TEST BANK for Human Sexuality: A Contemporary Introduction by Caroline F. Pukall

CHAPTER 1

Perspectives on Sexuality MULTIPLE CHOICE QUESTIONS 1. Though sexuality in general may be difficult for some people to talk about, why is it almost impossible to ignore? a) People are always trying to force you to talk about sex. b) There are many social and cultural messages out there about sexuality, including very subtle ones. c) It is far too commonly found in the public school curricula. d) The internet is full of porn.

2. Maria believes that people should only have sex inside committed relationships, and that anyone who has sex outside of these relationships is a slut or a whore. Maria's beliefs about what is good and bad are a ________. a) social exclusion, likely informed by religious beliefs b) social confusion, likely informed by uneducated caregivers c) social construction, likely formed by media d) social refusing, likely informed by peer groups 3. What role do media play in shaping our beliefs about sexuality? a) It provides a balanced and objective perspective on sexual norms. b) It creates and dictates societal norms, including norms about sexuality. c) It illustrates the wide diversity of sexual scripts available for people today. d) It conveys the importance of openness and honesty in non-monogamous relationships.

4. During the Victorian era, media often conveyed messages about sexuality in subtle, hidden ways, such as advertising vibrators for medical reasons. This was primarily driven by ________. a) religious censorship b) poor advertising strategies c) high consumer compliance d) lack of interest in sex 5. Lady Mary went to see a physician in the 1890s because she was distressed. The physician treated her with a vibrator. What was the likely diagnosis? a) hysteria b) marital infidelity c) depression d) ADHD 6. Why did scholar Thomas Malthus argue that sexually explicit material should be suppressed? a) Original sin by Adam and Eve had horrible consequences. b) The only sexual thoughts a person should have should be towards their partner in a Christian marriage. c) Children's schoolwork could be negatively affected if they were thinking about sex. d) Sexually explicit material would lead to an increase in the population that would overtax diminishing natural resources.

7. In which decade did advertisers first begin to increase the use of sex in their campaigns?

a) 1920s b) 1930s c) 1940s d) 1950s 8. Why do advertisers use scantily clad women in advertising? a) to exploit women's insecurities about their appearances, leading them to buy products so they can appear more like the "sexual ideal" b) to arouse women sexually, which has been linked to increased willingness to spend money c) to create associations between the product and a pleasurable activity (sex), making them more likely to buy the product d) to make women feel beautiful so they will "treat themselves" to new products 9. The 1950s brought about greater openness in advertising related to sexual content. This included at least three major 1950s ad campaigns: Maidenform's "I dream," Revlon's "fire and ice," and Clairol's "Does she or doesn't she? (colour her hair, that is!)". This shift is largely attributed to ______. a) the Shere Hite Report b) the Speculum Doctrinale c) Hugh Hefner d) the Kinsey Reports 10. Television in North America has the potential to raise concerns over what should and shouldn't be permitted in terms of sexual content. What question does this raise? a) Who is allowed to have sex on television? b) How explicit can sexual content be? c) Should sexual violence be shown? d) all of the above 11. What type of scene resulted in an American television company being fined $3.6 million? a) two men kissing b) a teenage orgy c) topless adult women d) a lesbian couple raising a child 12. Sam and Donald are in a same-sex relationship. They met a few years ago online. Why were they more likely to meet online than most mixed-sex couples? a) They were three times more likely because, on average, people attracted to the same sex hold fewer notions of taboos associated with online dating. b) They were ten times more likely because same-sex couples rarely go on dates or associate with other non-heterosexual people. c) They were twice as likely because the "gay villages" are not as popular as they once were since the advent of the internet. d) They are not more likely to meet online than anyone else.

13. What is lacking in most media portrayals of sexual activity? a) safer-sex messaging b) traditional gender roles Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) romantic portrayals of love d) real-life scenarios 14. What is the main drawback to the "fantasy model" of sex portrayed in today's media? a) Fantasies are not a good indicator of sexual behaviour and are unlikely to change someone's sexual practices. b) Fantasies rarely include safer-sex messaging about unwanted pregnancies and STIs. c) Fantasies are not real and have no place in sexual scripts. d) Fantasies often include hypersexualized people, which may distort erotic attractions.

15. Jake is caught up in the heat of the moment of a sexual encounter with his current partner Pam. In the middle of their sexual encounter, Pam asks Jake if they should use a condom. Jake is somewhat surprised that she asked this question because this was not how he envisioned the sexual encounter progressing. What did Pam's question conflict with? a) Jake's self-efficacy b) Jake's masculinity c) Jake's sexual script d) Jake's ability to read sexual innuendos 16. What percentage of television programs contain some form of sexual content? a) 80 per cent b) 70 per cent c) 50 per cent d) 40 per cent 17. Which of the following are credited for increasing demand for contraception in Mexico, India, and Kenya? a) television shows b) internet websites c) movies d) magazine ads 18. Showing scenarios on television where men contract syphilis from other men will likely result in which of the following? a) more men who engage in sex with men getting tested for syphilis b) fewer men who engage in sex with men getting tested for syphilis c) more men and women getting tested for syphilis d) fewer men and women getting tested for syphilis 19. Hollywood films and other forms of televised media have historically depicted black male's sexuality very differently than other races. Based on this situation, which of the following is NOT true? a) Hollywood films tend to dehumanize black males by objectifying their bodies during sex scenes far more often than occurs with white males. b) Black males are often depicted as blue collar (manual labor) workers with greater muscular features, which suggest greater sexual aggression. c) Black males are often given roles in which sex without intimacy is the norm and sexual partners are acknowledged through domination and for violence. d) Black music videos are more sexualized than are white music videos.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

20. Ally just saw an animated television show where the main character was transgender with a female love interest. This show most likely originated in which country? a) Japan b) Morocco c) Samoa d) the United States of America 21. Ava is used to seeing sexuality and fluid gender roles explored in movies and graphic novels, including transgender and intersex issues, but she would never discuss her sexuality, especially in terms of sexual and gender diversity. Where does Ava most likely live? a) Asia b) the Middle East c) North America d) Europe 22. In which medium is it common to stretch sexual acts beyond what one might expect, such as showing a penis penetrating an ear? a) Arabic movies b) Anime c) Hentai d) North American television 23. Until what century in Catholicism was sexual activity that did not involve penile-vaginal penetration forbidden and criminally punished? a) the first century CE b) the fourth century CE c) the fifth century BCE d) the tenth century CE 24. Which of the following methods of birth control is forbidden in Judaism? a) birth control pill b) condom c) IUD d) rhythm method 25. Which of the following religions tolerates male masturbation, depending on the source of interpretation? a) Islam b) Judaism c) Roman Catholicism d) Hinduism 26. What does the term hijra refer to? a) a third gender b) a sexual position c) an aphrodisiac Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) a form of bondage 27. At what level of government is sexual health education decided in Canada? a) municipal b) federal c) provincial d) regional 28. Which of the following was a finding published in Henry Havelock Ellis's Studies in the Psychology of Sex? a) It is our version of sex that is "normal." b) Sexual behaviour is determined by biology. c) If left to their own desires, humans would develop a range of sexual expressions which should be considered "normal." d) In the Mehinaku culture in Brazil, kissing on the lips does not occur.

29. What medical problem did the advertisers of the first vibrators promise to solve? a) back pain b) hysteria c) chest congestion d) headaches 30. Last week in sex class, John learned that in some parts of the world some people marry their first cousins and in other places engage in same-sex activities as a rite of passage into adulthood. John thought this was disgusting and could not understand why these things would happen. John's reaction is an example of _____________. a) introversion b) ethnocentrism c) self-efficacy d) conversion therapy 31. Which of the following is NOT true of Judaism in regards to sexuality? a) Abortion is permitted, in some circumstances. b) Foreplay is encouraged. c) Masturbation is encouraged. d) Divorce is permitted.

32. Though monotheistic religions often vary in many ways, one universal is that they all ___________. a) attempt to control or regulate sexuality in some way b) harshly condemn masturbation c) view sex outside of marriage as punishable by death d) attempt only to regulate young women's sexual behaviours 33. What belief did the "Eve versus Mary" narrative in the Christian tradition substantiate? a) the belief that women are either Madonnas or whores b) the belief that sexuality is a necessary part of every good woman c) the belief that women are ultimately more powerful than men d) the belief that a sexually corrupt woman can still be morally righteous

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

34. According to Jewish tradition, which of the following events is NOT followed by ritual cleansing? a) menstruation b) nocturnal emissions c) childbirth d) circumcision 35. Which form of contraception is permitted in Judaism under certain circumstances? a) a condom b) a diaphragm c) the birth control pill d) None of these are permitted.

36. In modern Judaism, what is the primary purpose of sex? a) reproduction b) to strengthen the bond between man and god c) to avoid nocturnal emissions d) to reinforce the marital bond 37. Why was a woman's choice to remain a virgin a subversive act in early Christianity? a) She was seen as claiming control over her own body, rather than submitting to men. b) She was seen as closer to God than those who engaged in sexual activity. c) She was not following the path set out for her in the Bible. d) She was seen as having valuable biblical knowledge.

38. Why is abortion not accepted after 120 days (except in extreme circumstances), according to Islamic law? a) This is approximately the time when the mother will feel the baby start to move in her womb. b) The fetus is ensouled at 120 days. c) The Prophet Muhammed was born at 120 days gestation. d) 120 is a holy number in Islam.

39. The treatment of women in early Islam can best be described as _____________. a) more equal with less division of gender roles compared to later Islam b) very difficult for women, particularly in relation to the control of sexual activity c) harsh and cruel, especially for young women d) fairly equal, in which women were often seen as the head of the household 40. Many of the Church's more repressive views of sexuality were based on the teachings of the Church Fathers, an early group of theologians that included St Augustine. Which of the following was one of the beliefs of St Augustine and his followers? a) The original sin of Adam and Eve was transmitted to every human through ejaculation. b) Men had an obligation to remain celibate in order to get closer to God. c) Sexual activity must be forbidden on Sundays and other holy days. d) Women and men who engaged in sexual acts without the express result of procreation were viewed as equally depraved.

41. In 1996, Gwen Jacobs successfully challenged Canadian Courts and won the right for women across Canada to do what? a) have abortions Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) go topless in public c) work legally in the sex trade d) claim birth control as a healthcare expense 42. How many countries legalized same-sex marriage at the federal level before Canada? a) one b) two c) three d) four 43. If you go topless in Canada, in which provinces will you be breaking the law? a) Alberta or Quebec b) all provinces c) everywhere but Ontario d) You are never breaking the law if you are topless in Canada.

44. Which of the following did the Supreme Court of Canada rule in 2003? a) that homosexual couples should have the same rights as married heterosexual couples b) that homosexual couples should have the same rights as heterosexual married or common-law couples concerning pension but not employer health benefits c) that homosexual couples should have the same rights as common-law heterosexual couples d) that common-law couples should have the same rights as legally married couples 45. In what year did the United States legalize sexual activity between members of the same sex? a) 1930 b) 1952 c) 1980 d) 2003 46. Anne and Lisa are a same-sex couple living in the United States and they want to get married. When they research same-sex marriage, what will they find? a) They can marry anywhere in the United States now that gay marriage is legal at the federal level. b) They can't legally marry anywhere in the United States. c) They can marry in a state where gay marriage is legal, and then their marriage will have to be recognized as legal in the other states. d) They can legally marry in some states, but their marriage will only be recognized as legal in those states.

47. Homosexuality was decriminalized in Canada _________ years before it was decriminalized in the United States. a) 2 b) 12 c) 25 d) 34

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

48. In what province would a person receive government-funded sex reassignment surgery? a) any province in Canada b) in Quebec c) in British Columbia d) in Ontario 49. Which of the following statements best characterizes the differences between same-sex and mixed-sex couples? a) Most mixed-sex couples fight more about housework. b) Gender differences are more pronounced in same-sex relationships. c) There is very little difference in terms of the interpersonal aspects of the relationship. d) Sexual satisfaction is higher among mixed-sex couples.

50. Why is it important for legalized marriage to be open to both same-sex and mixed-sex couples? a) It is not necessary; an institutionalized form of social support does not contribute to the wellbeing of couples, regardless of whether they are same-sex or mixed-sex. b) All couples should be able to file joint federal tax returns and enjoy other benefits of marriage. c) Having an institutionalized form of social support for relationships is associated with positive mental and physical health for individuals in the relationship. d) It would help even out the differences between same-sex and mixed-sex couples.

51. At the 2011 bi-annual Summit of the Commonwealth, a report was submitted that called for the creation of a human rights commissioner who would monitor the legal and social treatment of LGBTQ+ individuals in the Commonwealth. Which of the following is the most likely reason why the suggestion was not followed through? a) Sexual diversity is not a human rights issue. b) Fourty-one of the fifty-two Commonwealth countries still have laws against same-sex sexual activity. c) It would be too expensive to monitor legal and social treatment in these countries. d) It is wrong for this type of organization to interfere with the laws of nations.

