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12Gender and Sexuality

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Learning Objectives

After completing this chapter, you should be able to:

• Outline the biological and cognitive contributions in the emergence of gender identity.

• Describe the effect of various social influences on gender development.

• Account for gender differences in physical activity and play in childhood and adolescence.

• Compare and contrast school achievement and learning among males and females.

• Discuss the physical and psychological consequences of puberty.

• Evaluate demographic differences in sexual activity among adolescents; explain the consequences of teenage pregnancy.

• Explain how romantic relationships and sexual orientation contribute to identity formation.

• Detail the changes in sexuality that occur during adulthood.

• Explain how research has helped identify important elements of romantic relationships.

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Prologue

Chapter Outline

Prologue

12.1 The Development of Gender: Biology and the Brain Biological Influences Evolutionary Influences Cognitive Influences

12.2 Social Influences on Gender Development Home and School Media

12.3 Gender Differences in Physical Activity and Play in Childhood and Adolescence

12.4 Differences in School Achievement and Learning School Achievement Self-Efficacy

12.5 Sexual Maturation Puberty in Girls Puberty in Boys Secular Trends in Puberty Psychological Effects of Puberty

12.6 Becoming Sexually Active Sex Education Teenage Pregnancy

12.7 Sexual Orientation Lesbian, Gay, Bisexual, and Transgender (LGBT) Teens

12.8 Sexuality in Adulthood Sexual Response Changes Particular to Women Changes Particular to Men

12.9 Romantic Love and Intimacy Attachment and Romantic Love Pursuing Love Relationships Desired Characteristics of Long-Term Relationships Sexual Orientation and Love Relationships

Summary & Resources

Prologue Bruce Jenner won the gold medal in the 1976 Olympic decathlon, and with it he attained the title of “World’s Greatest Athlete.” Four decades later, in 2015, Jenner surprisingly disclosed lifelong struggles with gender identity, and at age 66, the desire to transition to a woman.

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Section 12.1 The Development of Gender: Biology and the Brain

Initial Hollywood sensationalism of the story shifted to Caitlyn Jenner becoming the face of the transgendered community, speaking poignantly, and perhaps unexpectedly, to those younger than she who struggle on an everyday basis with their sexual identity. Sexuality, a broad term that can refer to a capacity for sexual attraction and interest, gender identity, or sexual orientation, has been spotlighted like perhaps no other time in our history. Other stories have led to renewed discussion about sex and gender in society. Sasha Laxton from Great Britain, Storm Stocker from Toronto, Canada, and Pop from Sweden have all made headlines as their parents were determined to raise them without regard to gender. The children’s rooms were painted in neutral colors; hairstyles, Halloween costumes, and clothing were chosen with- out perceived regard for gender standards; exposure to toys and other activities were not limited by what was considered “normal” for a boy or a girl. As much as their parents tried, however, it is virtually impossible to remove all traces of gender from society, which would include limiting exposure to media, avoiding certain store shelves, and restricting access to preschool and other social activities. Further, it is apparent that biology pulls in its own direc- tion, regardless of how we try to promote neutrality.

For most of us, sex and gender are inescapably connected. It is extremely rare for a person to be born with undifferentiated sex organs. Even when someone is born with ambiguous genitalia, they still generally have either XX or XY genes. Biological sex is therefore not par- ticularly variable. By contrast, regardless of biological sex, gender is much more continuous. Some individuals are drawn quite strongly to the behaviors and activities of one gender over another, while others engage freely in more varied activities. Like Caitlyn Jenner, sometimes it takes many years for us to recognize how sex and gender integrate with identity develop- ment. This chapter explores these issues, as well as concerns related to sex and romantic relationships and their developmental consequences.

12.1 The Development of Gender: Biology and the Brain Recall the many different factors involved in the development of the self and the formation of personality. Gender is another key component in the development of the self, which is the focus of Chapter 11. In psychology, gender refers to the meanings societies and individuals give to female and male characteristics, unlike sex, which is biological. How much of gender is dependent on biological sex is a matter of great debate. Although overwhelming neurosci- entific evidence indicates that males and females are born different, reinforcement of gender through socialization is robust and begins early. Messages from parents, media, school, and peers strongly shape ideas about gender-specific behavior.

The way people define their own gender has a great deal to do with their later behavior. We construct gender roles based on sociocultural norms of what is considered acceptable sex- typed behavior. Individual experiences and societal expectations play strong roles in their development. How individuals integrate the various behaviors related to gender contributes to individual personality and gender identity. Our gender identify is a sense of the gendered self, influenced by social expectations and situational contexts, that is developed over time. For instance, boys and girls are socialized to dress and ornament themselves in a particular manner, play with certain kinds of toys, and assist in specific kinds of chores. Culture is closely tied to this process as well. Some cultures emphasize one role or activity over another. For example, in some parts of Asia, it is not unusual for boys and men to wear a kind of skirt that

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Section 12.1 The Development of Gender: Biology and the Brain

would be unusual in Europe or North America. These factors and more contribute to how gender is constructed.

Biological Influences Few areas in social and developmental psychology provoke as much controversy as the rela- tive influences of nature and nurture on gender identity. Biological intersex variations dis- cussed in Chapter 3 further complicate the discussion. Studies show that newborn male and female infant brains are quite different physically, before the environment has had a sub- stantial impact (Moir & Jessel, 1992). Subsequent research has confirmed their findings (e.g., Achiron, Lipitz, Hering-Hanit, & Achiron, 2001). Structures like the corpus callosum (the bun- dle of nerves that connects the two brain hemispheres) and, at the cellular level, the length and function of certain chromosomes are indeed distinct (Hammer, Mendez, Cox, Woerner, & Wall, 2008). Relative size differences also exist in structures related to memory, vision, and language processing (e.g., see Cahill, 2005). Specific anatomical brain differences sug- gest that gender is at first biologically and genetically driven; sex influences specific kinds of gender development and behavior. Just like bats have relatively large brain centers devoted to hearing, rats rely on smell and have relatively large olfactory centers, and humans rely on sight and have a sophisticated visual cortex, differences in the brains of humans imply relative strengths.

In females, the limbic system is larger and parts of the frontal cortex related to decision mak- ing are denser. In males, it is well established that the amygdala—involved in the fight-or- flight response and other emotionally laden stimuli—is larger (Goldstein, Kennedy, & Cavi- ness, 1999; Ruigrok et al., 2014). It is possible that the disparities may reflect differences in emotionality and different responses to stress. Furthermore, areas of the brain that are linked to activity, emotion, and self-regulation appear different in male and female brains, beginning at birth. As such, the distinctions in brain organization may contribute to sex differences seen in infant temperament, since the average male infant is more active and fussier than the aver- age female (Baron-Cohen, 2003; Eagly & Wood, 2013; Hines, 2005; Karaismailoğl & Erdem, 2013). Regardless of any brain differences between the sexes, variability within each sex is significantly greater than the differences between them (see the feature box, “Psychology in Action: Understanding Within-Group and Between-Group Differences in Social Statistics.”)

Psychology in Action: Understanding Within-Group and Between-Group Differences in Social Statistics

It is essential to understand what is meant by within-group differences as opposed to between- group (sometimes referred to as across-group) differences. Figure 12.1 expresses the hypo- thetical distribution of height for 14-year-old boys and girls. At this age, on average, boys are taller than girls by approximately 1.5 inches (3.8 cm). Typical girls can be anywhere from 60 to 68 inches tall (152–173 cm); typical boys range from 60.5 to 69 inches tall (154–175 cm). Therefore, the average difference between boys and girls of 1.5 inches is relatively small, whereas the range of heights within the group of all girls (Figure 12.1a) and the range of heights within the group of all boys (Figure 12.1b) is relatively large. The difference between

(continued)

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Inches 63 Inches 64.5

Average height of 14-year-old girls

Average height of 14-year-old boys

Within group di�erences for girls

Within group di�erences for boys

Di�erence between groups

a. b. c.

Section 12.1 The Development of Gender: Biology and the Brain

boys and girls is still significant, but not nearly as dramatic as the differences within each group. The effect size refers to the magnitude of the difference (Figure 12.1c). When the dif- ference between groups is small, there is considerable overlap and the effect size is small; when the difference between groups is large, there is little overlap and the effect size is large. These distinctions are especially important when investigating developmental differences between boys and girls.

Figure 12.1: Within-group versus between-group differences

Between-group sex differences are not nearly as strong as within-group differences.

Inches 63 Inches 64.5

Average height of 14-year-old girls

Average height of 14-year-old boys

Within group di�erences for girls

Within group di�erences for boys

Di�erence between groups

a. b. c.

Psychology in Action: Understanding Within-Group and Between-Group Differences in Social Statistics (continued)

In a widely publicized new brain study, researchers found striking physical evidence of differ- ences in how male and female brains are organized (Ingalhalikar et al., 2014). This informa- tion appears to confirm behavioral differences (such as verbal and math ability) that are often only observed. Brain imaging of 521 females and 428 males aged 8 to 22 years showed that male neural networks formed superior connections from front to back in each of the brain hemispheres (see Figure 12.2). According to the researchers, there is some indication that males have greater potential to connect perception with coordinated action, like learning the single task of riding a bicycle. In contrast, female brains have more neural communication between the two hemispheres, coinciding with a stronger connection between analyses and intuition. This pattern indicates that females might be better equipped for multitasking and working toward solutions that focus on group outcomes. The clear differences provide addi- tional evidence that males and females may be prewired to excel at different tasks.

