pelvic contractions are accompanied by a buildup of seminal fluid near the urethra that is ultimately forced out by contractions of genital muscles, (i.e., ejaculation). Resolution is the relatively rapid return to an unaroused state accompanied by a decrease in blood pressure and muscular relaxation. While many women can quickly repeat the sexual response cycle, men must pass through a longer refractory period as part of the resolution. The refractory period is a period of time that follows an orgasm during which an individual is incapable of experiencing another orgasm. In men, the duration of the refractory period can vary dramatically from individual to individual with some refractory periods as short as several minutes and others as long as a day. As men age, their refractory periods tend to span longer periods of time.

Figure 4. This graph illustrates the different phases of the sexual response cycle as described by Masters and Johnson.

In addition to the insights that their research provided with regards to the sexual response cycle and the multi-orgasmic potential of women, Masters and Johnson also collected important information about reproductive anatomy. Their research demonstrated the oft-cited statistic of the average size of a flaccid and an erect penis (3 and 6 inches, respectively) as well as dispelling long-held beliefs about relationships between the size of a man’s erect penis and his ability to provide sexual pleasure to his female partner. Furthermore, they determined that the vagina is a very elastic structure that can conform to penises of various sizes (Hock, 2008).

Sexual Orientation

A person’s sexual orientation is their emotional and erotic attraction toward another individual (Figure 5). While the majority of people identify as heterosexual (attraction to opposite-sexed individuals), there is a sizable population of people within the United States who identify as either homosexual (same-sex attraction) or bisexual (attraction to both sexes). Research suggests that somewhere between 3% and 10% of the population identifies as homosexual (Kinsey, Pomeroy, & Martin, 1948; LeVay, 1996; Pillard & Bailey, 1995).

Figure 5. Between 3% and 10% of the adult population identifies as homosexual. (credit: Till Krech)

Issues of sexual orientation have long fascinated scientists interested in determining what causes one individual to be heterosexual while another is homosexual. For many years, people believed that these differences arose because of different socialization and familial experiences. However, research has consistently demonstrated that the family backgrounds and experiences are very similar among heterosexuals and homosexuals (Bell, Weinberg, & Hammersmith, 1981; Ross & Arrindell, 1988).

Genetic and biological mechanisms have also been proposed, and the balance of research evidence suggests that sexual orientation has an underlying biological component. For instance, over the past 25 years, research has demonstrated gene-level contributions to sexual orientation (Bailey & Pillard, 1991; Hamer, Hu, Magnuson, Hu, & Pattatucci, 1993; Rodriguez-Larralde & Paradisi, 2009), with some researchers estimating that genes account for at least half of the variability seen in human sexual orientation (Pillard & Bailey, 1998). Other studies report differences in brain structure and function between heterosexuals and homosexuals (Allen & Gorski, 1992; Byne et al., 2001; Hu et al., 2008; LeVay, 1991; Ponseti et al., 2006; Rahman & Wilson, 2003a; Swaab & Hofman, 1990), and even differences in basic body structure and function have been observed (Hall & Kimura, 1994; Lippa, 2003; Loehlin & McFadden, 2003; McFadden & Champlin, 2000; McFadden & Pasanen, 1998; Rahman & Wilson, 2003b). In aggregate, the data suggest that to a significant extent, sexual orientations are something with which we are born.

Gender Identity

Many people conflate sexual orientation with gender identity because of stereotypical attitudes that exist about homosexuality. In reality, these are two related, but different, issues. Gender identity refers to one’s sense of being male or female. Generally, our gender identities correspond to our chromosomal and phenotypic sex, but this is not always the case. When individuals do not feel comfortable identifying with the gender associated with their biological sex, then they experience gender dysphoria. Gender dysphoria is a diagnostic category in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that describes individuals who do not identify as the gender that most people would assume they are. This dysphoria must persist for at least six months and result in significant distress or dysfunction to meet DSM-5 diagnostic criteria. In order for children to be assigned this diagnostic category, they must verbalize their desire to become the other gender.

Cisgender is an umbrella terms used to describe people whose sense of personal identity and gender corresponds with their birth sex, while transgender is a term used to describe people whose sense of personal identity does not correspond with their birth sex. Approximately 1.4 million U.S. adults or .6 percent of the population are transgender according to a 2016 report.

Many people who are classified as gender dysphoric seek to live their lives in ways that are consistent with their own gender identity. This involves dressing in opposite-sex clothing and assuming an opposite-sex identity. These individuals may also undertake transgender hormone therapy in an attempt to make their bodies look more like the opposite sex, and in some cases, they elect to have surgeries to alter the appearance of their external genitalia to resemble that of their gender identity (Figure 6). Transgender people who attempt to alter their bodies through medical interventions such as surgery and hormonal therapy are called transsexual individuals. They may also be known as male-to-female (MTF) or female-to-male (FTM). Not all transgender individuals choose to alter their bodies: many will maintain their original anatomy but may present themselves to society as another gender.

Figure 6. Chaz Bono, a transgender male, is a well-known person who transitioned from female to male. (a) In the 1970s, the world knew Chaz as Chastity Bono, the daughter of the famous entertaining duo Sonny and Cher; here young Chastity is pictured with Sonny. (b) Later in life, Chaz transitioned to align his physical body with his gender identity. (credit b: modification of work by “dvsross”/Flickr)

Cultural Factors in Sexual Orientation and Gender Identity

Gender is deeply cultural. Like race, it is a social construction with real consequences, particularly for those who do not conform to gender binaries. In order to describe gender as a concept, we need to expand the language we use to describe gender beyond “masculine” or “feminine.” Gender identity, or the way that one thinks about gender and self-identifies, can be woman, man, or genderqueer.

Gender expression, or how one demonstrates gender (based on traditional gender role norms related to clothing, behavior, and interactions) can be feminine, masculine, androgynous, or somewhere along a spectrum. Although gender has traditionally been considered in binary terms (male or female), increasingly gender is being seen as a spectrum; however, our vocabulary is still limited in terms of the ways in which we describe gender identity.

Issues related to sexual orientation and gender identity are very much influenced by sociocultural factors. Even the ways in which we define sexual orientation and gender vary from one culture to the next. While in the United States exclusive heterosexuality is viewed as the norm, there are societies that have different attitudes regarding homosexual behavior. In fact, in some instances, periods of exclusively homosexual behavior are socially prescribed as a part of normal development and maturation. For example, in parts of New Guinea, young boys are expected to engage in sexual behavior with other boys for a given period of time because it is believed that doing so is necessary for these boys to become men (Baldwin & Baldwin, 1989).

There is a two-gendered culture in the United States. We tend to classify an individual as either male or female. However, in some cultures, there are additional gender variants resulting in more than two gender categories. For example, in Thailand, you can be male, female, or kathoey. A kathoey is an individual who would be described as intersexed or transgender in the United States (Tangmunkongvorakul, Banwell, Carmichael, Utomo, & Sleigh, 2010).