52. How does the United States of America compare to Canada in terms of legalization of same-sex marriages? a) The path to legalization was roughly the same in both countries, with Canada legalizing same-sex marriage only a decade before the United States. b) Canada has been more progressive than the United States, decriminalizing same-sex sexual acts in the 1960s. c) The United States has been more progressive than Canada, holding the first Pride parade in 1970. d) Both countries have been slow to grant equal rights to same-sex couples.

53. In Canada, it was illegal for women to go topless before 1996, as female breasts were sexualized by men, and therefore, unlike male breasts, considered a private body part. What was the primary issue with this argument? a) It gave women a negative view of their bodies. b) It made it more difficult for women to breastfeed in public. c) It presumed men would be unable to function normally if they were around exposed breasts. d) It presented a double standard for men and women for what is essentially the same body part.

54. Which of the following is NOT one of the differences between the view of sexuality in North America and Europe? a) North America has a lower age of consent than Europe. b) Full-frontal nudity of males and females is much more common in European films. c) Female toplessness is more widely accepted in Europe.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) European countries began legalizing same-sex marriage before North American countries.

55. Boris went on vacation with his boyfriend, Matt. Matt insisted that they book separate rooms in the hotel and not hold hands or kiss when they go out or they could be arrested. Boris was incredulous, but Matt showed him the law online. Where did they most likely travel? a) Poland b) Nigeria c) Texas, USA d) Japan 56. According to St Augustine, what is the only acceptable way to engage in sexual intercourse? a) doggy-style b) face-to-face position c) side-to-side position d) cowgirl 57. Which of the following beliefs about sexuality is most universal? a) the incest taboo b) intolerance of homosexuality c) monogamy d) same-sex marriage 58. Canada shifted its policies regarding Syrian refugees in order to better help which of the following groups? a) gay men b) single mothers c) prostitutes d) HIV-positive individuals 59. Which area of Canada reports the highest frequencies of sexual intercourse? a) the Maritimes b) Quebec c) Ontario d) British Columbia 60. What aspect of gay marriage does Bill C-32 relate to? a) divorce b) adoption c) name changes d) estates 61. Mareille has a picture of herself with the first prime minister of Canada to march in a gay pride parade. Who is posing with Mareille in the picture? a) Justin Trudeau b) Pierre Trudeau c) Stephen Harper d) Jean Chretien 62. Which Olympic Games were protested because of laws that forbid the expression of sexual orientation in that location?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) Sochi b) Seoul c) Rio d) Vancouver 63. Polly remembers celebrating the day that same-sex marriage became legal across Canada. What year is Polly recalling? a) 2001 b) 2003 c) 2005 d) 2007 64. Sarah enjoys sunbathing topless. Where in Canada will other sunbathers be least likely to view Sarah's choice favourably? a) British Columbia b) Quebec c) Ontario d) Saskatchewan 65. Where in Canada was "teen" the top search term on Pornhub in 2014? a) British Columbia b) Quebec c) Ontario d) Nova Scotia 66. The first interracial kiss on American television was shown on ________. a) Star Trek b) Beverly Hills, 90210 c) The Bill Cosby Show d) The A-Team 67. Fran is having a heated argument with, Peter, a fundamentalist Christian, about when a fetus becomes a baby.

Peter says it happens right at the moment of fertilization. Fran replies, "Well, then apparently this truth has changed over time, because many early figures in Christian church argued that a fetus doesn't have a soul until ______." a) it begins to kick and move in the womb b) 120 days after conception c) it is blessed by a priest d) the mother starts experiencing morning sickness 68. By the end of the first century BCE, most Jewish relationships were ________. a) polygamous b) monogamous c) polyamorous d) menopausal 69. According to your text, women usually enter menopause somewhere between the ages of ________. a) 35 and 45 b) 45 and 55 Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) 55 and 65 d) 65 and 75 70. In the traditional practice of Judaism, which aspect of sexuality would require a ritual cleansing afterwards? a) nocturnal emissions b) childbearing c) menstruation d) all of the above 71. Up until 2014, some Islamic groups in Indonesia took part in a pilgrimage in the Javanese village of Solo where ________. a) young men are expected to perform fellatio on older boys/men b) unmarried individuals engaged in sex with a stranger in order to bring themselves luck c) married individuals engaged in sex with a stranger in order to bring themselves luck d) unmarried individuals have casual and group sex 72. In Japanese, the term hentai means ________. a) pervert b) sex c) explicit d) orgasm 73. In some areas of the Himalayas, a woman may be married to multiple men. This practice is referred to as _________. a) polyamory b) polygony c) polyandry d) polymer 74. Unlike Christianity, many interpretations of Islam promoted having sex for pleasure within a marriage, however, there are times where sex would be prohibited. Which of the following is not a time to prohibit sex according to Islam? a) during the daylight hour of Ramadan b) forty days after giving birth c) during menstruation d) during pregnancy 75. With regards to the practice of Hinduism and aspects of human sexuality, which statement is true? a) Sex outside of marriage is widely practiced. b) Divorce is permitted by the religion. c) Masturbation is never tolerated. d) Abortion is opposed in religious texts.

76. When comparing Canada and the US on aspects of sexuality, which statement is false? a) Canadian and American women report a similar number of sexual partners. b) Canadian and American men report a similar number of sexual partners. c) The percentage of individuals who reported having had a threesome is about the same for Canada and the US. d) The percentage of individuals who reported having had a one-night stand is about the same for Canada and the US. Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

77. According a 2005 Durex survey, Canadian men reported having approximately ________ lifetime sexual partners. a) 4 b) 7 c) 13 d) 23 78. In a recent study on the effects of cannabis use on sexuality, Lynn et al. (2019) found that ________. a) cannabis improves satisfaction with orgasm when used prior to sex by women b) cannabis improves satisfaction with orgasm when used prior to sex by men c) cannabis impairs satisfaction with orgasm when used prior to sex by women d) cannabis impairs satisfaction with orgasm when used prior to sex by men 79. Which statement about reporting sexual assault in Canada is false? a) The rate at which sexual assaults are reported to the police differs across the Provinces. b) The rate at which sexual assaults are reported to the police is about the same across the Provinces. c) The Prairies and BC had higher rates of reporting sexual assaults to police. d) It is difficult to accurately interpret crime report data when it comes to sexual assault.

80. According to Canadian census data, approximately ________ percent of same-sex couples are legally married. a) 13 b) 33 c) 50 d) 67 81. Which of the following statements is true when comparing same-sex relationships with mixed-sex relationships? a) The division of labour is often less gendered in same-sex relationships. b) Individuals are less affected by the loss of a partner in same-sex relationships. c) Individuals are less affected by the loss of a partner in mixed-sex relationships. d) There are a large number of differences when comparing same-sex relationships with mixed-sex relationships.

82. In 2012, which Canadian Province became the first to allow transgender people to change the gender on their birth certificate without having sex reassignment surgery? a) British Columbia b) Newfoundland and Labrador c) Quebec d) Ontario 83. In Canada, female toplessness ________. a) is legal in all Provinces and Territories b) has unclear legal rules and ramifications that differ by Province c) is not considered taboo by most d) is widely practiced in all Provinces and Territories 84. Who is considered to be the Hindu god of love and desire? a) Artha Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) Dharma c) Kamadeva d) Brahmacharya 85. The most common form of birth control at the time of the Prophet Muhammad was ________. a) the condom b) withdrawal c) douching d) the calendar method 86. In early Judaism, which of the following taboos was not punishable by death according to various books of the Torah? a) incest b) female masturbation c) bestiality d) sexual behaviour between men 87. Which statement is true regarding Japanese Anime and gender roles? a) Transgender themes are often used for comic relief. b) Transgender themes are less prevalent than in North American film and TV. c) Characters often display less sexual and gender fluidity than in North American film and TV. d) Characters always conform to the Western binary of gender/sex.

88. The most common dyadic relationship pattern throughout most of the world is ________. a) polygamy b) polyandry c) polyamory d) monogamy 89. ________ is a term that best defines a type of role play or lifestyle choice between two or more individuals that includes a wide range of activities involving safe and consensual manipulations of erotic power. a) BDSM b) Hentai c) Sadism d) Masochism 90. The Supreme court of Canada ruled that is was against ________ of the Canadian Charter of Rights and Freedoms to deny same-sex couples the protections afforded to heterosexuals in common-law relationships. a) Section 2 b) Section 15 c) Section 7 d) Section 10 SHORT ANSWER QUESTIONS 1. The ________ model of sexual behaviour, most often portrayed in popular media in North America, ignores risks such as pregnancy and sexually transmitted infections (STIs).

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

2. Some feminists argue that the Greek myth of ________ perpetuates the idea that sexual knowledge needs to be controlled by men.

3. Birth control is acceptable in Judaism as long as it is not a ________ method.

4. According to the Islamic religion, it is the ________ who decides if birth control is used within a marriage.

5. The last individual to have been incarcerated for "homosexuality" in Canada was ________ ________, sent to prison in 1967 and released in 1971.

6. The tendency to believe that one's ethnic or cultural group is the norm is known as ______.

7. Sexually explicit comics from Japan are called ________.

8. In the Himalayas, it is not uncommon to observe fraternal _______.

9. In India, a person who identifies as belonging to the third gender is referred to as ______.

10. Same-sex marriage became legal across Canada in ________.

11. Same-sex marriage became legal across the United States in ________.

12. The practice of having multiple wives is known as ________.

13. An Indigenous person who embodies both male and female identities is referred to as ________-________.

14. A ________ ________ is an involuntary ejaculation of semen during sleep (commonly known as "wet dream").

15. ________ is a controversial mental illness/disease that was seen as being specific to women and characterized by the conversion of psychological stresses into physical symptoms, as well as volatile emotions and attention-seeking behaviours.

16. The internal experience of femaleness and/or maleness, or neither, or other gender(s) is called ________ ________.

17. ________ is the act of killing a child within a year of its birth.

18. The physical manifestation of one's gender identity through appearance (e.g., hairstyle), clothing, and behaviour is called ________ ________.

19. Gay men and lesbians have been allowed to serve openly in the Canadian Armed Forces since ________.

20. An illness, disease, or infection transmitted from one person to another by means of sexual behaviour is called a ________ ________ ________.

ESSAY QUESTIONS Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. What role do media play in shaping identities and norms related to sexuality?

2. Dr. Green would like to conduct an experiment that compares views of acceptable sexual behaviour between two groups of youths: one that reports having viewed a lot of sexuality in media, and one that reports having viewed little sexuality in media. What might be some of the confounding (third variable) problems?

3. Describe at least two studies that have examined the impact of sexual imagery on consumer product recognition.

4. Based on your textbook, what are the pros and cons related to the popularity of sexual content on the Internet?

5. How has the advent of the Internet affected sexual behaviour and well-being?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. c 3. b 4. a 5. a 6. d 7. d 8. a 9. d 10. d 11. b 12. a 13. a 14. b 15. c 16. b 17. a 18. a 19. b 20. a 21. a 22. c 23. b 24. b 25. d 26. a 27. c 28. c 29. b 30. b

31. c 32. a 33. a 34. d 35. c 36. d 37. a 38. b 39. a 40. a 41. b 42. c 43. d 44. c 45. d 46. a 47. d 48. d 49. c 50. c 51. b 52. b 53. d 54. a 55. b 56. b 57. a 58. a 59. a 60. a

61. a 62. a 63. c 64. d 65. a 66. a 67. a 68. b 69. b 70. d 71. c 72. a 73. c 74. d 75. d 76. b 77. d 78. a 79. b 80. b 81. a 82. d 83. b 84. c 85. b 86. b 87. a 88. d 89. a 90. b

SHORT ANSWER QUESTIONS 1. fantasy 2. Pandora 3. barrier 4. wife 5. Everett Klippert 6. ethnocentricism 7. hentai

8. polyandry 9. hijra 10. 2005 11. 2015 12. polygamy 13. two-spirit 14. nocturnal emission

15. Hysteria 16. gender identity 17. Infanticide 18. gender expression 19. 1992 20. sexually transmitted infection

ESSAY QUESTIONS 1. Media play a large role in the formation of our identities and norms. Media help to shape how we think of ourselves, and others, in terms of gender, class, and race. Media also help to create and dictate societal norm, including norms about sexuality (Kellner, 2003). From media, we learn what is "normal" (Chapter 15), what we "should" desire, and what to buy—or buy into—in order to achieve the most satisfaction and normalcy. The idea Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

of what is "good" and what is "bad" is a social construction, and much of this social construction is created through media. Sometimes media are blatantly obvious in their intentions, but many times messages are conveyed through subtle advertising (Figure 1.1). What is portrayed in media does not necessarily reflect the reality of society; however, the ways in which characters are developed, plots played out, and topics focused on (or not) certainly provide insight into underlying attitudes about sexuality and LGBTQ+ individuals.