Perhaps the strongest evidence for a biological influence on gender development is the find- ing that androgens, the hormones responsible for male growth and development, have a significant effect on gender-typed behaviors. Girls who are exposed prenatally to abnormally high concentrations of androgens are more likely to later engage in male-type play behaviors, compared to their sisters who had less exposure. In general, higher levels of androgens are associated with more active, rougher play. Conversely, males who are exposed to higher than normal levels of the female hormone estrogen are more likely to display relatively high levels of stereotypically female behaviors (Hines, 2013; Karaismailoğl & Erdem, 2013). In fact, early

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Section 12.1 The Development of Gender: Biology and the Brain

Figure 12.2: Neural connectivity

These “connectome” maps show relatively more interhemispheric connections among females (orange) and relatively more intrahemispheric connections in male brains (blue).

Source: Ingalhalikar, M., Smith, A., Parker, D., Satterthwaite, T. D., Elliott, M. A., Ruparel, K., & Verma, R. (2014). Sex differences in the structural connectome of the human brain. Proceedings of the National Academy of Sciences of the United States of America, 111(2), 823–828.

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exposure to male hormones has been linked to male-typical behavior across the animal king- dom. Researchers have discovered that sex-based hormonal influences contribute to changes in brain structure, gene expression, and, ultimately, behavior throughout the animal kingdom (Arnold, 2009; Hines, 2011). Because of these findings, it has been said that the multitude of biological differences between the sexes “pervade all clinical experience” (Federman, 2006, p. 1514). Nevertheless, hormonal variations that produce anatomical modifications cannot account for the many gender differences we see in society.

Evolutionary Influences Some observers approach the biological contributions to gender from an evolutionary per- spective. Brains may have evolved differently due to a developmental advantage. For instance, males may show masculine qualities because our male ancestors needed to protect their families from harm. Females may be attracted to males’ activity and perceived strength in leadership. Similarly, it is argued that women propagate the species by showing nurturance, which begins with gentler childhood play (Meredith, 2015; Murray & Murray, 2011). Through natural selection and the imperative to maximize fitness, separate masculine and feminine traits became more valuable to the species.

Now, instead of genes being expressed strictly for the purpose of survival, perhaps they con- tribute to differences in activity levels and social preferences. For instance, on average, boys prefer more action toys and rougher activities. In contrast, girls engage in more role-playing and quieter activities. These preferences begin in early infancy and exist across cultures (Aydt & Corsaro, 2003; Braza et al., 2012; Campbell, Shirley, & Candy, 2004). Evolution suggests they may have been at least partially due to natural selection.

Cognitive Influences From a cognitive perspective, children begin to construct gender-type in the same way Piaget would say they construct knowledge about the physical world. That is, according to cognitive theorists, we interpret environmental clues that teach us how to act. Gender identity (or a schema for gender) is initially acquired in the second year (Campbell et al., 2004). Beginning at this age, children acquire beliefs and expectations about gender and are usually able to identify the differences between boys and girls based on outward appearances. As a result, a gender schema guides the way we view the world beginning at an early age. Because of cogni- tive limitations, however, preoperational children have rigid ideas about gender. For instance, a preschooler may think it is inappropriate or silly for women to wear a tie simply because “only men do that.”

At around 4 years of age, we acquire gender stability. Now we understand that boys become men and girls become women, but only so long as they act in a particular manner. If a boy dresses like a girl, he can become a girl. Finally, a year or two later, children develop an under- standing that gender is permanent. This is called gender constancy. Depending on cultural norms, this is the stage at which children may begin to give up hopes of achieving success in an area that is usually reserved for a gender other than the one with which they identify (Kar- niol, 2009; Ruble et al., 2007). If children aspire to behave in a way that is inconsistent with gender, self-concept and self-esteem may suffer.

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Section 12.2 Social Influences on Gender Development

12.2 Social Influences on Gender Development The biosocial perspective suggests that physical differences between males and females lead to distinctions in personality and social behavior. Males are stronger, and therefore they play more physically. Traditionally, women have done much of the caring, feeding, and nurturing, so they also engage in those activities through play and work. There is a presumption that an interaction exists between sex and gender identity development, but it also acknowledges that we are not destined to be limited by it (Eagly & Wood, 2013; Fisher, 2006). In modern society, there is more flexibility. For instance, neither physical strength nor nurturance is nec- essarily required to become a successful engineer, artist, or accountant. Men and women are not limited to pursuing activities and careers according to their physical types.

Therefore, each individual has a broad range of potential outcomes based on life experi- ences. For instance, we know that sex dif- ferences affect how adults respond to infant behavior. Psychosocial factors continue to operate in ways that turn boys and girls into masculine and feminine adults, depending on attitudes and culture. Beginning at an early age, when children (and adults) do not behave in ways that are representative of their sex, they are often rejected or rebuked, and laws of reinforcement and punishment operate to shape gender identity. Alternatively, evolv- ing attitudes have contributed to substantial changes in gender roles over recent decades. These mechanisms operate across cultures and nationalities (Pavlova, Weber, Simoes, & Sokolov, 2014; Ruble, Martin, & Berenbaum, 2006).

Home and School Furthermore, the principal mechanism behind social learning theory is the role of imitation. Fathers and mothers each model different types of behaviors. Fathers more typically engage in rough-and-tumble play and mothers tend to participate in more nurturing, softer kinds of activities. According to social learning theory, these behaviors either mimic or prescribe the same tendencies in young children. Regardless, the behaviors are reinforced. Even among children exposed to the “wrong” hormones, as discussed earlier, there is evidence that par- ents reinforce atypical sex play. That is, girls who were exposed to (male) androgens have been found to engage in more boy-typical play and are reinforced for doing so (Wong, Paster- ski, Hindmarsh, Geffner, & Hines, 2013).

Although boys as young as 9 months old spend more time engaged with traditional boys’ toys than with those labeled appropriate for girls—implying a biological beginning for

Critical Thinking

If the type of parent dyad (lesbian, gay, or heterosexual) has an effect on chil- dren’s behavior, what does this evidence tell us about the origins and development of gender-related behaviors? What if the reverse is true? That is, if type of parent has little effect on overall behavior, what does that tell us about the origins and development of gender-related behaviors?

Section Review Summarize the biological and cognitive factors that influence how gender identity develops.

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gender—boys and girls are typically offered different kinds of toys and levels of stimulation— pointing to the importance of learning factors (Laflamme, Pomerleaui, & Malcuit, 2002). Girls more than boys are reinforced for engaging in gender-specific behavior like dress-up. And when girls play more actively, they are met with more disapproval than are boys (Campbell et al., 2000; Lytton & Romney, 1991). In a comparison of lesbian, gay, and heterosexual parents, it was found that children who have same-gender parents have less stereotypical behavior. Their children are less inclined to follow typical gender roles. Sons of heterosexual parents demonstrate the most masculine characteristics, followed by sons of gay fathers; sons of les- bian mothers show the least amount of masculinity (Goldberg, Kashy, & Smith, 2012).

In addition, male and female babies tend to be spoken to and attended to differently (Clearfield & Nelson, 2006; Lovas, 2005). In one well-known experiment, 204 adults were shown the same videotape of an infant. Half of the participants were told they were witnessing a boy and half were told it was a girl. When adult raters assessed the infant’s emotional responses, sig- nificant differences emerged depending on whether adults thought the baby was a boy or a girl. The “boy” was seen as less fearful and experiencing more pleasure than the “girl.” The same behavior that was labeled “anger” when the adults thought they were observing a boy was more often labeled “fear” when adults thought it was a girl (Condry & Condry, 1976). Although subsequent behaviors of the children were not measured, it is reasonable to assume that different speech patterns and levels of attentiveness result in diverse behaviors. A study that placed parents with a 10-month-old infant with whom they were playing for the first time produced similar results. Mothers and fathers could choose between a football, a doll, and a neutral teething ring when introduced to the infant. When parents were told the baby was a boy, the majority of parents opted to play with the football; when parents were told the baby was a girl, most initiated play with the doll. These types of gender-typed activities occur with both women and men and across cultures (Sidorowicz & Lunney, 1980).

Differences in adults’ responses persist when children enter school. When there is a potential classroom conflict, kindergarten teachers are likely to treat girls in a gentler manner than boys. From elementary school until the end of high school, boys are more often called on in class, even when they do not initiate the interaction (one of the reasons that some adults advocate for all-girl schools). Boys are both praised and criticized more, yet teachers believe they are teaching from a gender-neutral position (Duffy, Warren, & Walsh, 2001; Garrahy, 2001; Jones & Dindia, 2004; Sax, Arms, Woodruff, Riggers, & Eagan, 2011). These different

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Sociocultural messages about how men and women should behave persist into adulthood.

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Section 12.2 Social Influences on Gender Development

responses affect self-concept and self-esteem and reinforce how children should behave; though we may not consciously notice, it may eventually influence the kinds of careers we think we ought to pursue (Ledin, Bornmann, Gannon, & Wallon, 2007). Normative messages are also incorporated into moral development, as examined in Chapter 7, and have life-long associations.

Media The media are often held up as fundamental agents of gender stereotypes. Although certainly the demeanor, dress, and behavior of television characters have changed dramatically over the past couple of generations, media of all types are instrumental in prescribing models of behavior. Regardless of the models that parents project, the effect of media is inescapable. From billboards to movies, we are all exposed to models that reinforce gender roles.

Analyses of children’s television programming has consistently discovered differences in male and female characters. Compared to males, females show higher amounts of non-physical aggression and are more concerned about their appearance; male characters display more physical aggression. Male characters in general, and superheroes in particular, outnumber females by two to one. This proportion has remained fairly steady for a number of years, despite more progressive attitudes. In one newer study, though, researchers concluded that the portrayals of male and female gender stereotypes in one of the three studied television networks (Disney Channel) had disappeared (Baker & Raney, 2007; Hentges & Case, 2013; Luther & Legg, 2007).

