“Clitoris. Clitoris. Clitoris. Clitoris,” is part of a juvenile conversation I had with myself years ago. A graduate psychology student, I’d been assigned to give a lecture on sexual and gender identity disorders. At the time, I knew nothing about the topic and would have preferred something less awkward; say, a merry little research jaunt down bipolar or schizophrenia lane.
Instead, my professor gave me the pleasure of stretching my mouth around words and phrases like clit, ambiguous genitalia, and gynecomastia. I practiced saying, “Penis. Penis. Penis. Penis...”—and every other sexually charged word—until I no longer smirked when I did.
My memory reflects just how uncomfortable it is for many Americans to “include sex and sexuality as pleasurable and natural in open frank conversation about the human condition,” to quote Dr. Joycelyn Elders, writing a commentary in the October issue of the Journal of Sexual Medicine (JSM).
Elder’s essay is part of a supplement to the JSM that includes the National Survey of Sexual Health and Behaviors (NSSHB)—one of the largest investigations into the bedroom behaviors of Americans since Kinsey’s work the 1930s and ’40s. The information gleaned from 5,868 adolescents and adults willing to bare all reflect our changing sexual landscape and a continued need to structure relevant public health policy.
“At a time when we can have nudity on HBO but cannot use the names of our genitals on the evening news, there remains a need to continue research on sexual health,” says Irwin Goldstein, Editor-in-Chief of the JSM and medical director of San Diego Sexual Medicine at Alvarado Hospital.
He echoes the sentiments of the researchers who acknowledge that we’ve got to know what folks are doing first, before we can develop and deliver “social service and health programs related to sexuality and sexual health.” But what exactly is sexual health? We tend to focus on sexually transmitted diseases, reproduction and fertility, the risks associated with certain practices, or a person’s general ability to get randy at a moment’s notice.
What is evident is that we still have a lot to incorporate into the dialogue, including the unpopular news that not all sex acts are created equal. The benefits of sex are inequitable with respect to gender, kink and homosexuality.
First, the Straight News…
Dr. Lissa Rankin, author of What’s Up Down There? Questions You’d Only Ask your Gynecologist if She Were Your Best Friend (St. Martin’s Press, October 2010), offers a well-documented list of some of the health benefits of sex for women. She includes lowered risks of breast cancer, bolstered immunity, improved sleep, enhanced fertility, lowered stress and depression, regulated menstrual cycles, spiritual growth, and relief from menstrual cramps, chronic pain and menopausal symptoms, among others.
Rankin joins a growing cadre of experts who highlight the good that sex does for men. For example, guys with active lust lives (defined as ejaculating at least twice weekly) have higher testosterone levels, healthier sperm, and lowered likelihood of getting prostrate cancer.
In some cases, having the same parts hasn’t fully translated into the same outcomes; the cardiovascular benefits (healthier hearts, lower blood pressure and associated longevity) of sex are demonstrated more conclusively for males than for females.
For Best Results, Insert Flap A into Slot B?
But documenting Americans’ sex lives and relating it to sexual health becomes more controversial when you examine the potential physical and mental health benefits of heterosexual intercourse compared to other acts. Stuart Brody, professor at University of the West of Scotland, School of Social Sciences, and author of “The Relative Health Benefits of Different Sexual Activities” (JSM, May 2010), did just that. After reviewing 174 international studies, he concluded: “Evolution strongly rewards behaviors that increase the likelihood of successful gene propagation, and only one behavior—penile-vaginal intercourse (PVI)—is potentially reproductive.”
It seems the biology of sex isn’t politically correct when it comes to conveying health benefits to the genders and those who like a little kink with their sex. Swedish babes, for instance, who achieved orgasm via penile-vaginal sex scored noticeably higher on standardized mental health inventory scales (i.e., they were happier) than women who did so via rubbing their clit, clit, clit. Only PVI (and not masturbation, anal or oral sex) was a clear indicator of self-reported satisfaction with mental health, in the same study, and Brody noted similar conclusions in several other academic papers.
There’s more and it gets edgier: Swiss and American patients who suffered from alexithymia (a fancy term for the inability to perceive, identify or express emotions) were also more likely to have hypoactive sexual desire (low sex drive), sexual dysfunctions (inability to experience arousal, desire or orgasm) and/or regularly use paraphilias (including the use of sex toys or engaging in “kinky” behaviors or BDSM).
After reviewing dozens of studies conducted in the U.S., South America and Europe that compared PVI to other sexual acts, Brody concurred with Kinsey’s assessment from decades ago: that “marital happiness” and mental health is associated most with unprotected female orgasm.
Meanwhile, on the Gherkin Front…
Speaking of sexing it up with an unwrapped pickle (used as a euphemism here, and not the actual snack), women, it turns out, can rejoice in the “cum cure.” Sperm—with its nutritious blend of prostaglandins, testosterone and other hormones that are absorbed in a woman’s bloodstream through the vagina—alleviates depressive symptoms in women who don’t use condoms. Not only does spunk get women out of a funk, but that extra testosterone absorbed from doing it unwrapped is a potential libidinous shot in the booty for women suffering diminished female arousal (take that, Big Pharma!).
Homosexual men, however, apparently get no such benefit from ejaculate. Reviewing several studies that controlled for things like a man’s psychological well-being, the acceptance of gay culture or same-sex marriage in his community, masturbation and non-PVI partnered activities, Brody found that swallowing cum didn’t help gay men in the same way it helped straight women who absorbed it the procreative way.
The Science vs. The Sexy
Brody spends a significant chunk of time on physiological aspects of sex, too: pain control, metabolism, vaginal and pelvic muscle function, cardiovascular and musculoskeletal health, and hormonal balance. He compares heterosexual sex to anal, oral and non-conventional ways to get your rocks on. Bottom line, according to Brody: Vanilla is the one and only flavor you can consistently count on to add vigor.
It’s impossible to cover the dozens of studies Brody digs into in the space of this article, or deny the controversy of his conclusions. Some, including noted sex researcher, Beverly Whipple, Ph.d., point out that we don’t know for certain whether sex makes people healthier or whether healthier people have more sex.
“It’s a chicken-egg situation,” Whipple says. “We can’t definitively say there’s a cause-and-effect relationship between sex and better health.”
Nevertheless, discrediting Brody’s methodology is also irresponsible. Sue Goldstein, member of the board of directors of the International Society for the Study of Women’s Sexual Health, the International Society of Sexual Medicine and the Sexual Medicine Society of North America, told me that while some considered Brody’s work divisive, his approach met with the rigorous standards of the journal. (She should know—she’s the editorial assistant for the JSM, publishers of Brody’s analysis, and the more recently, the NHHSB study.)
In the end, we may just have to settle with the truth that science about sex doesn’t always gibe with what we hope to prove or want to believe. But it will always make mental and genital waves.
(Special thanks to the San Diego Sexual Medicine at Alvarado Hospital for providing information and copies of the studies referenced in this article.)