2. A good response will discuss at least two confounding factors. One is that it is difficult to know whether children's self-reports were accurate; some may falsely claim not to see sex in the media for fear of getting in trouble, or some may falsely claim to have seen sexually explicit material in order to seem "mature." Another confound is that whether children have or have not seen sexually explicit material is not random and that factors such as parenting styles or religious beliefs may determine both whether a child has seen sexually explicit material and may influence what the child deems appropriate sexual behaviour. Thus, it would be difficult to conclude that views of appropriate sexual behaviour were "caused" by viewing or not viewing the sexually explicit material.

3. Research into the effect of sex on consumer behaviour has produced mixed results. In some cases sexual material has no impact on the ability of the consumer to remember a product's name if the product is not sex related (e.g., Severn, Belch, and Belch (1990)) which suggests that sex may not help sales, but in other cases, such as Gallup Research (2012), consumers were found to be 77 per cent better at recalling a product's name if sex was used in the advertising, regardless of what the product was. It seems reasonable to conclude that sex can impact a consumer's behaviour but that it is not guaranteed to affect a consumer's behaviour.

4. This development has led to the need for a variety of parental control features to help parents monitor the content that their children access online. The proliferation of online chat sites, message boards, role-playing systems (e.g. Second Life), and social networking sites (e.g. Facebook) has inadvertently provided sexual predators with a ripe new hunting ground for young victims. As a result, entirely new divisions of law enforcement have emerged to focus specifically on sex crimes facilitated by the Internet. The Internet has also played a positive role in promoting healthy, safe, and diverse human sexuality and behaviour. For example, the Internet has become a source of accessible sex education, has contributed to the normalizing of sexuality and diverse sexual identities, and has provided a new means of meeting potential partners.

5. Although the advent of the Internet has provided access of explicit sexual material and vulnerability of young people whose parents do not employ parental controls, the general consensus is that the overall impact of the Internet on sexual health has been positive. The Internet has had a particularly positive impact on facilitating the development of relationships between people in marginalized sexual groups such as members of the LGBTQ+ community.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 2

Theoretical Approaches to Studying Human Sexuality MULTIPLE CHOICE QUESTIONS 1. What issue arose from Sigmund Freud's ideas about sex? a) Sex became a more taboo topic. b) His theories incorrectly identified psychosocial problems. c) His theories caused sexual dysfunctions to be looked down on by the medical community. d) His theories pathologized adults, especially females.

2. What is one evolutionary explanation for homosexual behaviour? a) Homosexuals are less likely to help biological relatives with their survival needs. b) Homosexuals help biological relatives with their survival needs. c) Homosexuals adopt unrelated children who often times grow up to reproduce. d) In the past, groups of people could not sustain large numbers of offspring so homosexuality was necessary.

3. The early modern era was a time of great scientific breakthroughs related to sex and sexuality, particularly with the discoveries of sperm cells and eggs, as well as the studies of mate selection. What perspectives were the most important and scientifically rigorous in advancing knowledge about sexuality at this time? a) sociological and cultural perspectives b) physical and environmental perspectives c) biological and evolutionary perspectives d) statistical and pathological perspectives 4. According to Vasey and VanderLaan, what is a possible adaptive advantage of same-sex sexual orientation? a) inclusive fitness b) fixation c) self-efficacy d) none of the above 5. Who was the first theorist to present a theory of human psychosexual development? a) William Masters b) John Harvey Kellogg c) Sigmund Freud d) Alfred Kinsey 6. Dr. Hamish is conducting an experiment to see if religious affiliation affects the frequency of sex between married partners. What aspect of the research project is the prediction that religious affiliation affects the frequency of sexual encounters? a) the hypothesis b) the theory c) the psychodynamic theory d) the conclusion 7. Which of the following is NOT a feature of scientific theory?

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a) It provides absolute truths about human sexual behaviour. b) It organizes, self-corrects, and generates knowledge. c) It communicates about sexuality. d) It develops research ideas and methods.

8. Which theory is best for studying human sexuality? a) Human sexuality is complex and no one theory can capture all aspects. b) Evolutionary psychology has been proven to be the best theoretical orientation for capturing the wide range of sexual expression among humans. c) Sociobiology is grounded in empirical evidence and therefore provides the best insight into human sexual behaviour. d) Social constructionist views can predict human behaviour based on cultural norms and therefore offer the best scientific theory.

9. Which of the following is NOT part of an individual's personality, according to Freud? a) id b) superego c) ego d) libidinal energy 10. According to Freud's view of personality, which of the following would be responsible for sexual desire? a) the id and the ego b) the id c) the ego and the superego d) the ego 11. Psychic energy associated with mental desires and drives is known as ___________. a) erogenous energy b) castration anxiety c) motivational factors d) libidinal energy 12. Which term was NOT coined by Sigmund Freud? a) castration anxiety b) electra complex c) Oedipus complex d) penis envy 13. Areas of the body that have heightened sensitivity associated with erotic touch are known as __________. a) phallic zones b) erogenous zones c) fixation zones d) libidinal zones 14. According to Freud's psychodynamic theory, in what stage is a boy between the age of about six and puberty? a) phallic stage b) anal stage

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c) oral stage d) latency stage 15. Freud's superego is most closely associated with which of the following? a) social norms learned throughout a lifetime b) biological urges c) individual personality d) the unconscious 16. Jimmy has trouble with delaying gratification. According to Freud's psychodynamic theory, in which stage did he have trouble developing? a) latency stage b) oral stage c) phallic stage d) genital stage 17. What is one major criticism of Freud's psychodynamic theory? a) It is falsifiable. b) It is not falsifiable. c) It was developed before any research on the physiology of sex had been conducted. d) It was developed by a man.

18. Which process is most associated with Ivan Pavlov's famous work with dogs? a) operant conditioning b) classical conditioning c) the dual control model of sexuality d) biological theory 19. According to Freud's psychodynamic theory, at puberty, boys reach which stage? a) genital stage b) phallic stage c) anal stage d) oral stage 20. Jessica is obsessed with cleaning her apartment and making sure that everything is always in order. She has great difficulty maintaining a romantic relationship because she gets frustrated that she cannot control her partner's behaviours. According to Freud's psychodynamic theory, Jessica likely did not successfully pass through which stage of development? a) oral stage b) latency stage c) anal stage d) phallic stage 21. Jules is in sex therapy for his obsession with bananas in the bedroom. He has been instructed to imagine becoming sexually aroused by his unwanted or problematic fetish; when he actually becomes aroused, he is then instructed to smell ammonia salt capsules, which will make him feel extremely nauseated. Which approach is being used in this treatment?

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a) aversion therapy b) conversion therapy c) mere exposure therapy d) classical conditioning 22. Which of the following was a major contribution attributed to Sigmund Freud? a) He was one of the first to highlight the importance of childhood sexuality in relation to personality development. b) He presented one of the most egalitarian theories for men and women. c) He discovered the importance of natural selection in determining one's mate preferences. d) He was one of the first people to understand the role of womb development in relation to sexual development.

23. Which approach to human sexuality in Chapter 2 has been challenged for not being falsifiable, and therefore not actually a theory? a) Bandura's social learning theory b) Pavlov's classical conditioning c) Freud's psychodynamic theory d) Skinner's operant conditioning 24. Which of Freud's assertions has been completely refuted? a) A child can experience fixation if his or her libidinal energy is blocked during development. b) In order to sexually mature, women must move from clitoral to vaginal orgasm. c) An individual's personality is divided into the id, the ego, and the superego. d) Children between six years of age and puberty undergo the latency stage.

25. In operant conditioning, sex is ___________. a) fun b) a primary reinforcer c) a punishment d) paired stimulus 26. Pavlov described his theory of classical conditioning when he paired a ringing bell (__________) with his dogs' food (the unconditioned stimulus). Initially, the dogs would salivate at the sight of the food (the unconditioned response) but not in the response to the sound of the bell. However, with repeated presentation of both the bell and the food at the same time, the dogs began to salivate at the sound of the bell (___________), even when the food was not present. a) the neutral stimulus; the conditioned response b) the positive reinforcement; the unconditioned stimulus c) the conditioned stimulus; the unconditioned response d) the conditioned stimulus; the neutral response 27. In Daryl Bem's "exotic becomes erotic" theory, same-sex sexual orientation can develop when children engage more in activities typical of the opposite gender, causing which of the following? a) The same-sex gender is viewed as exotic, and children are attracted to their opposites. b) The same-sex gender is viewed as exotic, and therefore acts as a source of non-specific arousal that can be interpreted as romantic attraction. c) The opposite-sex gender is viewed as exotic, and therefore no attraction would develop.

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d) The opposite-sex gender is viewed as exotic, and therefore becomes a source of non-specific arousal that would not be interpreted as romantic attraction.

28. Operant conditioning may be related to sexual behaviour in which of the following ways? a) Sex is a primary reinforcer. b) People develop fetishes when items are associated with sexual arousal. c) Sex is a secondary reinforcer. d) Orgasm is an unconditioned response.

29. Which type of sex therapy often has a strong educational element and uses behavioural rehearsal to increase successful outcomes? a) classical conditioning b) behavioural therapy c) operant conditioning d) motivational therapy 30. In Daryl Bem's (1996) theory of the origins of homosexual feelings, what is the term for non-specific arousal in the presence of a same-sex peer? a) an unconditioned response b) an unconditioned stimulus c) a conditioned response d) a conditioned stimulus 31. Which theory uses the principles of operant conditioning but also recognizes the importance of social context and environmental factors and posits that human behaviour is learned by observing other people's behaviours, attitudes, and outcomes? a) social exchange theory b) cognitive theory c) social learning theory d) sociobiology theory 32. Research by social learning theorists has found that a person's thoughts about losing their virginity can either increase or decrease their sense of what? a) sexual identity b) sexual self-efficacy c) gender identity d) dyspareunia 33. After learning about condom use in sex education class, Marillia goes home and practices using a condom.

Practicing using a condom increases Marillia's confidence until it is used in a real-life situation. After using condoms successfully a number of times, Marillia feels very confident in her ability to use condoms and could potentially teach others about them. Marilla's belief that she can use condoms is best described as ___________. a) self-loathing b) self-proclaimed ability c) self-reliance d) self-efficacy

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34. In a coupled relationship, one partner feels as though they are contributing more to the relationship and the other partner is reaping all the benefits. The partner who feels they are contributing more becomes unhappy and seeks additional rewards outside of the relationship in an attempt to re-establish a balance. This is an example of __________. a) social learning theory b) social cultural influences c) social exchange theory d) social mores 35. Cognitive theories are associated with a number of researchers who describe how our thinking affects how we feel and behave. These theories recognize that our thoughts are subject to a number of misconceptions, distortions, false assumptions, and errors in evaluating situations or information. These errors can result in __________. a) distress b) psychological disorders c) inappropriate or harmful behaviours d) all of the above 36. Social exchange theories explain behaviour in sexual relationships by suggesting partners consider which of the following? a) costs and benefits b) the self-efficacy of their partner c) what other people do in relationships and copying it d) the social status of their partner and trying to maximize it 37. What is dyspareunia? a) pelvic pain during intercourse experienced by some women b) the experience of feeling that the costs in a relationship outweigh the benefits c) a common cause of premature ejaculation in men d) the word for when a person is disappointed with the loss of their virginity 38. Dr. Maruk is a sex therapist who tries to uncover her clients' misconceptions in the hopes that correcting misconceptions can help them. To which perspective is Dr. Maruk most likely to ascribe? a) psychoanalytic theory b) social learning theory c) social exchange theory d) cognitive theory 39. According to social exchange theory, when is an individual more likely to stay in a relationship? a) when the comparison levels for alternatives are low b) when the comparison levels for alternatives are high c) when the comparison levels are high d) when the comparison levels are low 40. Ruoshan has been in a relationship with Kevin for several years, but Kevin recently lost his job and hasn't been actively searching for new employment. He also hasn't helped out more around the house. Ruoshan is considering ending the relationship. Which theory is coming into play here?

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a) sociobiological theory b) social exchange theory c) sociological theory d) social script theory 41. Katelyn has trouble reaching orgasm when she has sexual intercourse. She perceives this as a failure on her part, and becomes less and less interested in having sex. Which theory might help to explain this? a) self-efficacy b) sociobiological theory c) social-learning theory d) cognitive theory 42. Joanne experiences pain in her vagina during every sexual intercourse. What might she be suffering from? a) mucosa b) dyspareunia c) amenorrhea d) endometriosis 43. Timothy has sparse body hair, a lanky build, and is infertile. Which of the following theories is most likely to explain his infertility? a) genetic theory b) sociobiological theory c) evolutionary theory d) cognitive theory 44. Studies examining genetic factors related to sexuality have found what trend in the concordance rate of same-sex sexual attraction between identical twins and fraternal twins? a) The concordance rate for identical twins was about 30 per cent higher than for fraternal twins. b) The concordance rate for identical twins was about 20 per cent higher than for fraternal twins. c) The concordance rate for identical twins was about 50 per cent higher than for fraternal twins. d) The concordance rate for identical twins was about 10 per cent lower than for fraternal twins.