In other research, exposure to male superheroes was found to be associated with both boys’ and girls’ use of weapons during free play. In spite of the increased use of weapons, superhe- roes were associated with higher levels of male-stereotyped play behavior among boys, but not girls. Furthermore, parents were largely unsuccessful when they attempted to discourage the use of weapons during play, especially when addressing their daughters (Coyne, Linder, Rasmussen, Nelson, & Collier, 2014).

Activity Consider again the Coyne et al. (2014) study cited in the nearby text. Which conclusion do you think is more accurate? (1) Boys view programs with superheroes more frequently than girls because boys have a stronger innate identification with the characters or (2) Higher levels of stereotyped play are the result of relatively more exposure among boys to superheroes. That is, do boys watch superheroes because they identify with the masculinity of the characters, or do they first watch superheroes (perhaps due to encouragement by peers and family) and then begin to imitate the behavior?

As children move into adolescence, there continue to be strong stereotypes on television. Pro- grams geared specifically toward emerging adolescents (“tweens”) showcase distinctive and stereotypical portrayals of personality characteristics, behaviors, and concern for appearance (Gerding & Signorielli, 2014). As noted in Chapter 11, adolescence is a particularly important stage of identity development. These messages no doubt contribute to the shaping of identity (Steensma, Kreukels, de Vries, & Cohen-Kettenis, 2013).

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Adults continue to absorb gender messages in the media. For better or worse, companies market differently to men and women. Many examples exist of tobacco, pharmaceutical, cos- metics, and other industries specifically creating not only images designed to appeal to one gender or the other, but also distinctly female or male brands for products that are clearly gender neutral. For instance, Coke Zero and Dr Pepper TEN were specifically created so that men would not have to order a “diet” soda. Certain automobile styles depict only one gender in their advertising (e.g., “muscle cars” for men and cute subcompacts for women). Not sur- prisingly, these practices are pervasive throughout the world (e.g., Khan, Khalid, Khan, Jabeen, 2011; Lou et al., 2012; Toll & Ling, 2005). It is unknown whether men learn to enjoy video games and sports in the media more than women because of their greater propensity for activity or because they have been socialized to behave that way. Similarly, images of men and women seeking certain professions are alternatively either a reflection of true aspirations or an extension of early gender stereotyping. These career issues will be addressed further in Chapter 14.

Section Review Summarize the various environmental factors that influence the development of gender identity.

12.3 Gender Differences in Physical Activity and Play in Childhood and Adolescence

One area of great interest in examining gender development is the nature of activities in which children engage, especially physical activity, a topic we first considered in Chapter 6. A number of cross-cultural studies have shown that physical activity in general contributes to an increase in overall attention and greater cognitive development throughout childhood. For instance, one longitudinal study equipped 4,755 students with an accelerometer (a device for measuring acceleration that is the central feature of fitness bands that track movement) and assessed participants at ages 11, 13, and 16. The researchers were especially interested in separating moderate or vigorous movement from light activity, which the accelerom- eter allowed them to do (Booth et al., 2014). At every year of measurement, amount of moderate to vigorous activ- ity predicted higher math, English, and science scores. Furthermore, research- ers found a significant “dose response effect.” That is, even among students with high activity levels, more activity

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Play styles tend to differ between genders. When playing with blocks, boys are more likely to build tall structures that may crash.

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Gender Differences in Physical Activity and Play in Childhood and Adolescence Section 12.3

predicted higher scores on academic measures. Statistical associations were especially strong for activity among girls and later science scores. This information is particularly important in light of increased emphasis on encouraging females to pursue science education and careers.

This information can also be used to help us understand how certain interactions during play are associated with strength of gender type. Individual and cultural differences have a sig- nificant role in this area as well. That is, some parents and cultures are more free-spirited in allowing children to play energetically, whereas others are more restrictive. In general, both boys and girls enjoy a variety of activities. Once again, greater variation is observed within groups than between groups. So the question remains, is there more gender-stereotyped play because children are biologically drawn to one type of play, or do they become more strongly socialized for that type of play? This section considers more closely what research tells us about differences in physical activity.

There is evidence that childhood activity levels are associated with temperament and level of activity during infancy, suggesting a genetic basis for differences in motor activity (Allan, Mikolajewski, Lonigan, Hart, & Taylor, 2013; Strelau & Zawadzki, 2012; Wood, Saudino, Rog- ers, Asherson, & Kuntsi, 2007). Early on, comparatively more boys are interested in move- ment, manipulation, larger play spaces, and more vigorous play. When playing with blocks, boys prefer tall structures that may crash, as opposed to the lower, more balanced creations that girls prefer.

By 4 years of age, the majority of children segregate themselves by sex and style of play. There are interesting differences in the nature of play at this time, too. Play is more purposeful for boys. For instance, when a newcomer enters a playgroup, personality is less important than whether or not the boy is useful in play. Girls, by contrast, look to other girls with curiosity and friendship. Reflecting this difference, girls remember names of playmates better than boys do (Moir & Jessel, 1992; Sumaroka & Bornstein, 2009).

As children move on to high school and college, pro- viding opportunities for physical activity continues to reap benefits. Since the passage of Title IX in the United States in 1972, schools receiving federal funds for edu- cation have been required to provide equal athletic opportunities for high school and college athletes. In only 6 years after its inception, Title IX was responsible for a more than sixfold increase in the number of girls who participated in high school sports, from 4.5% to

28.6% (Stevenson, 2010). Title IX accounted for a substantial increase in high school girls continuing their education and about 40% of the rise in employment for those women once they graduated college. Girls who participate in high school sports have lower pregnancy rates, keep better grades in school, and have reduced rates of obesity (Bower & Hums, 2013; Kaestner & Xu, 2010). Long-term effects include better educational and work prospects and better overall health.

Participation in sports is consistently associated with stronger academic performance, as ath- letes apparently are better able to manage their study time (Bass, Brown, Laurson, & Cole- man, 2013; Ruiz et al., 2010; Trudeau & Shephard, 2008). Adolescents who participate in sports activities tend to watch less television and spend less time with video games. High school athletics also appear to increase cognitive control and attention. It is difficult, however,

Critical Thinking

What do you think accounts for the reduc- tion in pregnancy rates and better edu- cational and work prospects among girls who participate in sports?

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Section 12.4 Differences in School Achievement and Learning

to know whether athletics is actually a catalyst that increases performance on cognitive tests. Perhaps athletes as a whole perform better on cognitive tests or—in contrast to the stereo- type—are smarter and more attentive than non-athletes overall.

Section Review What is the evidence that boys and girls play differently?

12.4 Differences in School Achievement and Learning Advances in neuroscience and technology allow us to monitor brain activity while engaged in various tasks. It is not uncommon for researchers to look at activity while study participants are reading, writing, performing calculations, manipulating objects in space, or following a map. Though often a controversial, unpopular topic, we find there are measurable differences in school achievement and learning between girls and boys. When we compare differences, we find that girls consistently perform better at left-brain-dominated language tasks and boys consistently score better on tests of right-brain-dominated mathematical reasoning and spatial tasks (Guiso, Monte, Sapienza, & Zingales, 2008). But an individual’s own perceptions about his or her ability to succeed can also play a role in achievement and learning.

School Achievement In the United States, sex differences in mathematical achievement remain fairly robust throughout childhood and adolescence, whereas the gap closes slightly in verbal skills as chil- dren transition into adulthood (National Assessment of Educational Progress, 2014). Lan- guage processing tends to be more abstract in girls and is evident in the way boys and girls process language differently, relying on distinctive areas of the brain (Burman, Bitan, & Booth, 2008). Females are traditionally better at nonverbal communication, as well. For instance, they are consistently more accurate than males in understanding emotion from nonverbal cues (Hall, 1984; Sax, 2005). Differences remain across ages, culture, and whether or not males or females are the senders of communication.

One large meta-analysis of academic achievement examined the performance of 1.5 million adolescents in reading and math across 75 countries. With few exceptions, boys scored con- sistently higher than girls in math. In reading, girls scored higher than boys in all 75 countries (Stoet & Geary, 2013). Although this research suggests that biology plays a strong role in gen- der differences, an alternative meta-analysis of cross-national differences in mathematics by Else-Quest, Hyde, and Linn (2010) concluded that gender differences varied widely. In their analysis, boys in some countries scored higher, and in other countries girls did. In still others, no significant gender difference was found. Instead of gender, the researchers said factors like national characteristics of women (e.g., the number of women in higher education) and a country’s overall emphasis on education were the most important factors in predicting dif- ferences. They concluded that sex differences in cognitive pursuits are strictly due to “cultural variations in opportunity structures” and overall gender inequity affecting girls and women (Else-Quest et al., 2010, p. 103).

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Section 12.4 Differences in School Achievement and Learning

Conclusions reached by Else-Quest et al. (2010) contrast with the gender gap that persists in the United States, where education is relatively strong. Sex differences remain in specific skill areas, too. For instance, a recent study found that boys significantly outperformed girls in mechanical reasoning tasks, which are fundamental to many STEM (science, technology, engineering, and mathematics) disciplines (Lemos, Abad, Almeida, & Colom, 2013). The gap in scores increases throughout adolescence. This finding suggests that boys and girls may be reinforced differently. That is, teachers and parents likely support boys in STEM fields more than girls, leading to a preponderance of males in those careers.

Self-Efficacy It is reasonable to conclude that gender shapes expectancy and self-efficacy, which is a situation-specific appraisal of a person’s own ability to succeed in specific situations. It varies as a function of individual, behavioral, and environmental influences and affects a multitude of endeavors, like understanding quantum mechanics or being able to ride a skateboard (Ban- dura, 1986). Boys and girls are expected to pursue certain areas of study as soon as they show a slight interest; teachers and parents may selectively ignore other interests depending on a child’s gender (Eccles & Wigfield, 2002; Hannon, 2012). This kind of gender bias and lack of awareness probably persists into adulthood, where, for instance, available medical information is more relevant to men than to women (Verdonk, Benschop, de Haes, & Lagro-Janssen, 2009).

In college, there are distinct gender dif- ferences in self-efficacy. Women who have the same knowledge and skills as men rate themselves as less competent in most science and math fields. These distorted perceptions provide another reason why more males than females pursue STEM careers. However, once they are in graduate school, women and men persist in STEM programs at a similar rate (Miller & Wi, 2015). Interestingly, on average, females earn higher grades in science at all academic levels, but males generally outperform them on standardized tests (Halp- ern, 2006). Perhaps teachers require lower standards for girls throughout elementary and high school, which would also contribute to a false sense of self-esteem and lower self-efficacy.

As women enter the workforce, they have lower overall self-efficacy than men, including the ability to deal with work and family role conflicts (Buse & Bilimoria, 2014; Cinamon, 2006).

Self-efficacy can also be important when understanding how diversity affects interpersonal relationships. For instance, among nursing students, those with less experience have more difficulty gathering information from patients from different cultural backgrounds (Sarafis & Malliarou, 2013). Similarly, self-efficacy of counselor trainees is affected by the culture of the client. Among both men and women, one study found that whites do not enjoy higher

iStock/Thinkstock

While males generally outperform females on standardized tests in the field of science, it is females who earn higher grades in science at all academic levels.

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Section 12.5 Sexual Maturation

self-efficacy than minority groups, even though whites are often considered the dominant, more privileged culture (Lam, Tracz, & Lucey, 2013). Consequently, it is likely that decreased self-efficacy results in a lack of in equity of care. Future training could include more specific feedback about self-efficacy and diverse world views.

Section Review What are some possible explanations for achievement and career differences between males and females?

12.5 Sexual Maturation We can know from brain scans whether or not an infant is male or female, but only genitalia differentiates males from females at birth. The internal and external physical characteristics that distinguish the sexes at birth are called primary sex characteristics. For females, they include the clitoris, vagina, uterus, fallopian tubes, and ovaries. Male primary sex characteris- tics include the scrotum, testes, penis, and the glands that contribute to semen.

During adolescence, physical changes take place that further differentiate males from females. These visible changes are called secondary sex characteristics and are part of the complex biological process that serve to prepare us for reproduction. Studying the onset and tempo of these changes is challenging. As Table 12.1 shows, secondary sexual characteristics typi- cally occur in a prescribed order, but there are considerable variations in timing. Worldwide, pubertal changes vary with race, ethnicity, income, environmental conditions, location, and nutrition (Eveleth & Tanner, 1990; Herman-Giddens et al., 1997; Parent et al., 2003).

Table 12.1: Average age and normal range of selected pubertal changes in North American boys and girls

Girls Average Normal range Boys Average Normal range

Breast budding 10 8–13 Testes begin to enlarge 11.5 9.5–13.5

Growth spurt begins

10 8–13 Growth spurt begins 12 10.5–16

Pubic hair growth begins

11 8–14 Pubic hair growth begins

12 10.5–14.5

Peak of growth 11.7 10–13.5 Peak of growth 14 12.5–15.5

Menarche 12.5 10.5–14 Spermarche Facial hair growth begins Voice deepens

13.5 14 14

12–16 12.5–15.5 12.5–15.5

Mature pubic hair growth

14.5 14–15 Mature pubic hair growth

15.5 14–17

Adult stature reached

13 10–16 Adult stature reached 15.5 13.5–17.5

Source: Based on Herman-Giddens, et. al. (1997 & 2001)

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Puberty in Girls In girls, a dramatic increase in the production of the hormone estrogen induces secondary sex characteristics that include breast development, widening of the hips (perhaps to gain a wider birth canal, an evolutionary advantage), and increased fat deposits around the hip area. Additionally, because of the increase in fat, skin becomes softer. Breast budding is the first visual sign of burgeoning sexual development and is a sign that menarche, or the first menstrual period, will follow in 2–3 years. Menarche is an indication that ova are becom- ing mature enough to be fertilized. For many girls, it is the first sign of adulthood. Most girls complete pubertal changes in 3–4 years, but the normal range is anywhere from 2 to 6 years (Archibald, Braber, & Brooks-Gunn, 2006).

Puberty in Boys In boys, the hormone testosterone causes a deepening of the voice and coincides with an enlargement of the Adam’s apple (larynx), increased muscle mass, facial and body hair, and broadening of the shoulders. Boys’ skin becomes coarser because of fewer fat deposits. Though the first visual sign of puberty is an enlargement of the testes, it is of course not as noticeable (or as well known) as the first indication in girls. Later, pubic hair growth begins, and the penis enlarges and elongates; there is concurrent maturation of the prostate gland and seminal vesicles. Fluid from those glands, together with sperm from the testes, comprises the semen and provides a signal that the male is ready to reproduce. Spermarche, or first ejaculation of semen, occurs about 2 years after secondary sex characteristics begin to appear (Dorn, Dahl, Woodward, & Biro, 2006).

Secular Trends in Puberty As discussed in Chapter 5, height has increased gradually over the centuries. People in indus- trialized nations are now closer to their optimal genetic height than they have ever been. This change over time, or secular trend, occurs in the timing of puberty, too. The average age of menarche has declined from nearly 17 years old in 1840 to around 13 years old today. That decline includes a drop of one year in just 25 years beginning in the late 1960s (Herman- Giddens et al., 1997; Marshall & Tanner, 1969).

Popular media, including many nonscientific websites, have suggested that earlier onset of puberty is caused by hormones fed to poultry, cows, and other livestock. These hormones could theoretically get into human bodies, but they are not digestible (Kaplowitz, 2006). There is simply no scientific evidence that bovine growth hormone fed to cows to increase milk production causes early puberty (Kaplowitz, 2006; Partsch & Sippell, 2001). Instead, the initial decline in average age of menarche coincides with the beginning of the Industrial Revo- lution, when improved standards of living and advanced technologies began to change the health of people living in developed countries (Kaplowitz, 2006). There are indeed analogous data today that support this idea. In some underdeveloped countries, where malnutrition is common and health is relatively poor, menarche is delayed until about age 16; within devel- oping countries, girls from more advantaged homes reach menarche 6–18 months earlier than those who are economically disadvantaged (Parent et al., 2003).

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Section 12.6 Becoming Sexually Active

Psychological Effects of Puberty The timing of puberty leads to social consequences as well. Early-maturing boys view them- selves more positively than do late-maturing boys. They are more popular and successful ath- letically, and some studies show they have a relatively more successful family life and career in adulthood. Perhaps early maturity provides the social advantage of more attention from girls and prepares boys for better future relationships with their spouses, employers, and customers. On the other hand, they have also been found to use tobacco, alcohol, and ille- gal substances more often and to be more involved in delinquent behaviors, though these behaviors are often only transitory, without long-term negative consequences (Taga, Markey, & Friedman, 2006; van Jaarsveld, Fidler, Simon, & Wardle, 2007; Westling, Andrews, & Hamp- son, 2008).

When girls mature early, their experiences are quite different from those of boys or later- maturing girls. The earliest maturing girls are often uncomfortable in their own bodies as they stand out from their peers and are sometimes the subject of ridicule. In a review of the literature, Mendle, Turkheimer, and Emery (2007) concluded that early-maturing girls are more depressed and anxious, use more illicit substances, and do worse in school. They are also more likely than their same-age peers to elicit attention from older boys, leading to greater rates of delinquency and earlier sexual activity.

This awareness affects the way teenagers view themselves. Adolescents are often already pre- occupied with appearance and have unrealistic perceptions of what the ideal body looks like (Carter & Ortiz, 2008). This preoccupation probably plays a role in eating disorders (dis- cussed in Chapter 6). As bodies mature, body image changes accordingly. On average, body esteem, or the self-assessment of one’s appearance, decreases for girls and increases for boys during the initial years of puberty and persists into adulthood (Bearman, Presnall, Martinez, & Stice, 2006; Fitzsimmons-Craft et al., 2015).

12.6 Becoming Sexually Active Regardless of individual timing, sexual maturation is a normal developmental change. Yet few discussions about teenagers and sex emphasize this perspective. Instead, most research focuses on avoiding high-risk behaviors that result in pregnancy and sexually transmitted dis- eases and infections, which we learned about in Chapter 6. American parents have relatively restrictive attitudes about sex, compared to Western European parents. Yet, in the United States and most European countries, the majority of adolescents first have sex (sometimes referred to as sexual debut in research literature) during high school. By 17 years of age, over 50% of girls and nearly 60% of boys in the United States report having had intercourse.

Section Review Describe changes that occur with the onset of puberty.

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Section 12.6 Becoming Sexually Active

As Figure 12.3 shows, there are a number of cultural differences in age of sexual debut. In the United States, Blacks lose their virginity relatively early, at about 15 years old, whereas Asians on average wait until they are 18 (Cavazos-Rehg et al., 2009). As is often the case, some racial and ethnic differences are confounded by other variables, especially socioeconomic status. Early sexual activity is associated with early puberty, parental discord and divorce, an absent father, lack of parental supervision, poor academic performance, and drug and alcohol use (Crockett, Raffaelli, & Shen, 2006; Darroch, Singh, & Frost, 2001; Davies & Windle, 2000; Ellis et al., 2003).

Figure 12.3: Probability of having sex at each age, by race and gender

Different racial and ethnic groups have different patterns of sexual behavior. On average, over half of all 17 year olds in the United States have had sex.

Source: Adapted from Cavazos-Rehg et al. (2009).