45. Individuals with Klinefelter's syndrome, which is characterized by sparse body hair and broader than average hips, have which combination of sex-linked chromosomes? a) XYY b) XXY c) XO d) YY 46. Which theory of human sexuality would use a study of twins to determine the concordance rates of same-sex sexual orientation? a) genetic theory b) sociobiological theory c) social learning theory d) dual control model of sexuality 47. Sociobiological theory is the application of which of the following to explain social behaviours?

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a) biochemistry b) brain structures c) evolutionary biology d) morphology 48. Which term refers to a specific evolutionary process favouring traits that allow a member of a sex to out-perform another member of the same sex for sexual partners? a) intrasexual competition b) intersexual selection c) sexual selection d) sexual strategy 49. Which process is at work when a female peacock picks the most colourful male to mate with? a) intrasexual selection b) sexual strategy c) intersexual selection d) mating assessment 50. Theorists who support the dual control model of sexuality suggest that which of the following are the best predictors of current and lifetime sexual satisfaction in women? a) olfactory issues b) excitatory factors c) inhibitory factors d) religious beliefs 51. Competition between members of the same sex for access to breeding with a member of the opposite sex is known as ___________. a) sexual selection b) natural selection c) interpersonal selection d) intrasexual competition 52. In sociobiology theory, who invests more time in the reproductive process? a) males b) females c) both males and females equally d) Neither males nor females invest time in this phenomena.

53. What is the application of evolutionary theories to understand emotional and psychological processes, mainly in human beings? a) sociological theory b) genetic theory c) psychological theory d) evolutionary psychology 54. In a species of bird where there are significant physical differences between males and females, which of the following is true?

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a) Both the males and females participate equally in rearing offspring. b) Males are rarely or never involved in rearing offspring. c) Males guard the offspring of multiple female partners. d) Males only help rear male offspring.

55. Which theory of human sexuality would determine mate selection based on sexual strategies such as the likelihood of a mate to produce healthy offspring? a) psychodynamic theory b) social exchange theory c) sociobiological theory d) dual control model of sexuality 56. Why do male peacocks have vibrant plumage? a) because of intrasexual selection b) because of intersexual selection c) for flight d) to scare away rival birds 57. Which theory of human sexuality suggests that each person's sexual responses involve an interaction between sexual excitatory and sexual inhibitory neurobiological processes? a) dual control model of sexuality b) psychodynamic theory c) social exchange theory d) sociobiological theory 58. What does the evolutionary theory, applied in the dual control model of sexuality, say about gender and sexual inhibition? a) Women exhibit a greater propensity toward sexual inhibition and men towards excitation. b) Women exhibit a greater propensity toward sexual excitation and men towards inhibition. c) Women and men exhibit equal propensity toward sexual excitation and inhibition. d) Women exhibit a greater propensity toward sexual excitation during menstruation, but their male partners experience inhibition at those times.

59. Abby is concerned that her family religion is different from her current partner's. Her family and their religious background are very important to her, and she believes that she may not be able to commit to her partner because of their differing religious beliefs. Which theory of human sexuality best explains Abby's situation? a) dual control model of human sexuality b) sociological theory c) psychodynamic theory d) social exchange theory 60. The influence of kinship and religion on sexual behaviour can be explained by which theory? a) sociological theory b) dual process theory c) sociobiological theory d) psychodynamic theory

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61. What is one key feature of the dual control model of sexuality? a) It attempts to combine biological and psychological theories in one unified theory of sexual behaviour. b) It contradicts years of research aimed at the influence of sociocultural factors on sexual behaviour. c) It builds on Freud's notion of psychosocial sexual development to bring to light new information about childhood sexuality. d) It is rarely useful in the clinical setting and can therefore be applied to a theoretically-driven approach to human sexuality.

62. Which of the following may be a sexual inhibitory factor for a woman? a) agreeable sexual power dynamics b) concern over sexual functioning c) olfactory factors d) agreeable situational factors 63. In Quebec, common-law marriage is more commonly viewed as an acceptable institution for regulating sexuality than other parts of Canada. Which theory may help to explain this phenomenon? a) social exchange theory b) sexual script theory c) sexual strategies theory d) sociological theory 64. Which of the following scenarios would most likely be stated by someone applying the social script theory of sexual behaviour? a) Juan's preference for submissive women in sexual relationships is the result of a history where heterosexual men controlled what developed into a cultural norm. b) Paige's dissatisfaction with her sex life is the result of rigid sexual conventions. c) Ulrich prefers multiple sexual partners in order to increase the likelihood that his genes will be passed on. d) Tim's erectile dysfunction is the result of anxiety about not performing sexually.

65. Which theory would suggest that women in China are at a distinct advantage in selecting a mate because they are underrepresented and can therefore choose the mate that best fits their optimal partner? a) sexual strategies theory b) social exchange theory c) dual control model of sexuality d) sociobiological theory 66. What did Wentland and Reissing find when they studied attitudes about casual sexual relationships among university aged men and women? a) Men and women had different definitions of casual relationships. b) Men and women had similar definitions for all types of casual sexual encounters. c) What women considered an attempt at assessing a mate for a long-term relationship men considered a "booty call." d) Women would consider a long-term relationship with men they had had casual sex with repeatedly while men would not.

67. Based on results of Wentland and Reissing's 2011 study of the sexual strategies theory in casual sexual interactions, what would young women most likely look for in their male one-night-stand partners?

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a) the ability to satisfy them sexually b) the ability to pay for dinner and buy them gifts c) their suitability as a father of their children d) the ability to defend them from other men 68. Which of the following is NOT a tenet of a sexual strategies theory? a) Men and women pursue short-term mating and long-term mating when reproduction benefits outweigh costs. b) Men and women choose partners based on values of institutions such as family and religion. c) The adaptive problems that men must solve are different from those that women must solve because of differences in reproduction opportunities and constraints. d) Men and women evolved specific psychological mechanisms to solve problems associated with short-term and long-term mating.

69. Sexual theorists believe that the low birth rate in Quebec compared to the rest of Canada is the result of what? a) Quebecers' concerns about having children with someone to whom they may be related b) better job security for women of childbearing ages c) inability of women in Quebec to demand the same amount of support from the father of a child born out of wedlock as women in other parts of Canada d) a rejection of the culture of the Catholic Church following the "Quiet Revolution" that took place in the 1960s 70. In which Canadian province are common-law unions most common? a) Ontario b) Quebec c) British Columbia d) Alberta 71. Raelyn and Abbas were out on their first date. About halfway through their date at an ice skating rink, Raelyn leaned over and kissed Abbas on the cheek and I said "I love you." Abbas was taken aback and did not know how to respond. Abbas ended the date as quickly as possible and never spoke to Raelyn again. Which theory best explains Abbas' reaction? a) dual control model of human sexuality b) social script theory c) psychodynamic theory d) social exchange theory 72. What is one potential drawback of rigid sexual scripts in long-term relationships? a) low satisfaction b) boredom c) difficulties with arousal and desire d) all of the above 73. Ardene has gone on a few dates with Ravi, but after a date he suddenly tries to touch her crotch through her jeans, and they haven't even kissed yet. Why might Ardene be put off by this? a) They should have discussed it first. b) It is invasive. c) It doesn't follow a typical sexual script. d) She didn't indicate in any way that she was interested in having sex yet.

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74. People grounded in feminist theories are most likely to raise objections to what practice in Western societies? a) male circumcision b) cosmetic vulvar surgery c) the face-to-face position d) evolutionary theories of mate selection 75. Overreliance on Viagra for treating male erectile dysfunction could be an example of which trend that feminist researchers and clinicians warn about? a) the sterilization of sexuality b) penis envy c) the medicalization of sexuality d) the Oedipus complex 76. Which of the following scenarios would most likely be stated by someone applying feminist theory to sexual behaviour? a) Jane's beliefs about sexual roles are the result of the sexual preferences of heterosexual males. b) Mark and Amy's relationship is largely influenced by predefined, culturally recognizable sequences of behaviours. c) Jake's sexual behaviour is the result of mating problems faced by his ancestors. d) Kate's avoidance of sexual activity is the result of her false assumptions about what is "normal."

77. Which theoretical perspective would approach the treatment of premature ejaculation by focusing on the pleasure of pleasing a partner to reinforce learning techniques to control and/or delay ejaculation? a) operant conditioning b) classical conditioning c) social learning theory d) feminist theory 78. Which theoretical perspective would approach the treatment of premature ejaculation by increasing sexual self-efficacy by exploring sexuality in general and expectancies about erectile performance in particular? a) the dual process perspective b) the cognitive perspective c) the social learning perspective d) the biological perspective 79. Which perspective would argue that premature ejaculation is the result of a problem in the power relationship between the man and his female partner(s)? a) the feminist perspective b) the social learning perspective c) the evolutionary perspective d) the sexual script perspective 80. In a clinical setting, how might a practitioner who is grounded in feminist theory treat an individual who has problems with the power dynamic of a relationship between a man and woman? a) by focusing on sexuality beyond intercourse; examining and resolving power issues in the relationship b) by expanding the couple's sexual repertoire

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c) by prescribing serotonin re-uptake inhibitors or other antidepressants d) by increasing sexual self-efficacy through exploring sexuality in general and expectancies about the relationship 81. In a clinical setting, how would a therapist grounded in a classical conditioning framework treat someone with ejaculatory delay issues? a) by engaging in psychoanalysis to bring to consciousness the source of underlying problem b) by examining thoughts that bring about the progression of arousal; identifying which cognitive processes are involved in the early ejaculation c) by expanding the sexual repertoire d) by learning techniques to control and delay ejaculation 82. A sexual script theorist who believed that premature ejaculation was the result of a fixation on vaginal penetration may recommend which of the following as the best way to approach the problem? a) prescribing Viagra b) exploring other sexual activities other than penetration c) focusing on pleasing the partner and not worrying about performance d) learning to delay ejaculation 83. John has problems with premature ejaculation. His therapist believes it is because John cares only for his orgasm and not his partner's. Which theoretical orientation is this therapist using? a) classical conditioning b) cognitive c) social learning d) operant conditioning 84. Which of the following is NOT a reason why theories are important in the study of sexuality? a) Theories help us communicate about topics that are often considered private, sensitive, and value-laden. b) Theories help researchers come up with predictions. c) Theories can be tested, refuted, and built upon. d) Theories provide easy, fixed solutions for sexual therapists to quickly classify all patients' problems.

85. Which of the following terms best suggests that there are specific sequences of behaviours that, based on societal beliefs and values, individuals consider appropriate for particular sexual situations? a) sociological theory b) traditional sexual script c) sexual strategies d) sexual selection 86. ________ ________ theory was used as the framework to investigate intrinsic and extrinsic sexual motivation and posits that humans have three basic psychological needs (autonomy, competence, and psychological relatedness). a) Social script b) Dual control c) Self determination d) Social exchange

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87. Which theory best offers a theoretical framework to critically examine research and ideas by highlighting that identities and experiences are not fixed and categorical? a) queer theory b) feminist theory c) social script theory d) cognitive theory 88. According to Freud's Psychosexual Stages of Development, the repression of sexual feelings is most likely to happen in the ________ stage. a) phallic b) anal c) genital d) latency 89. A person who identifies as ________ may have little to no interest in engaging in sexual activity with others. a) queer b) biphobic c) asexual d) homosexual 90. ________ is the process of coming to accept for oneself a particular sexual and/or gender identity label. a) Self-identification b) Coming out c) Identity disclosure d) Conforming SHORT ANSWER QUESTIONS 1. Dr. Glick has a patient who is bothered by a sexual fetish related to women's shoes. Dr. Glick asks the patient to imagine the shoes until the patient is aroused and then presents the patient with ammonia (smelling salts). Dr. Glick is using ________ ________ to treat the client.

2. Maya is in a relationship with Jake and although she doesn't like that he plays a lot of video games, she enjoys their sexual relationship, doesn't like being single, and doesn't know many other single men. According to social exchange theory, Maya is staying in the relationship because her comparison level for alternatives is ________.

3. Social exchange theories that explain sexual behaviour use the term ________ ________ to refer to what a person expects to get out of the relationship versus what they put into it.

4. According to ________ ________ theory, the two reproductive constraints on women when considering short-term mates are extracting resources immediately and assessing prospective long-term mates.

5. ________ selection/competition can account for male deer having antlers.

6. ________ ________ theory explains sexual behaviour as being tied to self-efficacy.

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7. Common-law marriages are most prevalent in the province of ________.

8. According to Sigmund Freud, boys have castration anxiety, and girls have ________ ________, now called the Electra complex.

9. Genital and/or pelvic pain during or after sexual activity is known as ________.

10. A person who identifies with the gender they were assigned at birth can be described as ________.

11. Amy thinks that her research study will show that men are more accepting of casual sex than women. Amy's prediction is her research ________.

12. According to Freud, children who are gaining bowel and bladder control are in the ________ stage of psychosexual development.

13. The theory that dreams contain repressed memories is problematic because it is not ________.

14. Social learning theory posits that sexual behaviour develops from ________ others.

15. Dr. Mann believes that dyspareunia results from a woman thinking she is an inadequate lover. Dr. Mann supports a ________ theory of dyspareunia.