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Section 12.6 Becoming Sexually Active

Sex Education Special challenges exist in educating youth about sex. Although research indicates that a sci- entific approach is best (as opposed to one directed at a particular population or to sup- port specific goals), community and educational implementation remains difficult. Schools often contract out to service agencies that do not share a standardized scientific curriculum, and sex education therefore lacks guidance and consistency (Ott, Rouse, Resseguie, Smith, & Woodcox, 2011). Therefore, the short-term sex education classes that most public schools offer end up being inadequate.

No doubt many children today get their information from the Internet, where unrealistic activities proliferate. Children also learn through peers and other media, including television and film. Sexual content in the media is usually depicted in an unrealistic and misleading man- ner: as a carefree, spontaneous event lacking any negative consequences. And the amount of exposure to sex in the media has been found to affect attitudes and behavior about sex, including intentions to have sex (Brown, El-Toukhy, & Ortiz, 2014; Strasburger et al., 2010; Ward & Friedman, 2006).

Teenage Pregnancy Probably as a result of more restrictive sex education, use of birth control is relatively low and rates of teen pregnancy are relatively high in the United States compared to other Western countries (Darroch et al., 2001; Kann et al., 2014). Though the number of teenage pregnan- cies has dropped considerably in recent years, high-risk sexual behaviors persist. The teen pregnancy rate remains up to eight times higher in the United States than in other developed countries, despite similar patterns of sexual intercourse. The birth rate among 15- to 19-year- old teens in the United States is 42 per 1,000 teens. By contrast, rates are 14.1 in Canada, 8.2 in Germany, and 4.5 in Japan (United Nations Statistics Division, 2013). Many Central and South American countries have substantially higher rates: Costa Rica has 62 births per 1,000 teens and Uruguay has 41. Regardless of differences in health care systems, unfavorable physical outcomes for children born to teenagers occur throughout Western countries (e.g., Da Silva, Hernandez, Agranonik, & Goldani, 2013; Liran, Vardi, Sergienko, & Sheiner, 2013).

As Figure 12.4 shows, in 2013, the overall teenage birthrate in the United States continued the decline that has been evidenced since the early 1990s. The rates of pregnancy among 15–19 years old have fallen over 50% from the 1991 peak.

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Section 12.6 Becoming Sexually Active

Since first being tracked in the United States in 1940, there are now historic lows for all recorded racial and ethnic groups, as depicted in Figure 12.5. There has been a parallel decline in abortions as well, providing strong evidence that the reduction in live births is due strictly to fewer pregnancies, not an increase in abortions. Infants born to mothers aged 10–14 sunk another 15% in 2013, to an all-time low, but still numbered 3,108 live births (Martin, Hamil- ton, & Ventura, 2015).

Figure 12.4: Rates of teenage pregnancy per thousand, 1990–2013

The rate of teenage pregnancy has declined significantly for over 20 years.

Source: Adapted from CDC/NCHS, National Vital Statistics System, 2014.

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Section 12.6 Becoming Sexually Active

Reversing negative outcomes in low-SES households in the United States is a particular challenge, since girls typically use birth control less frequently than their higher-SES peers (Strasburger et al., 2010). Low SES and teenage pregnancy are associated with poor aca- demic performance, lower rates of parental education, physical violence in the home, and less supervision. Consequently, teenage mothers have a higher risk of dropping out of school and living in poverty. Their female children are at high risk of becoming pregnant themselves, perpetuating the cycle of poverty.

However, young mothers are not necessarily locked into perpetual negative outcomes if there are interventions aimed at reducing risk factors. The key to breaking the cycle of poverty is to delay future births and continue education (Albert, 2010; Coyne, Långström, Lichtenstein, & D’Onofrio, 2013; Wheeler, 2010). Surveys have found that parental influence is the most com- pelling factor cited by teens wanting to avoid pregnancy. Children of parents who are involved both emotionally (e.g., sharing information about friends, school) and in activities (e.g., attending athletic events, cooking dinner together) are more likely to delay sexual debut and have a reduced chance of teenage pregnancy (Cavazos-Rehg et al., 2010).

Section Review What are the most important issues when adolescents first become sexually active?

Figure 12.5: Birth rates for teenagers aged 15–19 year, by ethnicity

Rates of teenage motherhood vary considerably by race, though all have seen a marked drop over more than 20 years. Rates for fatherhood parallel those seen among mothers (Hamilton et al., 2014; Martin et al., 2015).

Source: Adapted from CDC/NCHS, National Vital Statistics System, 2014, and Martin et al., 2015.

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National Epidemiological Survey on Alcohol and Related Conditions, 2004–2005

National Survey of Family Growth, 2006–2008 (Age 18–44)

General Social Survey, 2008

California Health Interview Survey, 2009

National Survey of Sexual Health and Behavior, 2009

Canadian Community Health Survey, 2005 (Age 18–59)

Australian Longitudinal Study of Health and Relationships, 2005

UK Integrated Household Survey, 2009–2010

Norwegian Living Conditions Survey, 2010

1.0% 0.7% 1.7%

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Section 12.7 Sexual Orientation

12.7 Sexual Orientation When considering sexual attraction and the emotions of romantic relationships, not everyone displays clear patterns, even beyond adolescence. The pioneering sex researcher Alfred Kin- sey suggested that sexual orientation runs along a continuum with “exclusively heterosex- ual” on one end and “exclusively homosexual” on the other (Kinsey, Pomeroy, & Pomeroy, 1948). That is, sexual orientation does not consist of discrete ends of a scale as was once thought. People who are in the middle of the scale show equal attraction to males and females and are usually referred to as bisexual. According to most studies, between 1% and 4% of individuals identify as gay, lesbian, or bisexual by the time they reach adulthood (see Figure 12.6). However, these percentages could reflect a degree of underreporting, as studies indi- cate that many more individuals have exclusively homosexual relationships at some time in their lives (e.g., Diamond, 2003).

Figure 12.6: Percentage of adults who identify as lesbian, gay, or bisexual

With one exception, studies indicate the rate of same-sex attraction between 1.2% and 3.7%.

Source: How many people are lesbian, gay, bisexual, and transgender? By Gary J. Gates, Williams Distinguished Scholar, 2011. Used by permission.

National Epidemiological Survey on Alcohol and Related Conditions, 2004–2005

National Survey of Family Growth, 2006–2008 (Age 18–44)

General Social Survey, 2008

California Health Interview Survey, 2009

National Survey of Sexual Health and Behavior, 2009

Canadian Community Health Survey, 2005 (Age 18–59)

Australian Longitudinal Study of Health and Relationships, 2005

UK Integrated Household Survey, 2009–2010

Norwegian Living Conditions Survey, 2010

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Section 12.7 Sexual Orientation

Although several notable studies have found very high concordance rates for homosexuality among monozygotic twins compared to dizygotic twins (suggesting a genetic determinant), those studies suffer from poor methodology, including self-selected samples (e.g., Bailey & Pillard, 1991; Kallman, 1952). Nevertheless, more recent research using random sampling supports the assertion that heredity has a significant role in sexual orientation. Using exten- sive statistical analyses, researchers found that about 40% of homosexual behavior in men and about 20% in women is explained by genetic differences (Långström, Rahman, Carl- ström, & Lichtenstein, 2010). Other biological evidence for homosexuality includes differ- ences in brain structure and chemistry between heterosexuals and homosexuals. Finally, there remains virtually no evidence that points to an environmental determinant for sexual orientation (Meyers, 2014).

Lesbian, Gay, Bisexual, and Transgender (LGBT) Teens Differences in sexual orientation no doubt have an association on behavior beginning at an early age. On average, the characteristics of play among children who later identify as homo- sexual are more like that of the opposite gender (Rahman & Wilson, 2003). These findings not only support the existence of biological determinants in sexual orientation, but also provide evidence of a neurobiological foundation for gender.

Although acceptance of romantic relationships among homosexual youth and adults has been increasing, a great number remain stigmatized. As a result, identity formation may suffer due to prejudice and feelings of shame. Homosexual relationships during adolescence are often fraught with additional anxiety for fear of persecution and rejection. Gay, lesbian, bisexual, and transgender (LGBT) adolescents will therefore sometimes first date members of the other sex. More than heterosexuals, LGBT teens question their sexuality and their gender, epitomizing what Erikson referred to as role confusion (see Chapter 11; Carver, Egan, & Perry, 2004; Pew Research, 2013a; Rahman & Wilson, 2003).

Although many children report being confused about gender and sexual feel- ings, as adults the vast majority no lon- ger feels that way (Wallien & Cohen- Kettenis, 2008; Zucker, 2005). With regard to self-concept, an individual’s comfort with his or her identity as homosexual or bisexual predicts higher self-esteem and less depression than in those who are less accepting. In this regard, what is important is a person’s feelings about his or her gen- der identity, not what that gender is (Zhao, Montoro, Igartua, & Thombs, 2010). It should not be surprising to learn, however, that LGBT teens are disproportionately the target of bully- ing and aggression, which usually con- tributes to negative feelings of worth. The greater exposure to harassment

Creatas/Thinkstock

Individuals who are comfortable with their own gender identity and sexual orientation, whatever those may be, experience less depression and higher self-esteem than those who are not comfortable with those aspects of their identity.

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Section 12.8 Sexuality in Adulthood

probably contributes to higher rates of substance abuse, depression, and suicidal ideation (Reisner, Greytak, Parsons, & Ybarra, 2014).

Section Review Explain how romantic relationships and sexual orientation contribute to identity formation.

12.8 Sexuality in Adulthood The hormones that lead to secondary sexual characteristics also play a major role in regu- lation of the reproductive cycle and sexual arousal. Regardless of gender identity or sexual orientation, both men and women experience specific kinds of hormonal changes, which can have direct and indirect effects on energy, mood, cognition, sexual desire, and relationships.

Sexual Response Sexual desire is a biological drive. It consists of the secretion of hormones from the ovaries, testes, and other glands. Although biology plays an essential role in desire and arousal, sen- sory stimulation and psychological factors (like styles of communication) also contribute. The sexual response cycle, first identified by Masters and Johnson (1966), has four phases: excite- ment, plateau, orgasm, and resolution. For men and women, maintaining sexual desire comes from a combination of biological, psychological, and social factors, including good health, a healthy partner, good sexual functioning, and positive sexual self-esteem (Kontula & Haavio- Mannila, 2009).

Aging changes the timing in all four phases of the response cycle in both men and women (Saxon et al., 2010). It is estimated that women on average reach their peak sexual desire in their early 30s, while on average men peak in their early 20s (Schmitt et al., 2002). As adults age, changes in sexual desire occur, but it rarely stops completely in healthy individuals. The frequency of sexual activity when young is a key predictor for sexual activity in older age (Mazo & Cardoso, 2011). That is, it appears that the adage “use it or lose it” has some empiri- cal truth.

In general, middle-aged adults who have a partner engage in sex at least a few times per month, and often more frequently. In fact, during middle age many couples express a renewed interest in sexual activity. In many cases, children have left the house and the potential worry about becoming pregnant has passed (Greenberg, Bruess, & Conklin, 2011). Contrary to the stereotype, adults worldwide continue to have intercourse well into old age, sometimes mul- tiple times per week (Kalra, Subramanyam, & Pinto, 2011; Nicolosi et al., 2004). In a survey among adults in the United Kingdom, over 80% of adults 50 to 90 years old reported that they remained sexually active. Similarly, an international survey revealed that about 80% of seniors were still interested in sex. The percentage was even higher in developed countries (von Simson & Kulasegaram, 2012).

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Section 12.8 Sexuality in Adulthood

Changes Particular to Women The major change in middle adulthood for women is perimenopause, the gradual transition to the inability to conceive children. Perimenopause occurs over a 10–15 year span and is often referred to in popular literature as menopause (thus the term “going through meno- pause”). Technically menopause is only a marker—a day, really—when menstrual periods have stopped for precisely 1 year. The average age of menopause is 51, but there is wide varia- tion (Minkin & Wright, 1997). It can occur as early as 40 and as late as 60 years of age.

Like other physical changes, women generally do not notice the transition into perimenopause until well after its onset. As menopause is approaching, it is normal for menstrual cycles to become intermit- tent, corresponding to irregular hormone produc- tion. Sometimes a month or more is skipped, other times perimenopausal women have two periods within a few weeks. Rate of flow is similarly erratic.

Symptoms of perimenopause vary greatly. Just over half of women report not experiencing the charac- teristic “hot flashes” that are thought to be associ- ated with erratic hormone production. In general, the majority of women do not complain of serious symptoms (Rossi, 2004). However, some women may experience fatigue, headaches, moodiness, sleep disturbances, vaginal dryness, or other symp- toms (Lyndaker & Hulton, 2004). For unknown rea- sons, smoking, excessive alcohol consumption, and depression generally aggravate perimenopausal symptoms (Sabia, Fournier, Mesrine, Boutron- Ruault, & Clavel-Chapelon, 2008). On the other hand, remaining physically active and maintaining normal weight are the most significant modifiable factors that can reduce severity of symptoms (Yim et al., 2015).

There are notable cultural differences in perimenopausal symptoms. Japanese women report different experiences than other Western women, suggesting an influence of sociocultural factors (Lock, 1991). In a longitudinal study of 347 women, results showed that women who reported high levels of stress, a lower income level, and concerns about aging also reported intensified symptoms (Nosek et al., 2010). These types of studies suggest that attitudes and environmental factors can influence the severity of menopausal symptoms. Importantly, though menopause is a major milestone for women both physically and psychologically, many women welcome this change. Research on women in midlife has found that women associate menopause with many positive life changes, such as relief from hormonal cycling, concerns about birth control, and worry about an unexpected pregnancy (Utian & Boggs, 1999).

iStock/Thinkstock

In addition to the hot flashes that just over half of women report experiencing, other symptoms of menopause can include headaches, fatigue, moodiness, sleep disturbance, and vaginal dryness.

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Section 12.8 Sexuality in Adulthood

Hormone Replacement If the unpleasant symptoms of perimenopause result from lower hormonal levels, it seems logical to assume that simply replacing hormones would reduce the symptoms. For years, physicians prescribed replacement hormones in an intervention called hormone replacement therapy (HRT). The Women’s Health Initiative initiated a study to determine whether HRT was beneficial in preventing chronic diseases in older women. However, in 2002, the study was stopped because researchers found that HRT led to an increased risk of breast cancer, heart disease, stroke, and blood clots in the lungs. The risks far exceeded the benefits (Rossouw et al., 2002). Even additional estrogen alone (called estrogen replacement therapy, or ERT) was related to increased chance of stroke and blood clots (Rossouw et al., 2007). A recent follow- up study supported the earlier findings related to HRT (Chlebowski et al., 2013).

There are newer medical alternatives to HRT, as well as some untested homeopathic rem- edies. For instance, there is some evidence that relaxation therapy and acupuncture reduce the frequency of hot flashes (Mintziori et al., 2015; Taylor-Swanson et al., 2015). Like other preventive factors, regular exercise and dietary supplements (often including calcium) are key components to a balanced treatment program. In addition, social support can help to ameliorate emotional effects associated with the onset of menopause (Gibbs, Lee, & Kulkarni, 2012). Because of the constant flow of new information, scientists recommend that women consult with medical professionals as well as do their own research before deciding on any treatment protocol.

Changes Particular to Men Men experience less dramatic hormonal changes than women, with a gradual decrease of about 1% a year in the production of testosterone starting in middle adulthood. The only substantiated impact of this change is a very gradual (and often slight) reduction in sex drive (Stones & Stones, 2007). Like women, sexual activity for men can remain vibrant well into old age, despite the decreasing hormone production. A problem now commonly associated with aging men is erectile dysfunction, which is the inability of a man to regularly achieve or maintain an erection. Although erectile dysfunction can result from lower testosterone, low levels alone do not usually result in the inability of males to achieve and maintain an erection. Age alone is by no means the sole factor in changing sexuality. A lack of exercise, obesity, and smoking are all negatively associated with the ability to achieve and maintain an erection. More than half of men with diabetes report the problem at one time or another. Pre- scription drugs (such as Viagra), which work by increasing blood flow to the penis, provide a safe, effective treatment, among the elderly as well. In addition to improving sexual satisfac- tion, treatments generally improve confidence, increase self-esteem, and reduce symptoms of depression (Gareri, Castagna, Francomano, Cerminara, De Fazio, 2014; McCabe & Althof, 2014; McCullough, Steidle, Klee, & Tseng, 2008).

During middle age and through the end of life, the prostate gland, a small gland under the bladder that produces liquid to assist the flow of semen, becomes enlarged. As the prostate grows, it puts pressure on the urethra, squeezing it. Like squeezing a water hose, this results in difficulty starting to urinate, an increased urge to urinate, and a slower stream of urine. Most men will eventually have a recognizable enlargement, but not all cases are serious enough to pursue treatment. Medications include drugs that relax muscles around the bladder so that urinating is easier, as well as enzyme inhibitors that shrink the gland. As noted in Chapter 6, the prostate can become cancerous and can also contribute to bladder and kidney disorders.

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12.9 Romantic Love and Intimacy Recall that Erikson’s theory of psychosocial development, discussed in Chapter 11, enjoys both theoretical and applied support. Erikson defined intimacy as “the capacity to commit . . . to concrete affiliations and partnerships and to develop the ethical strength to abide by such commitments, even though they may call for significant sacrifices and compromises” (Erik- son, 1950/1963, p. 263). Different types of relationships, including romantic relationships, fall within the scope of this definition. If adolescents successfully develop a sense of iden- tity, then they move into adulthood with the capability of forming an emotionally intimate relationship with another person. Intimacy is an interpersonal process that includes self- disclosure and partner responsiveness. It begins when people reveal personal information, and it is listened to in a caring and accepting way (Reis & Shaver, 1988). Intimate conversa- tions link people. Expressions of intimacy may also be nonverbal in nature, such as a look or a touch. Nonverbal communication is often as an essential component in maintaining intimate relationships (Laurenceau & Kleinman, 2006).

Attachment and Romantic Love Just like infants, adult romantic partners feel comforted by each other and have a desire to be close. But the environment must provide opportunities to fulfill that need (Feeney & Collins, 2007; Englund, Kuo, Puig, & Collins, 2011). Some theorists have extended infant attachment theory to adult intimacy and romantic relationships (see, for instance, Hazan & Shaver, 1987). They do not suggest that infant and adult attachment are the same; instead, they theorize that infant and adult attachment share the principle that biology, environment, and individual personality traits interact to prescribe specific kinds of attachments in relationships.

As opposed to the experience of “liking” someone, we can distinguish the early stages of romantic love by physiological arousal, intense interest, and caring for another (Hendrick & Hendrick, 2003). People are primed to experience these feelings and label them “love” because of behaviors and verbalizations witnessed in families, society, and in the media. In this way, what individuals may label “romantic love” varies from culture to culture. Even more difficult to define than “love” is “falling in love.” Although falling in love nearly always includes some degree of romance and affection, defining it remains fairly subjective (try defining it right now!).