16. Female birds' preference for mates with the brightest plumage is an example of ________ selection.

17. The dual control model of sexuality proposes that sexual responses result from an interaction between excitatory and ________ neurobiological processes.

18. The ________ model is a framework used to understand how personal, relationship, and environmental factors interact and influence each other.

19. According to the ecological model, a relationship partner is part of an individual's ________.

20. Theories that attempt to understand human behaviour by focusing on thought processes are called ________ ________.

21. The concordance rate of same-sex sexual attraction was higher for ________ twins when compared to ________ twins.

22. ________ selection is the evolutionary process in which organisms best adapted to their environment are most likely to survive and reproduce.

23. One of the tenets of ________ ________ theory is that men dedicate more time to short term mating than women because of asymmetry in parental investment.

24. ________ theory often focuses on the inequalities of men's and women's relationships and their effects on women's sexuality.

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25. Sam supports that all notions of gender, sexual orientation, and sexual behaviour are socially constructed and embedded within society. Sam's ideology best fits with ________ theory.

26. The Samoan fa'afafine are birth-assigned as ________.

27. Bem's "exotic becomes erotic" theory is an example of how ________ conditioning can be used to explain sexual orientation.

ESSAY QUESTIONS 1. How can classical conditioning be used to treat people with unwanted sexual fetishes?

2. Describe Daryl Bem's hypothesis about the cause of sexual orientation.

3. Describe each of the two sexual strategies available to males according to evolutionary psychology.

4. Discuss the results of Wentland and Reissing's (2011) research into the nature of short-term sexual behaviour in males compared to females and the implications of these results on sexual strategies theory (SST).

5. Why is scientific theory important for studying human sexuality?

6. What is social exchange theory and what are the four components?

7. What is the dual control model of sexuality and why is it promising to sexuality researchers?

8. What is a social script theory? Provide one example other than a first date.

9. In relation to social learning theory, how can the notion of self-efficacy be applied to the study of human sexuality?

10. What is sex in terms of operant conditioning? (Please do not describe the act itself!)

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. d 2. b 3. c 4. a 5. c 6. a 7. a 8. a 9. d 10. b 11. d 12. b 13. b 14. d 15. a 16. c 17. b 18. b 19. a 20. c 21. d 22. a 23. c 24. b 25. b 26. a 27. b 28. a 29. c 30. a

31. c 32. b 33. d 34. c 35. d 36. a 37. a 38. d 39. a 40. b 41. d 42. b 43. a 44. a 45. b 46. a 47. c 48. a 49. c 50. c 51. d 52. b 53. d 54. b 55. c 56. a 57. a 58. a 59. b 60. a

61. a 62. b 63. d 64. b 65. a 66. b 67. a 68. b 69. d 70. b 71. b 72. d 73. c 74. b 75. c 76. a 77. a 78. c 79. a 80. a 81. d 82. b 83. d 84. d 85. b 86. c 87. a 88. d 89. c 90. a

SHORT ANSWER QUESTIONS 1. classical conditioning 2. low 3. comparison level 4. sexual strategies 5. Intrasexual 6. Social learning 7. Quebec 8. penis envy 9. dyspareunia

10. cisgender 11. hypothesis 12. anal 13. falsifiable 14. observing 15. cognitive 16. intersexual 17. inhibitory 18. ecological

19. microsystem 20. cognitive theories 21. identical; fraternal 22. Natural 23. sexual strategies 24. Feminist 25. queer 26. male 27. classical

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ESSAY QUESTIONS 1. A therapist can ask an individual to think about the unwanted fetish until he or she becomes sexually aroused, and then, once the individual is aroused, present him or her with an unpleasant stimulus (e.g., ammonia) or encourage him or her to think about unpleasant consequences such as incarceration. Ideally the individual will learn to associate the fetish with unpleasant emotions and the urge to seek out the fetish item will be reduced.

2. Bem's hypothesis is known as "exotic becomes erotic." In his hypothesis, some children choose to play with children of the opposite sex, making children of the same sex seem "exotic" and unfamiliar. These exotic same-sex peers become a source of non-specific arousal, which is then interpreted as erotic and/or romantic attraction. The non-specific arousal is linked to the same-sex peer and through the process of classical conditioning, the same-sex peer eventually becomes a source of sexual arousal.

3. Males do not need to invest much energy to pass on their genes. However, there are two different ways to ensure that those genes are passed on to future generations. A male can either reproduce with many females, knowing there is a high probability that at least some offspring will survive, or a male can produce fewer offspring but participate in protecting those offspring, ensuring that his genes are passed on that way.

4. The only gender difference that the researchers observed was in the terminology that (some) men used to refer to various sexual relationships. Men in the male-only group mentioned terms like dick 'em and dump 'em, hit it and quit it, and use 'em and lose 'em, whereas these terms were not mentioned by participants in the female-only group or the co-ed groups. In regard to the themes that were identified, there were no gender differences, and both genders identified the specific components that differentiate these casual sexual relationships—namely, frequency of contact, type of contact (sexual and/or social), personal disclosure, discussion of the relationship, and friendship. According to SST, one would expect that women view casual sex differently than men do. Yet Wentland and Reissing's study found that both male and female participants in all four groups were able to discuss the various scripts associated with each type of casual sexual relationship. Thus, women may not be assessing their casual sexual partners based on the immediate resources they supply (as predicted by SST), such as payment for dinner or tangible gifts; rather, they are more likely to assess these partners for their ability to engage in satisfactory sexual activity.

5. Theory makes it possible for us to formally talk about sexuality and explain otherwise intensely personal or even secret physical and emotional events. Thanks to theory, things that are often considered taboo and that may elicit uncomfortable laughter can actually be researched and discussed in an academic manner. Theory also guides how researchers examine a topic, facilitates researchers' interpretation of results, and helps researchers come up with predictions, or hypotheses, that can then be tested through experimentation. Human sexual development, sexual identity, and sexual behaviours are very complex, universal human phenomena that are affected by biology, culture, thinking, learning, feeling, and an individual's particular history and circumstance.

6. Social exchange theory describes how, in any relationship, people try to maximize rewards and minimize costs.

The theory is based on four components: the balance of costs and rewards, equity/equality, comparison level, and comparison level for alternatives (Byers & Wang, 2004). Within this theory, comparison level refers to what a person expects to get out of the relationship in comparison to what she or he puts into it, and comparison level for alternatives refers to how a person feels about the current relationship compared to other available options.

7. The dual control model of sexuality, developed by John Bancroft and Erick Janssen (2000) at the Kinsey Institute, suggests that each person's sexual responses involve an interaction between sexual excitatory and sexual inhibitory neurobiological processes. These processes have developed in human beings in response to

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evolutionarily adaptive pressures. It is a promising attempt to combine biological and psychological factors in a unified theory of sexuality. Researchers and clinicians are beginning to explore the clinical usefulness of the theory in relation to a variety of sexual problems (Bancroft, 2009).

8. A theory based on the idea that our social interactions tend to follow, or are at least heavily influenced by, predefined, culturally recognizable sequences of behaviours. Examples will vary.

9. Bandura's term of self-efficacy can be applied as sexual self-efficacy, which refers to the level that one is sexually competent and capable. High levels of sexual self-efficacy have been associated with positive sexual adjustment and sexual satisfaction. Furthermore, those with low levels of sexual self-efficacy may have a risk of developing an impairment of sexual response.

10. In terms of operant conditioning, sex is both a primary reinforcer and a behaviour that can be shaped by rewards and punishments. A primary reinforcer is a powerful reward that is intrinsically satisfying. According to operant conditioning, sex is an innate phenomenon, but also something that can be learned.

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CHAPTER 3

Sex Research Methods MULTIPLE CHOICE QUESTIONS 1. Who did William Masters first propose recruiting as participants for his study of the sexual response cycle? a) married American women b) unwed mothers from a local shelter c) sex trade workers d) graduate students at the University of Washington 2. Which of the following has always been a significant challenge for researchers in conducting sexuality research? a) finding participants b) understanding the theories of sexuality c) the reliability of surveys d) providing adequate compensation for study participants 3. A study in which participants have been selected at random to accurately represent the population of interest in terms of gender, racial, socioeconomic, behavioural, and other characteristics is known as ___________. a) rigid sampling b) purposeful sampling c) random sampling d) reliability 4. Specifically in sexuality research, even when random sampling techniques are used, a representative sample may be difficult to ascertain because ____________. a) people who are willing to participate in research related to sex differ from those who would not b) there is little to no evidence regarding the accuracy of random sampling in sex research c) people lie to make themselves appear more socially desirable to the researcher d) few people are ever willing to participate in sex research 5. Richard von Krafft-Ebing's Psychopathia Sexualis (1886) is often credited as the first text to approach sexuality from a modern scientific perspective. Which acts were pathologized in this text? a) sadism b) same-sex attraction c) fetishes d) all of the above 6. When researchers want to make sure the results of their research apply to the whole population, what must they must generate? a) a random sample b) a large sample c) a convenience sample d) a significant hypothesis

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7. What were the findings of research into the vaginal blood flow patterns (a physiological measure of arousal) of Asian-Canadian women who reported sexual guilt and lower arousal? a) Reports of low arousal predicted low vaginal blood flow levels. b) Blood flow levels were comparable to women who did not report low arousal or guilt related to sex. c) Reports of low arousal predicted higher than average vaginal blood flow levels. d) Self-report of arousal is a good predictor of vaginal blood flow levels.

8. What is an essential responsibility of researchers who conduct research? a) making participants feel safe b) paying participants for their time c) using the most up-to-date technology possible d) avoiding using sex offenders as participants 9. What was the focus of Richard von Krafft-Ebing's approach to sexuality in Psychopathia Sexualis? a) describing "normal" and "abnormal" b) describing all behaviours along a continuum c) describing causes of abnormality d) describing cross-cultural trends in sexual phenomena 10. What research method did Alfred Kinsey use in his 1939 study of human sexual behaviour? a) experiments b) surveys c) interviews d) observations 11. Who is known as the "father of sexology"? a) Iwan Bloch b) Richard von Krafft-Ebing c) Sigmund Freud d) Alfred Kinsey 12. How did Iwan Bloch approach in sex research the natural variations in sexual phenomena such as masturbation and same-sex attraction? a) by surveying sexual behaviours in a longitudinal study b) by describing their occurrence across cultures and in healthy, "normal" individuals c) by interviewing thousands of participants about their sexual histories d) by observing patterns of sexual response in the laboratory 13. Alfred Kinsey's research addressed a wide variety of topics, including marriage, sexual education, physical history, nocturnal sex dreams, masturbation, heterosexual experiences, same-sex sexual activity, and sexual contact with animals. What method did he primarily use to investigate these topics? a) self-report questionnaires b) observation c) secondary data-analysis d) interviews

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14. What was one major criticism of Alfred Kinsey's work? a) He used questionnaires. b) He deceived participants into revealing personal information. c) He used a non-random sample. d) He used a random sample.

15. What are the major criticisms of Kinsey's research? a) inaccuracies in the reported prevalence of various behaviours and disorders b) oversampling of non-white ethnic groups c) use of random sampling d) none of the above 16. Although Masters and Johnson are often credited as the first to use observational techniques in sex research, there were a number of other researchers who had used this method. What was the actual reason that their techniques were innovative? a) They enabled researchers to understand the prevalence of certain sexual responses. b) They were the first to use direct observations of cervical contractions and blood flow changes during orgasm in a female patient. c) They were the first to observe mechanical interactions between the penis and vagina. d) They enabled researchers to measure sexual response.

17. What was one criticism of Masters and Johnson's observational approach to the study of physiological sexual responses in humans? a) They focused on the orgasm as the "normal" outcome of sex. b) They oversampled the African American population in their studies. c) They oversampled university students in their study. d) They treated same-sex relationships as "normal" at a time when same-sex relationships were not tolerated in society.

18. Aaron scores a 6 on Kinsey's scale of sexual orientation. What can you infer about Aaron's past sexual experience from this score? a) He had more than incidental heterosexual behaviour. b) He had more than incidental homosexual behaviour. c) He had exclusively homosexual behaviour. d) He had exclusively heterosexual behaviour.

19. Gabriela is conducting qualitative research in sexuality. What is one topic she may be studying? a) vaginal blood flow during and after intercourse b) sex hormone levels in gay and straight men c) words people use to describe feelings during oral and vaginal sex d) the correlation between Kinsey's sexual orientation scale scores and people's score on a test measuring emotional intelligence 20. How did Kinsey develop his sexual orientation scale? a) qualitative methods only b) quantitative methods only c) qualitative and quantitative methods

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d) correlations 21. It can be implied from Masters and Johnson that the goal of sex is ____________. a) pleasure b) orgasm c) reproduction d) improved mental health 22. What is the value of using qualitative methods? a) They never introduce bias into the study and therefore are generalizable to almost all populations. b) They allow the researcher to objectively identify and measure behaviour and physical processes (erection, vaginal lubrication, etc.) that occur during sexual activity. c) They are able to account for subjective aspects of sexuality that are difficult to measure, such as a person's attitudes, beliefs, and emotions about sexuality. d) They account for both the subjective and objective aspects of human sexuality and therefore provide the best analysis for research findings.