Nevertheless, in a statistical analysis, researchers found that we can most easily describe love relationships with three components: intimacy, passion, and commitment (Aron & Westbay, 1996). The most widely regarded model incorporating these factors is the triangular the- ory of love (Sternberg, 1986, 2006). Intimacy, placed at the top of the metaphorical triangle, consists of emotional connectedness and being comfortable with openness and vulnerability. Passion refers to physiological changes, including sexual attraction; commitment is the will- ingness and decision to remain with another person, even when times are difficult. The three

Section Review How does sexuality change over the lifespan? In what ways does it remain the same?

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components are interdependent and can cause either of the others to become stronger or weaker.

As Table 12.2 demonstrates, there are eight possible kinds of love in Sternberg’s theory. The importance of one component over another changes over time, and we are not meant to con- sider each type of love as absolutely pure. Instead, different triangle shapes (i.e., different lengths of the sides) represent distinct balances among the three parts. According to Stern- berg, the most important correlation to happiness is the close alignment of the amount and type of love couples have for each other (Sternberg, 2006).

Table 12.2: Sternberg’s types of love

Combinations of love

Type of love Intimacy Passion Commitment Example

Nonlove The way you feel about people with whom you feel no connection (e.g., a col- lege counselor you don’t know well).

Liking X Friends who interact on social media and get together at parties during school breaks.

Infatuated love X Someone with whom you might “hook up” at a party because you were mutu- ally attracted.

Empty love X Couples who stay married “for the kids.”

Romantic love X X Couples who might date regularly but otherwise have no future plans.

Companionate love

X X A loving couple that no longer feels sexual interest in each other.

Fatuous love X X A couple that moves in with each other after meeting only recently.

Consummate love X X X An emotionally close, sexually exciting, long-term relationship.

In Sternberg’s theory, each component develops at different times and in different amounts, depending on the person and the relationship. Sternberg says that a relationship based on a single element is less likely to survive than one based on two or three elements. Early rela- tionships are marked by relatively strong passion and less intimacy and commitment (infatu- ated love). If intimacy does not develop, then the relationship is not likely to survive. While passion is at its peak, biological and neurochemical changes take place in the brain’s pleasure centers. Intimacy often follows the neurochemical changes (Acevedo, Aron, Fisher, & Brown, 2012).

Therefore, passion does not disappear as much as it is transformed. By developing inti- macy, a couple may become more committed. According to Sternberg, couples who experi- ence all three components of consummate love are the ideal. In these kinds of relationships, couples overcome difficulties with grace and dignity. Sternberg cautions that maintenance of

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consummate love is more difficult than obtaining it: “Without expression, even the greatest of loves can die” (1987, p. 341). In other words, we cannot take our relationships for granted; we must pay attention to them.

Pursuing Love Relationships From a psychosocial perspective, when we begin pursuing romantic relationships in adoles- cence, we are continuing the process of forging an identity while learning how to establish intimacy. Hormones spike sexual interest, but parents and culture usually dictate the formal initiation of dating. For instance, on average, first-generation Asian parents have more conser- vative views and are more restrictive of dating behavior than are other parents in the United States. Dating privileges in Asian families are often tied to academic achievement. However, these parental attitudes also result in more scheming as teenagers try to date without telling their parents (Lau, Markham, Lin, Flores, & Chacko, 2009; Trinh, Ward, Day, Thomas, & Levin, 2014).

Overall, adolescent romantic relationships benefit from positive parental and peer role mod- els. Adolescents with more exposure to hostility and conflicted relationships experience a greater degree of conflict in romantic relationships. Alternatively, adult models who demon- strate warmth and sensitivity contribute positively to dating relationships (Arriaga & Foshee, 2004; Connolly, Furman, & Konarski, 2000; La Greca & Mackey, 2007).

Girls are more likely than boys to identify relationships as romantic. This finding is not sur- prising, since boys are more likely to hide emotions, whereas girls are perceived as relatively more prosocial, kinder, and empathic. The media usually support these differences, as well. Although it is commonly assumed that boys and girls are socialized to behave differently, recall also that brain imaging and evolutionary evidence suggest that girls are better at pro- cessing complex emotions (see Chapter 10). From an evolutionary perspective, emotions are more important for females who need to attract a mate, leading to a stronger inclination for modern-day romance. It has been suggested that males deemphasize emotions because evo- lution dictates that they simply need to distribute their genes. However, evidence indicates that males clearly appraise emotional reactions prior to having romantic and sexual encoun- ters (Dawkins, 2006; Domes et al., 2010; La Greca & Mackey, 2007; Shin et al., 2005).

Desired Characteristics of Long-Term Love Relationships In 1967 more than 1,000 college students were asked, “If a boy/girl had all the other quali- ties you desired, would you marry this person if you were not in love with him/her?” (Keph- art, 1967). More than 35% of men and 75% of women reported that they would. Just 20 years later, only 14% of men and 20% of women responded similarly. For women, at least, the dramatic drop probably reflects the independence many have gained through employment. Attitudes around the world have comparably transformed. During the middle of the last cen- tury, approximately 70% of Japanese marriages were arranged; by 2005, the proportion had dropped to 6.4%. A trend toward individual choice in marriage based on love is observable in many other countries as well (Regan, 2008).

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Traditionally, what people report as being desirable in a love relationship varies by culture, person, and genera- tion. Psychologist David Buss (Buss, 2003; Buss et al., 1991) and his col- leagues have collected surveys from over 10,000 young adults spanning a demographically and geographi- cally diverse sample of individuals in 37 countries. Respondents were from both wealthy and poor nations, and in some cases questions had to be read aloud because participants were illit- erate. Though mutual attraction and love was the most desired trait overall, not surprisingly it was ranked lower overall in China and some African countries where arranged marriages still take place. Even college students in Pakistan and India report that marrying without love is acceptable (Madathil & Benshoff, 2008).

Over time, men have become less concerned that their mate is a good cook and housekeeper. Interestingly, women are now less concerned about ambition and industriousness in a mate (perhaps because they are more likely to be ambitious and economically independent them- selves). Among other factors, chastity has become far less important for both men and women, and an educated spouse has become much more desirable. These preferences are consistent for both heterosexuals and homosexuals (Buss et al., 1991; Russock, 2011).

One problem with this research on mate preferences is that it has focused almost exclusively on university students; psychologists have not explored differences in preference over the lifespan. One recent study began to address this gap, using nearly 30,000 responses from an online attraction test (http://explainyourbrain.com/cgi-bin/attraction/attractiontest.pl) (Brumbaugh & Wood, 2013). Research participants rated dozens of photographs of people aged 18–25 on their level of attractiveness. Findings indicated remarkable consistency in preferences across many countries and cultures (among those who use the Internet). As adults move into middle and later adulthood, both men and women are attracted to people who display communal characteristics, such as the tendency to be forgiving and to perceive others positively. They were less attracted to people who appear trendy or nontraditional. Evidence of a communal shift in mate preferences was somewhat stronger among women, although the shift was evident for men also. “People may become more conventional and communal as they age, partially to accommodate the preferences of potential mates” (p. 104).

Sexual Orientation and Love Relationships Research has consistently shown that the same factors that distinguish lasting, happy rela- tionships for heterosexual couples apply to same-sex couples as well. These factors include partners who show mutual trust, share values and activities, are similar in socioeconomic

iStock/Thinkstock

Over time, men and women have become less concerned about certain traits in a mate. Men are less concerned with finding a mate who is a good cook and housekeeper and women are less concerned with ambition in a mate.

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status, and allow room for autonomy. They also share time together, agree on chores, and have the same general ideas regarding sex, finances, and children (Diamond & Butterworth, 2008). In a study comparing heterosexual married couples to same-sex couples from Ver- mont (which in 2000 became the first state to legalize civil unions), same-sex couples actually reported better relationship quality, increased intimacy, less conflict and, for women, more frequent sex (Balsam, Beauchaine, Rothblum, & Solomon, 2008).

Rather than falling neatly into what we might term one feminine and one masculine partner, same-sex couples exhibit gender roles that are more similar to each other rather than differ- ent. This contrasts with traditional stereotypical conceptions of heterosexual relationships in which roles are ascribed as masculine or feminine. Without obvious gender differences, on average same-sex couples divide chores based on individual preferences rather than stereo- typed roles (Huston & Schwartz, 2002; Solomon, Rothblum, & Balsam, 2004). That leads to more equality, an important factor in relationship satisfaction and success. These slight dif- ferences in roles aside, same-sex couples are generally found to want the same things and behave the same way as heterosexual couples. The ways that roles continue to shape identity are explored further in Chapters 13 and 14.

Section Review How do researchers study romantic love and intimacy? What are the most important elements?

Summary & Resources

Chapter Summary A multitude of factors and processes explain the wide set of gender-related behaviors. Though evidence confirms that brain differences between boys and girls do indeed exist, the ways in which adults respond to those differences probably have a much greater influence on later behavior. Parents, teachers, peers, and media reinforce certain behaviors and skills, according to sex, which continues into career achievement and other parts of adulthood. On the other hand, biological aspects of sexuality are better understood and more predictable than gender differences. Nevertheless, there are substantial secular changes and ethnic dif- ferences in such areas as puberty and symptoms of perimenopause.

Becoming sexually active and pursuing romantic relationships remain essential parts of development as physical, cognitive, and psychosocial domains all play strong roles. Though still problematic, recent trends indicate positive advances for such issues as unplanned teen- age pregnancies and acceptance of sexual orientation. For both men and women worldwide, sex commonly remains a vital part of relationships well past middle age and into old age. In addition to passion as part of a sexual relationship, intimacy and commitment comprise the three interdependent components of the most popular theory of love. Other social relation- ships with family and peers provide different roles, which we will explore next.

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Summary of Key Concepts The Development of Gender: Biology and the Brain

• There is strong evidence for distinctions between male and female brains, at both the cellular and structural levels, but those distinctions may not translate into marked differences in ability in the absence of a social bias.

• Sex and gender are integral to identity. There is empirical support for biological, evo- lutionary, social, and cognitive influences that help to explain gender development. Taking an interactive approach to gender development once again appears to be the most relevant perspective.

• With regards to differences on any one particular variable, between-group sex differ- ences are not nearly as strong as within-group differences.

• Differences exist in the brains of males and females, but there is no convincing evi- dence that either males or females are cognitively advantaged overall relative to the other. Structural differences may or may not have a strong observable impact.

• Evolution suggests there are advantages for each gender. It is thought that through natural selection separate masculine and feminine traits have become more valuable to the species.

• From a cognitive perspective, children begin to construct gender-type in the same way Piaget would say they construct knowledge about the physical world. According to cognitive theorists, we interpret environmental clues that teach us how to act.

Social Influences on Gender Development

• Although research finds biological differences between boys and girls beginning at birth, the effect of social learning on gender is undeniable, including the use of dif- ferent colors to designate boys and girls, toys, different kinds of social interactions, and the media.

• Although it may make intuitive sense that playing with gender-typed toys is entirely learned, evidence does not support this view. Boys are more physically active than girls, which may predict different kinds of activities.

• Regardless of any potential biological basis for gender identity, boys and girls are encouraged to engage in gender-typed behavior. This process occurs with direct reinforcement, modeling, and through the media.

Gender Differences in Physical Activity and Play in Childhood and Adolescence

• By 4 years of age, the majority of children segregate themselves by sex and style of play. Play is more purposeful for boys; personality is less important than whether or not the boy is useful in play. Girls, by contrast, look to other girls with curiosity and friendship.

• Since the passage of Title IX in the United States in 1972, schools receiving federal funds for education have been required to provide equal athletic opportunities for high school and college athletes. In only 6 years after its inception, Title IX was responsible for a tremendous increase in the number of girls who participated in high school sports.

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Differences in School Achievement and Learning

• It is hard to know if gender differences in achievement are attributable to socializa- tion or biology. Although there are definitive differences in the brains of girls and boys, we do not know what the differences mean.

• In the United States, sex differences in mathematical achievement remain fairly robust throughout childhood and adolescence, whereas the gap closes slightly in verbal skills as children transition into adulthood. On the other hand, cross-national differences in mathematics vary widely.

• Boys and girls are probably reinforced differently in school and by parents, including in the STEM fields, leading to a preponderance of males in those fields.

• Women who have the same knowledge and skills as men rate themselves as less competent overall and in most science and math fields.

Sexual Maturation

• Puberty is a time of great physical change. The adolescent growth spurt and the development of secondary sex characteristics physically transform children into adults.

• Though scientists have observed a number of secular trends, explanations for how and why they have occurred are not completely clear.

• Late-maturing girls and early-maturing boys generally have psychosocial advantages.

Becoming Sexually Active

• Sexual activity is a developmental process. Surveys reveal that, by the end of high school, the majority of adolescents in the United States have had sexual intercourse, which is another avenue of psychosocial change. Nevertheless, romantic relation- ships leading to sex are often discussed as a kind of risky behavior rather than as something that is developmentally appropriate.

• Though the rate of teenage pregnancy is at its lowest rate ever, it still remains high relative to other developed countries.

Sexual Orientation

• Whereas gender identity is a self-constructed view of male or female behavior, sexual orientation refers to attraction. Sexual orientation is not a binary decision; attraction is a continuum, with those who are exclusively heterosexual on one end and those who are exclusively homosexual on the other.

• LGBT teens are often at special risk because of the possibility of peer rejection, persecution, or a sense of shame. Many will first have a heterosexual relationship, epitomizing the identity crisis described by Erikson.

• Although many children report being confused about gender and sexual feelings, as adults the vast majority no longer feels that way.

Sexuality in Adulthood

• Men and women experience specific kinds of hormonal changes, which can have direct and indirect effects on energy, mood, cognition, sexual desire and relationships.

• The sexual response cycle consists of four phases; for men and women, aging changes the timing in all phases of the response cycle.

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• Adults worldwide continue to have intercourse well into old age, sometimes mul- tiple times per week.

• The major change in middle adulthood for women is the 10–15 year span that is called perimenopause. Menopause marks the day when menstrual periods have stopped for precisely 1 year. As menopause approaches, it is normal for menstrual cycles to become intermittent, corresponding to irregular hormone production.

• Beginning in middle adulthood, men experience a gradual decrease in testosterone of about 1% a year. The decline is associated with only a very gradual reduction in sex drive.

• Most men will eventually have an enlarged prostate, but not all cases are serious enough to pursue treatment.

Romantic Love and Intimacy

• Intimacy is an interpersonal process that includes self-disclosure and partner responsiveness from both people in a pair.

• There are three primary components to Sternberg’s triangular theory of love: inti- macy, passion, and commitment. Intimacy consists of emotional connectedness and being comfortable with openness and vulnerability. Passion refers to physiological changes, including sexual attraction; commitment is the willingness and decision to remain with another person. The three components are interdependent and can cause either of the others to become stronger or weaker.

• Men and women often look for both similar and different desired characteristics in long-term heterosexual love relationships. These preferences have changed as social norms have changed; preferences may also change by stage of adulthood. Factors such as mutual trust, shared values, and SES distinguish lasting, happy relationships for all couples.

Critical Thinking and Discussion Questions

1. What advice would you give parents who want to raise their children in a gender- neutral manner? (Hint: Consider the study from Meredith, 2015, provided in Addi- tional Resources.)

2. If your children had an opportunity to attend a prestigious same-sex elementary or secondary school, would you encourage it? Would you want them to attend a same- sex college or university? Explain.

3. Consider a peer who defends more men in science careers by providing data that indicate high school girls do not perform as well as high school boys in STEM fields. Using what you know about gender development, and between-group and within- group differences, how would you respond? (Hint: Consider the study by Cunning- ham, Hoyer, and Sparks, 2015, provided in Additional Resources.)

4. If you deny your sexually active, high school children the opportunity to have sex at your house, they are likely to pursue other locations that are not as safe. How do you reconcile this set of circumstances?

5. In a long-term relationship, what are your “deal-breakers” and “must-haves”? That is, what characteristics in another person are essential?

6. How can evidence from nonhuman primates be used to understand sex-typed behavior? In what ways is caution warranted?

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Additional Resources Web Resources

• Association for Women in Science (U.S.): An organization that supports and pro- motes women in STEM http://www.awis.org/

• Arthur Ashe Courage Award: A video (and story about) Caitlyn Jenner (formerly Bruce Jenner), who was honored with the 2015 award http://espn.go.com/espys/2015/story/_/id/13264599/caitlyn-jenner-accepts -arthur-ashe-courage-award-espys-ashe2015

• WISE: A campaign to promote women in STEM (U.K.) https://www.wisecampaign.org.uk/

Further Research

• Cunningham, B. C., Hoyer, K. M., & Sparks, D. (2015). Gender differences in science, technology, engineering, and mathematics (STEM) interest, credits earned, and NAEP performance in the 12th grade. National Center for Educational Statistics, Institute of Educational Sciences. http://nces.ed.gov/pubs2015/2015075.pdf

• Eagly, A. H., & Wood, W. (2013). The nature-nurture debates: 25 years of challenges in understanding the psychology of gender. Perspectives on Psychological Science, 8, 340–357.

• Kann, L., Kinchen, S., Shanklin, S. L., Flint, K. H., Hawkins, J., Harris, W. A., . . . Zaza, S. (2014). Youth risk behavior surveillance—United States, 2013. Morbidity and Mor- tality Weekly Report, 63. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf

• Meredith, S. L. (2015). Comparative perspectives on human gender development and evolution. American Journal of Physical Anthropology, 156(supplement S59), 72–97.

• Sternberg, R. J. (1986). A triangular theory of love. Psychological Review, 93, 119–135.

• Sternberg, R. J. (1994). Love is a story. The General Psychologist, 30(1), 1–11.

Key Terms androgens The hormones that are respon- sible for male growth and characteristics.

effect size The statistical and practical magnitude of the difference between two groups.

erectile dysfunction The inability of a man to regularly achieve or maintain an erection.

estrogen A hormone responsible for female growth and characteristics.

gender constancy The understanding that people are permanently masculine or feminine.

gender identity The masculine or feminine qualities with which people identify.

gender stability The awareness of the sta- bility of gender over time.

intimacy An interpersonal process that includes self-disclosure and partner respon- siveness by two people.

menarche First menstrual period.

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http://www.awis.org/

http://espn.go.com/espys/2015/story/_/id/13264599/caitlyn-jenner-accepts-arthur-ashe-courage-award-espys-ashe2015

https://www.wisecampaign.org.uk/

http://nces.ed.gov/pubs2015/2015075.pdf

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menopause The day that marks when men- strual periods have stopped for precisely 1 year.

perimenopause The hormonal transition to the inability to conceive children. Occurs over a 10–15 year span. Often referred to in popular literature as menopause.

primary sex characteristics The internal and external physical characteristics that distinguish the sexes at birth.

prostate gland A small gland under the bladder that produces liquid to assist the flow of semen.

secular trend Change over time.

self-efficacy A situation-specific appraisal of a person’s own ability to succeed in spe- cific situations.

sexual debut First sexual experience.

sexual orientation The gender to which people are attracted.

sexuality A broad term that refers to having a capacity for sexual attraction and interest, sexual identity, and sexual orientation.

spermarche First ejaculation of semen.

testosterone The principal male sex hormone. Part of a group of hormones responsible for male growth and sexual characteristics.

triangular theory of love A model of love relationships that incorporates three inter- dependent factors: intimacy, passion, and commitment.

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