23. What is the value of using quantitative methods? a) The never introduce bias into the study and therefore are generalizable to almost all populations. b) They are able to account for subjective aspects of sexuality that are difficult to measure, such as a person's attitudes, beliefs, and emotions about sexuality. c) They allow the researcher to objectively identify and measure behaviour and physical processes (erection, vaginal lubrication, etc.) that occur during sexual activity. d) They account for both the subjective and objective aspects of human sexuality and therefore provide the best analysis for research findings.

24. What type of investigations can be helpful at the start of a research project because they may identify important issues not captured by general summaries? a) quantitative b) qualitative c) correlational d) empirical 25. Why do some researchers believe qualitative approaches are unnecessary to the research process of sexual behaviour? a) They are not applicable to general populations. b) They do not accurately represent real-life situations. c) They are difficult to interpret. d) none of the above 26. Riza wishes to summarize patterns of sexual attitudes and behaviour. What kind of research design will he use? a) descriptive b) correlational c) psychophysiological d) translational model

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27. What research design is useful when researchers wish to summarize patterns of sexual attitudes and behaviour, and/or generate ideas for future research by documenting aspects of sexuality through observation and participants' self-report? a) inductive research designs b) descriptive research designs c) mixed-methods research designs d) correlational research designs 28. What are the strengths of the direct observation research method? a) It's descriptive, has increased ecological validity and accuracy, and can provide much contextual information. b) It enables researchers to uncover detailed descriptions that reflect the richness of individual's lived experiences. c) It retains meaning and richness of data. d) It can evaluate clinically important patient groups and it offers some degree of control over experimental parameters.

29. What are the weaknesses of quasi-experiments? a) They cannot be used to make strong statements about cause and effect and the influence of confounding variables is unknown. b) They are prone to inaccuracies when records are incomplete and variables in past records may not be ideal measures of current interests. c) They cannot infer causation and may be confounded by related but distinct constructs. d) They can be ethically implausible to use in research involving human subjects.

30. Using standardized procedures to evaluate the causal relationship between two variables using randomization, generally in quantitative research, is known as ___________. a) experiments b) archival data-mining c) surveying d) correlational design 31. What is one disadvantage of descriptive studies? a) They are susceptible to memory bias and responder bias. b) The results are not usually generalizable. c) They are prone to inaccuracies when records are incomplete. d) They can be ethically implausible to use in research involving human subjects.

32. Which research method allows for inference of cause and effect relationships? a) an experimental design b) a quasi-experimental design c) a correlational design d) a descriptive design 33. Which type of study involves examining two or more variables that change in relation to one another? a) an experiment b) a survey c) a case study d) a correlational research design

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34. If it is important for participants of a research study to remain anonymous, which of the following methods should you use? a) a survey b) an experiment c) a quasi-experiment d) a case study 35. A negative correlation between genital sensitivity and number of past sexual partners may suggest that individuals who have had many sexual partners have lower genital sensation than do individuals who have had few sexual partners. Yet this correlation can easily be explained by a third variable: age. Which concept is being illustrated here? a) Correlation is not causation. b) Referencing is not validity. c) Memory bias interferes with results. d) Responders can be bias.

36. Which of the following requires that an individual make simple perceptual judgments on whether a stimulus is detectable, whether the stimulus is more or less intense than a previous sensation, and in some cases whether the stimulus is painful? a) thermography b) quantitative sensory testing c) doppler ultrasonography d) penile strain gauge 37. Which tool is used to indirectly detect changes in blood flow associated with brain regional neural activity, including the most common technique, which is to assess cognitive, emotional, and sensory processes associated with sexual arousal, orgasm, genital pain, and even romantic love? a) functional magnetic resonance imaging (fMRI) b) quantitative sensory testing c) penile photo-plethysmography d) penile strain gauge 38. Rachel is conducting a study focusing on female sexuality in individuals with a history of childhood sexual abuse, and it is important for the participants to remain anonymous. Which research method or design would be best to use? a) a survey b) an interview c) direct observation d) a case study 39. Fateema has decided to use archival data-mining as part of her study on sexual behaviour. Which of the following obstacles may she come across? a) The variables used in the past may not measure current interests. b) The records used in the past will not allow her to infer causation. c) It will be difficult to organize all the information obtained. d) It will be difficult to quantify the data.

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40. Gerald would like to study couple communication as a predictor of divorce. Which of the following research methods/designs would be most useful? a) archival data-mining b) an experiment c) a quasi-experiment d) direct observation 41. Which of the following research designs is the least intrusive on its subjects? a) a case study b) a survey c) direct observation d) an experiment 42. What kind of design involves identifying themes of meaning in a text or set of observations? a) content analysis b) a case study c) descriptive study d) surveys 43. When conducting observational studies, researchers generally try to avoid interfering with the phenomena they are observing in order to do which of the following? a) preserve ecological validity b) record things more accurately c) prevent memory bias d) prevent theoretical bias 44. Which of the following is the best definition of memory bias? a) the tendency for a participant to answer questions in a way she or he believes the researcher expects b) a bias that can result from an individual's strict adherence to a specific theoretical approach c) a bias that results from the fact that different people interpret behaviours and situations in different ways, based on their personal experiences, opinions, and beliefs d) a bias that results from cognitive processes that interfere with the way in which a person remembers an event 45. Juanita is recording people's reactions after viewing BDSM porn for the first time. She later goes back and reviews the recordings and reports on them in her research. By using this technique, what is she avoiding? a) ecological observation b) participant interference c) memory bias d) interpretive anxiety 46. Using video recordings, John Gottman monitored conversations between mixed-sex and same-sex couples at his laboratory. He found that participants' expressions of positive or negative emotion during a 15-minute couple conversation about marital conflict could predict marital outcome years later. During this research, if Gottman had had other researchers working with him to analyze the recordings, what concern would he be addressing? a) interpretation bias b) memory bias

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c) participant bias d) responder bias 47. Pete is summarizing detailed descriptions from a small sample of individuals who participated in his research project. Which of the following statements is most likely true? a) Pete used a qualitative approach. b) Pete used a quantitative approach. c) Pete will not be able to draw any generalizable conclusions from his research. d) Pete probably conducted a focus group.

48. Which research method can be used qualitatively to uncover patterns or themes that naturally emerge from the research and to develop new ways of describing certain phenomena? a) quasi-experimental b) focus group c) longitudinal research d) content analysis 49. Sandeep is conducting a study on marital conflict in same-sex couples versus mixed-sex couples. One of his concerns is the possibility of responder bias. Which research method is he likely using? a) surveys b) interviews c) direct observation d) case studies 50. When working with case studies, why is it an issue for researchers that there is a lack of a control group or experimental design? a) It makes the information gathered unreliable. b) It prevents the researcher from being able to draw any conclusions about cause-and-effect relationships. c) It means there may be an interpretation bias. d) none of the above 51. Carolyn is working on a study about a poorly understood aspect of sexuality that would be unethical to study through the use of experiments. Which of the following research methods or designs would be more suitable? a) a quasi-experiment b) direct observation c) a case study d) none of the above 52. Which of the following is the best definition of responder bias? a) the tendency for a participant to answer questions in a way she or he believes the researcher expects b) a bias that can result from an individual's strict adherence to a specific theoretical approach c) a bias that results from the fact that different people interpret behaviours and situations in different ways, based on their personal experiences, opinions, and beliefs d) a bias that results from cognitive processes that interfere with the way in which a person remembers an event 53. Freud and Breuer's case study of Anna O. illustrates how objective interpretation of a person's behaviour can be limited by which of the following?

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a) memory bias b) theoretical bias c) responder bias d) interpretation bias 54. How might researchers avoid a biased result while conducting a survey? a) by sampling from a large group b) by sampling from a group with a wide variety of demographic characteristics c) by selecting participants at random d) all of the above 55. Cindy Graham and her colleagues at the Kinsey Institute wanted to identify factors that can increase or decrease the level of a women's sexual arousal. They began by holding focus groups, after which they drew meaning from the sessions' transcripts. Based on the transcripts, the researchers noted that the participants judged how sexually aroused they felt based on certain physical cues, including genital "tingling, warmth, fullness, swelling, and lubrication." Which method were the researchers using? a) longitudinal study b) case study c) sexual psychophysiology d) qualitative content analysis 56. Dr. Chen is interested in whether there is a relationship between the number of older brothers a man has and his score on Kinsey's sexual orientation scale at age 30. What type of design will Dr. Chen use? a) a correlational design b) an experimental design c) a quasi-experimental design d) a case study design 57. Helen is creating a survey for her research project. What should she do to ensure the data she gathers will be valid and reliable? a) Create open-ended questions. b) Use proper scientific terms. c) Use clearly worded multiple choice questions. d) Make sure concepts overlap in a single question.

58. Which term refers to a psychological, behavioural, and/or biological variable that changes along with the manipulated experimental variable? a) independent variable b) confounding variable c) dependent variable d) subject 59. Why are experimental research designs rarely used in human sexuality research? a) It is unethical. b) It is impractical. c) It is impossible to create truly random assignments to experimental and control groups. d) all of the above

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60. Afshan is investigating whether physical activity can enhance sexual arousal in women. Which research method/design is she most likely using? a) delayed control-group design b) experimental design c) quasi-experimental design d) none of the above 61. Warren is conducting a research study where he is asking participants to rate the intensity of erotic stimuli.

Which research method/design is Warren most likely using? a) case study b) interview c) experiment d) quasi-experiment 62. Why is psychophysiological research popular in current research on sexuality? a) It provides a purely objective measure of sexual experience. b) It provides a purely subjective measure of sexual experience. c) It allows subjective experiences to be related to physiological changes occurring at the same time. d) It eliminates the problem of demand characteristics.

63. If you want to study female sexual arousal using a method that shows results in real time with no delay, which method would you use? a) vaginal photoplethysmography b) labial thermistor c) doppler ultrasonography d) thermography 64. What is one weakness of using penile volume plethysmography to study male arousal? a) It is the most expensive method available. b) It does not provide data in real time. c) It does not measure the firmness of an erection. d) The tight-fitting apparatus is uncomfortable during an erection.

65. Deidre is conducting research on sexual arousal in females and is taking a psychophysiological approach.

Which of the following methods would be best for measuring genital vascongestion? a) vaginal photoplethysmography b) vaginal pulse amplitude c) doppler ultrasonography d) None of these methods will conclusively show a correlation between clitoral or vaginal blood flow and self-reported sexual arousal.

66. What is one criticism of vaginal pulse amplitude as a measure of arousal? a) There is no conclusive evidence that the light reflected is correlated with arousal. b) There is no conclusive evidence that blood flow is correlated with arousal. c) There is no conclusive evidence that electrical activity is correlated with arousal. d) The device is so uncomfortable that it actually may impede sexual arousal.

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67. What is the most common and reliable method for measuring male arousal? a) penile thermography b) the penile strain gauge c) penile photoplethysmography d) penile volume plethysmography 68. What is the most valid and reliable use of female vaginal blood flow as a measure of arousal? a) within-participant comparisons b) control group comparisons c) between-participant comparisons d) delayed control group comparisons 69. What has been found in studies using quantitative sensory testing techniques? a) no physiological differences in pain transduction in people who report pain during sex b) increased sensitivity to both genital and non-genital pain for people who report pain during sex c) differences in pain sensitivity for women who report pain during sex but not for men who report pain during sex d) decreased non-genital pain sensitivity and increased genital pain sensitivity in people who report pain during sex 70. Which of the following can researchers study using brain imaging technology? a) arousal b) orgasm c) love d) all of the above 71. Which of the following possible sex research methods is MOST likely to be ethically implausible? a) an experiment b) archival data-mining c) direct observation d) content analysis 72. ________ ________ is a branch of sex research that examines the relationship between the physiological and subjective components of sexual arousal. a) Sexual physiology b) Sexual neurophysiology c) Sexual psychopathology d) Sexual psychophysiology 73. A researcher found that as the temperature outside decreases, the number of times that couples engage in sex increases. What does this statement best reflect? a) a positive correlation b) a zero correlation c) a negative correlation d) the average 74. The measure of central tendency that reflects the most frequently occurring value is referred to as the

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________. a) mean b) median c) mode d) range 75. ________ ________ occurs when a researcher conducting a case study strictly adheres to their specific theoretical approach such that it could limit the objective interpretation of a participant's behaviour. a) Responder bias b) Observer bias c) Theoretical bias d) Interpretation bias 76. Jane and Bill are both researchers working on the same project. They are independently looking through popular magazines and coding articles based on different sexual topics. The type of study that they are conducting is most likely a ________ ________. a) true experiment b) content analysis c) direct observation d) case study 77. Jane and Bill are both researchers working on the same project. They are independently looking through popular magazines and coding articles based on different sexual topics. They both look at the same magazines and code the same articles. The main reason for having both researchers code the same articles is to provide _______ ________. a) ecological validity b) demand characteristics c) direct observations d) inter-rater reliability 78. Which method that is commonly used to study physiological changes associated with sexual arousal can be biased by body movements and can also be affected by the presence of thick pubic hair? a) labial thermistor b) laser Doppler imaging c) penile photoplethysmography d) Doppler ultrasonography 79. Which psychophysical method requires that an individual make simple perceptual judgments on whether a stimulus is detectable, whether the stimulus is more or less intense than a previous sensation, or in some cases whether the stimulus is painful? a) quantitative sensory testing b) qualitative sensory testing c) psychological sensory testing d) physical sensory testing 80. The increased vascular blood flow in the genitals during sexual arousal is referred to as _________. a) vasculation

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b) vasocongestion c) vasodilation d) vasoconstriction 81. According your text, volunteers for sex research studies have been found to exhibit all of the following characteristics except that ________. a) volunteers are often more sexually experienced b) volunteers are often older c) volunteers often hold more liberal sexual attitudes d) volunteers often have higher levels of sexual self-esteem 82. According to Wiederman (1999), college students are more likely to participate in which type of study on human sexuality? a) anonymous questionnaires b) direct observation studies c) face-to-face interviews d) content analysis 83. Which early text on human sexuality described a way to engage in sexual intercourse called dok al arz (the pounding on the spot)? a) The Kama Sutra of Vātsyāyana b) Plain Facts for Old and Young c) Plain Talks on Avoided Subjects d) The Perfumed Garden for the Soul's Recreation 84. Over the course of 18 years, Alfred Kinsey and his colleagues conducted approximately how many interviews on human sexuality? a) 733 b) 5500 c) 12,500 d) 17,500 85. In what year were the characteristics of orgasms first carefully studied from hundreds of qualitative descriptions from young men and women which lead to a two-dimensional model of orgasm being developed? a) 1939 b) 1966 c) 1990 d) 2002 86. In research on human sexuality, case studies are usually considered to be ________ research methods, while surveys and questionnaires are usually considered to be ________ research methods. a) experimental; correlational b) correlational; experimental c) qualitative; quantitative d) quantitative; qualitative 87. A research design that includes groups receiving the same treatment, tested at different points in time to better

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understand the time course of the treatment effects is called a ________. a) quasi-experimental research design b) experimental research design c) archival data mining d) delayed control-group design 88. A small group of demographically diverse individuals who participate in a guided discussion to help a researcher better understand a certain belief, behaviour, or phenomenon is called a ________. a) focus group b) random assignment group c) dependant group d) delayed-control group 89. ________ involves the measurement of swelling, blood flow, and genital temperature to indicate arousal. a) Vaginal photoplethysmograph b) Phallometry c) Vasocongestion d) Penile strain gauge 90. To discover changes in condom use between the 1990s and 2010s, Raj should use which research method? a) focus group b) interview c) archival data mining d) survey SHORT ANSWER QUESTIONS 1. The four-stage ________ ________ ________, related to sexual experience, was first described by Masters and Johnson.

2. One criticism of Alfred Kinsey's research on human sexual behaviour was that he focused on ________ and not on ________.

3. The work of Masters and Johnson was unique in that it was the first to ________ sexual responses.

4. The value of ________ research is that it allows you to examine subjective experiences.

5. The value of ________ research is that it allows you to develop cause-and-effect relationships.

6. If Fatima is using standardized procedures to evaluate a correlation between two variables and does not use random assignment, Fatima's methodology would be referred to as a(n) ________.

7. One weakness of a case study as a research methodology is that it is susceptible to ________ ________.

8. The primary limitation of correlational designs is that they cannot be used to determine ________.

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9. A ________ is the most common technique for studying brain activity during sexual arousal.

10. The strength of a ________ as a research method is that it allows for the collection of a large amount of information.

11. Anne is being interviewed about her sexual history. She doesn't recall much from her high school years. A possible problem with Anne's data is that it will be affected by ________ ________.

12. To avoid interpretation bias, researchers must carefully ________ all behaviours.

13. Brian is answering a survey about his sexual preferences based on what he thinks the researcher is interested in studying. Brian's responses are influenced by ________ ________.

14. The variable measured by the researcher in an experiment is known as the ________ variable.

15. The use of a heat-sensing camera to measure blood flow is called ________.

16. The most common and reliable method for measuring an erection is the ________ ________ ________.

17. Research has shown that ________ require more mechanical force to perceive touch during sexual arousal.

18. The extent to which the behaviours that are observed in a research setting are representative of what actually happens in the real world is called ________ ________.

19. ________ ________ is the tendency for a participant to answer questions in a way they believe the researcher expects.

20. The level of agreement between the genital and subjective components of sexual arousal is called ________ ________.

ESSAY QUESTIONS 1. What are four factors that can make it difficult to conduct good quality research on sexuality?

2. What are four types of bias that can arise in research? Suggest at least one way to prevent each type of bias.

3. Explain why traditional vaginal photoplethysmography may not be the best measure for psychophysiological studies of arousal and describe two newer approaches that overcome the problems with this older approach to measuring arousal in women.

4. Dr. Franco is using an fMRI to look at brain blood flow while participants are presented with erotic images.

After reviewing his results, compared to brain blood flow when no image is presented, he concludes that individuals have a "sex centre" in their brain that is active when erotic stimuli are present. What are at least two flaws in Dr. Franco's design and conclusions? What can be done to improve the experiment?

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5. Describe the challenges associated with conducting sex research.

6. What is a descriptive design research methodology? What are the strengths and weaknesses of this method?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. c 2. a 3. c 4. a 5. d 6. a 7. b 8. a 9. a 10. c 11. a 12. b 13. d 14. c 15. d 16. d 17. a 18. c 19. c 20. c 21. b 22. c 23. c 24. b 25. a 26. a 27. b 28. a 29. a 30. a

31. b 32. a 33. d 34. a 35. a 36. b 37. a 38. a 39. a 40. d 41. c 42. a 43. a 44. d 45. c 46. a 47. a 48. d 49. b 50. b 51. c 52. a 53. b 54. d 55. d 56. a 57. c 58. b 59. d 60. a

61. d 62. c 63. a 64. c 65. d 66. a 67. b 68. a 69. b 70. d 71. a 72. d 73. c 74. c 75. c 76. b 77. d 78. b 79. a 80. b 81. b 82. a 83. d 84. d 85. d 86. c 87. d 88. a 89. b 90. c

SHORT ANSWER QUESTIONS 1. sexual response cycle 2. behaviour; experience 3. measure 4. qualitative 5. quantitative 6. quasi-experiment 7. interpretation bias

8. causation 9. fMRI 10. survey 11. memory bias 12. operationalize 13. demand characteristics 14. dependent

15. thermography 16. penile strain gauge 17. men 18. ecological validity 19. Responder bias 20. sexual concordance

ESSAY QUESTIONS 1. Four major difficulties include finding research participants willing to talk about their sexuality and sexual behaviour, using a random sample of people from the whole population of interest to the researcher, finding

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methodologies that participants are comfortable with, and ensuring that research remains bias-free.

2. Responder bias: participants responding in a way they feel the researcher will see as socially acceptable; can be prevented by framing research so that the respondent feels that all behaviours are acceptable.

Memory bias: results from cognitive processes interfering with accurate recall of events; can be reduced by using direct observation to gather data about a subject.

Theoretical bias: a researcher observes and interprets actions that support their own theoretical point of view; this is a specific type of interpretation bias and can be reduced by researchers clearly defining concepts by operationalizing them before conducting the research.

Interpretation bias: results from people inferring things about behaviour because of their own personal beliefs; can be reduced by having clear operational definitions of behaviours.

3. The causal relationship between vasocongestion and the amount of light that gets reflected has yet to be conclusively proven and increases in VPA do not always correlate with self-reported "subjective" sexual arousal and some researchers have suggested that other physiological factors may affect the amount of reflected light. In efforts to improve upon the limitations of vaginal photoplethysmography, theoretically, methods based on more direct measures of blood flow should provide superior measures of female sexual arousal. Examples include Doppler ultrasonography and labial thermistor methodologies.

4. One flaw is that Dr. Franco does not include a control condition of non-erotic stimuli. It is possible that merely watching the images activated those areas of the brain. A second problem is that some brain activity changes may be the result of autonomic arousal in general, but not specific to sexual arousal. A solution to these problems would be to include a control condition where neutral images are shown and brain blood flow activity in that condition is compared to brain blood flow activity while the participant is looking at erotic images.

5. Human sexuality studies can be challenging to conduct for a number of reasons. For one thing, given the highly sensitive nature of the subject matter, researchers may have difficulty finding participants who are willing to openly and honestly disclose their thoughts and feelings about their sexual experiences. This problem becomes even more pronounced when the researcher is interested in understanding a population of individuals who have difficulty with sexuality, which is often the case in clinical research. Perhaps even more difficult than finding willing participants is finding interested participants who are representative of the entire population that the researchers are interested in studying. A related challenge is representing the types of people who are disinclined to volunteer to participate in sexuality research, as there is evidence that individuals who are willing to participate in sexuality research differ in important ways from individuals who are unwilling to participate (Strassberg & Lowe, 1995). Another challenge is finding a research method that participants will not find intimidating. In addition, it may be difficult for the research to remain free of bias.

6. Definition: summarizing patterns in attitudes toward sex and sexual behaviours; generally used in qualitative research, but can also be used in quantitative research. Strengths: enables researchers to uncover detailed descriptions that reflect the richness of individuals' lived experiences. Weaknesses: results are not usually generalizable; cannot be used to prove causation or relationships among variables.

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CHAPTER 4

Genital Anatomy and Sexual Response MULTIPLE CHOICE QUESTIONS 1. Which of the following is NOT part of the vulva? a) vagina b) clitoris c) labia majora d) labia minora 2. The external genitals of the female consist of the mons pubis, the clitoris, the labia majora, the labia minora, the vulvar vestibule, and the urethral and vaginal openings. Together, these organs are called the ____________. a) vulva b) pubis majora c) uterus d) cervix 3. What is the rounded fatty pad of tissue that covers the pubic symphysis (the place where the left and right sides of the pelvis meet in the midline) that is sensitive to touch? a) mons pubis b) vagina c) labia majora d) vulva 4. What is the only known function of the clitoris? a) passing urine b) pheromonal signalling c) sexual pleasure d) padding and protection 5. Janice regularly removes all of her pubic hair. According to the online survey by Herbenick and colleagues from 2010, what kind of woman would she most likely be? a) young, likely to engage in oral sex, and having a positive perception of her genitals b) young, likely to avoid oral sex, and concerned about the cleanliness of her genitals c) older, likely to engage in oral sex, and considering her genitals unattractive d) older, avoiding oral sex, and considering her genitals unattractive 6. Why does pubic hair exist? a) for sexual communication through pheromonal signalling, by helping to dissipate volatile compounds b) to provide protective padding during the friction of intercourse c) to signal sexual maturity d) all of the above 7. What is the function of the clitoris? a) pleasure Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) stimulation of pubic hair growth c) to signal the release of eggs during the menstrual cycle d) all of the above 8. What are the secretions made up of dead skin cells, oils, and moisture, which can form in the genital folds of males and females called? a) smegma b) ejaculate c) perinea d) crus 9. Where is smegma most commonly found? a) under the clitoral hood and the foreskin b) around the anus c) only in the foreskin of uncircumcised males d) the perineum 10. What erectile tissue can be found in both male and female sexual anatomy? a) corpora cavernosa b) urethra c) labia majora d) Skene's gland 11. What are also known as the "outer lips" and are made up of pads of fatty tissue that run lateral to the labia minora and the urethral and vaginal openings? a) Labia majora b) Clitoris c) Mons pubis d) Cervix 12. What are also known as "the inner lips" and are hairless folds of skin that extend upward and forward toward the clitoris to form the clitoral hood (prepuce), and meet posterior to the vaginal opening in an area called the fourchette? a) labia minora b) clitoris c) labia majora d) perineum 13. Which of the following is important for sexual stimulation and arousal in the female? a) labia minora b) labia majora c) clitoris d) all of the above 14. What is the teardrop-shaped area of the vulva inside the labia minora within which lie the vaginal and urethral openings? a) vulvar vestibule b) labia majora Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) clitoris d) cervix 15. Louise is considering a labiaplasty, but her family doctor warns her of potential risks. What do these risks include? a) unpleasant hypersensitivity in the area b) decrease in pleasurable sensations c) scarring d) all of the above 16. An "excisor" has just performed female genital mutilation on her granddaughter. According to research by Chalmers and Omer-Hashi (2003), what would she NOT use to cover the wound? a) Bat droppings b) Alcohol c) Vinegar d) Eggs 17. A female virgin who hasn't had her first period yet comes to a doctor with abdominal cramps but no bleeding.

The doctor says she is in fact menstruating, but the hymen traps the blood. What kind of hymen does she have? a) microperforate b) imperforate c) triperforate d) septate 18. Which of the following is NOT true of the hymen? a) It is an accurate indication of virginity. b) It can be torn during sport or some other non-sexual activity. c) In some cultures it is used as an indicator of virginity. d) It can sometimes be partial, thin, and/or flexible enough to remain intact even after intercourse.

19. Which of the following is true of girls raised in countries where female circumcision is common? a) The girls are raised knowing what the surgery consists of and knowing they will undergo the procedure when they are about ten years old. b) The girls are raised knowing what the procedure involves and that they will undergo the procedure when they begin menstruating. c) The girls are told stories detailing the surgery as part of normal childhood. d) The girls know little about the procedure as codes of secrecy surround it both before and after it is performed.

20. When surveyed, what do most women who have undergone female circumcision report? a) They are happy to have had the procedure. b) They feel ashamed to have had the procedure. c) They experienced no change in sensation in their genitals. d) They have no sexual sensation in any area of their genitals.

21. Felicity is very concerned about the cleanliness of her body, including her vagina. Washing between the vulvar folds is not enough for her, so she uses vaginal douches every day just to feel fresh. What condition is she risking? a) endometriosis Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) ectopic pregnancy c) decreased fertility d) all of the above 22. Which of the following is NOT true of vaginal lubrication? a) It is primarily designed for childbirth to lubricate the vagina. b) It generally begins 10-30 seconds after effective sexual stimulation. c) It raises the chances of conception. d) It increases sexual pleasure.

23. Elaine feels that her vagina is not lubricated enough during sexual intercourse. Which of the following is NOT a good substance to help her lubricate the vagina? a) massage oil b) a lubricated condom c) saliva d) a water-based lubricant 24. Joanne would like to locate her G-spot. Where should she direct her fingers? a) to the front vaginal wall, 5 cm from the vaginal opening b) to the back vaginal wall, 5 cm from the vaginal opening c) to the front vaginal wall, 1 cm from the vaginal opening d) to the back vaginal wall, 1 cm from the vaginal opening 25. Soo Yeon has been stimulating her G-spot area, but she doesn't feel any special pleasure from it. Should she be concerned? a) No, because studies show that approximately 40 per cent of women don't find the G-spot area highly sensitive at all. b) No, because G-spot is a myth disproved by numerous studies. c) Yes, and she should ask her family doctor about a G-spot amplification procedure. d) Yes, because studies show that 100 per cent of healthy women reach orgasm through G-spot stimulation.

26. The Skene's glands are now believed to ________________. a) contribute to the sensitivity of the G-spot b) stimulate sexual hormones in the female c) fill with blood during sexual arousal to produce swelling in the vulvar area d) all of the above 27. What is considered to be the female equivalent of the male prostate gland? a) the Skene's gland b) the Bartholin gland c) the vestibular bulbs d) the glans 28. From where does female ejaculatory fluid exit? a) the anus b) the vagina c) the urethra d) the clitoris Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

29. Which of the following is true about the G-spot? a) It is a hyper-sensitive region of the vulva present in all women. b) It is a small erogenous zone within the pelvic region of all women. c) It can be accentuated effectively with surgical intervention. d) It is difficult to study because stimulating the G-spot also stimulates many other areas.

30. Which of the following best describes the cervix? a) the bottom third of the uterus b) a sphincter muscle at the bottom of the uterus c) the area covered by the hymen d) the relay station of the female erogenous zone 31. Kate is pregnant, but she doesn't want anyone to find out. She needs to terminate the pregnancy, but she can't go to a clinic. She wants to perform the abortion herself, with a coat hanger. What injury is she risking the most? a) She might pierce the vaginal wall in the posterior fornix and cause infection in the abdominal cavity. b) She might pierce through the vaginal wall to the bladder and cause a kidney infection. c) She might scratch the cervix and cause cervical cancer. d) She might pierce through the vaginal wall to the rectum and cause infection in the abdominal cavity.

32. Anna told you her family doctor warned her she was in a high-risk group for cervical cancer, but she didn't tell you why. Why could that be? a) She's been using birth control pills for over five years. b) She hasn't had regular Pap tests. c) She's had many sexual partners. d) all of the above 33. What is the first warning sign of cervical cancer? a) abnormal bleeding b) cervical dysplasia c) pain during urination d) vaginal discharge 34. Which layer of the uterus is shed during menstruation? a) endometrium b) perimetrium c) myometrium d) labium 35. When a female begins to menstruate she possesses approximately how many ova? a) 1,000,000 b) 300,000 c) 200,000 d) 100,000 36. What is the most likely reason we cannot locate the "G-spot"? a) The roots of the clitoris lie just to the sides of this region, and any pressure on the anterior vaginal wall in the area of the Skene's glands is likely to indirectly stimulate the clitoral roots as well as the urethra.

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b) Recent research indicates that the G-spot does not really exist; in fact, most women are experiencing misattributed orgasm. c) The G-spot is elusive and shifts in position in most women depending on the menstrual cycle. d) all of the above 37. Why is dysplasia of the cervix a concern for a female's health? a) because it can develop into cancer if left untreated b) because it is often cancerous c) because it displaces the anatomical structure of the uterus and contributes to infertility d) because it does not respond to most medical treatments 38. What are the 3 sections of the penis? a) root, shaft, glans b) base, tube, head c) root, tube, head d) crura, head, glans 39. What is the spongy tube that runs the length of the penis and contains the urethra called? a) corpus spongiosum b) corpora cavernosa c) crura d) shaft 40. Where in a woman's body does the fertilization of an ovum typically occur? a) in the uterus b) in the fimbriae c) in the infundibulum d) in the ovary 41. Worldwide, approximately what percentage of men are circumcised? a) 10 per cent b) 30 per cent c) 50 per cent d) 70 per cent 42. In 2011, "intactivists" in the US fought to have what practice banned? a) male circumcision b) female circumcision c) labiaplasty d) castration 43. What have researchers found about the sensitivity of the glans of circumcised versus uncircumcised penises? a) Circumcision decreases sensitivity. b) Circumcision has no effect on sensitivity. c) Circumcision heightens sensitivity. d) There is no consensus among researchers 44. In what province are 44.3 per cent of males circumcised?

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a) Alberta b) Ontario c) Nova Scotia d) British Columbia 45. Which structure of the penis remains spongy when engorged with blood so as not to impede urination or ejaculation? a) the corpus cavernosa b) the corpus spongiosum c) the glans d) the urethra 46. In Ancient Greece, what type of penis was preferred, as it was considered to make conception more likely? a) a large penis b) a small penis c) a penis that angled left d) a penis that angled right 47. Which of the following statements is true? a) More than half of all men believe their penis is larger than average. b) Larger flaccid penises increase more in size than small flaccid penises when they become erect. c) The average penis is about 6 cm long when flaccid. d) Smaller flaccid penises increase more in size than larger flaccid penises when they become erect.

48. If a man is standing up with an erection, what is the average angle of the penis? a) 10 degrees above horizontal b) 10 degrees below horizontal c) 20 degrees above horizontal d) 5 degrees below horizontal 49. Which sex organ includes the dartos muscle? a) the penis b) the cervix c) the scrotum d) the uterus 50. More men believe that their penis is _____________. a) smaller than average b) larger than average c) average size d) none of the above 51. What involuntary muscle responds to temperature and contracts if the testes are cold, causing the testes to rise, the scrotum to look smaller, and the skin of the scrotum to wrinkle? a) dartos b) pelvic c) scrotum d) epididymis Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

52. What are the testes analogous to in females? a) ovaries b) fallopian tubes c) eggs d) fimbriae 53. The cremaster is essential for which of the following? a) keeping sperm healthy b) producing sperm c) maintaining an erection d) ejaculation 54. In the Middle Ages, why did men sometimes have their left testicles removed? a) as a form of contraception b) because they believed that sperm from the right testicle produced male children c) because they believed that sperm from the right testicle produced female children d) as a court-ordered punishment for adultery 55. When a male is hit in the scrotum, where does he feel the pain? a) in the scrotum and down the legs b) deep in the body cavity where the testes first developed c) in the penis and scrotum where the nerves in the two areas are interconnected d) localized in the scrotum 56. Historically, eunuchs have had _________. a) completely asexual lifestyles b) celibate lifestyles despite interest in sex c) roles in European choirs d) such difficulty with erections that they have been unable to perform sexually 57. What will happen if a boy is castrated before puberty so he can serve as a eunuch? a) He will go through normal puberty and be indistinguishable from other male adults but will not be able to ejaculate. b) He will not develop secondary sexual characteristics and will be taller than average. c) He will not experience a change in penis size with puberty but he will develop normal secondary sexual characteristics. d) He will stop growing taller and not develop secondary sexual characteristics.

58. Luis is a male with a full beard, an increased risk of developing diabetes and osteoporosis, and menopausal symptoms, such as hot flashes. Which of the following is most likely true? a) Luis was castrated as a young child. b) Luis was chemically treated for prostate cancer. c) Luis has no interest in being sexual. d) Luis probably has a high voice.

59. Suodan has released more than the average teaspoon of semen during his last ejaculation. Which of the Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

following statements could be true? a) Suodan is a younger male. b) Suodan took a long time to become fully aroused. c) Suodan had not ejaculated for a long time. d) all of the above 60. Miguel had an elective surgery that reduced his likelihood of developing prostate cancer but caused him to lose muscle mass and gain weight. What procedure did Miguel likely undergo? a) castration b) a vasectomy c) adult circumcision d) prostate surgery 61. In North America today, what is chemical castration a common treatment for? a) repeat sexual offenders b) obesity c) antisocial personality disorder d) prostate cancer 62. Where are sperm produced? a) in the interstitial cells b) in the seminiferous tubules c) in the epididymis d) in the vas deferens 63. What was the purpose of castration of pre-pubescent males in Europe in 17th to 19th centuries? a) to alter development and enhance their operatic voices b) to maintain infertility of unwanted races c) to change the size of the male penis for sexual pleasure among the upper class d) all of the above 64. Long, thin, coiled tubes that are packed into the testes are called ____________. a) seminiferous tubules b) vas deferens c) seminal vesicles d) spermatic cords 65. What carries the sperm up through the lower abdominal wall (via the inguinal canal) and around the bladder to the prostate gland? a) vas deferens b) seminiferous tubules c) epididymis d) testes 66. What are the two tubular glands next to the prostate gland, near the ends of the vas deferens that secrete a sugary, alkaline fluid that constitutes up to 70 per cent of the male ejaculate? a) seminal vesicles b) seminiferous tubules Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) vas deferens d) testes 67. What secretes a thin, milky, alkaline fluid, resulting in a chemically safe environment to maintain sperm? a) prostate gland b) seminal vesicles c) vas deferens d) testes 68. What proportion of Canadian men can expect to be diagnosed with prostate cancer? a) 1 in 3 b) 1 in 5 c) 1 in 7 d) 1 in 9 69. What is the purpose of the fluid produced by the seminal vesicles? a) It comprises 70 percent of each ejaculation. b) It stops sperm from dying when they enter the female body. c) It comprises 30 percent of each ejaculation. d) It is the only chemical produced during sex with high salinity.

70. What is the main function of the prostate gland? a) to support erections b) to produce sperm c) to produce chemicals that provide an ideal environment for sperm to live d) to push sperm forward during ejaculation 71. Sperm cells account for about what percentage of the volume of a typical ejaculation? a) 0.5 per cent b) 1 per cent c) 5 per cent d) 7 per cent 72. What secretes a small amount of clear, slippery, alkaline fluid (pre-ejaculate, or pre-cum) that is believed to counteract the acidity of the urethra and prepare the urethra for the flow of seminal fluid? a) Cowper's glands b) Skene's gland c) vas deferens d) testes 73. The scrotum, the anus and surrounding perineal area, the buttocks, the wrists, the ears, the neck, the axillae (armpits), the breasts, and the nipples are all considered __________. a) erogenous zones b) non-sexual body parts c) areola d) secondary sex characteristics 74. What is the most common sexual position for humans?

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a) face-to-face b) rear-entry c) side-to-side d) straddling 75. Which anatomical structure helps prevent the penis from slipping out of the vagina during intercourse? a) the pubic symphysis b) the cervix c) the suspensory ligament d) the corpus cavernosa 76. Barb and Pedro find they often have to adjust their posture to avoid separation during coital sex, and they find it distracting. What is the most likely cause? a) Pedro is experiencing mild erectile dysfunction known as "the hinge effect." b) Barb's cervix and uterus did not elevate as part of the excitement phase of Master and Johnson's sexual response cycle. c) Either Pedro or Barb is experiencing a psychological dysfunction that is prohibiting them from finding the primal, reflexive nature of the sexual act. d) none of the above 77. What is the term for increased muscle tension during sexual response? a) hypotonia b) myotonia c) the hinge effect d) vasocongestion 78. Which of the following statements is true of vasocongestion? a) It cannot be triggered by sexual thoughts. b) It occurs in just a few seconds in both males and females. c) It can be slowed down by high alcohol levels or fatigue. d) It requires direct genital stimulation.

79. Gary is in the middle of a sexual activity and is experiencing nipple erection. Which phase of Masters and Johnson's sexual response cycle is he in? a) excitement b) plateau c) orgasm d) resolution 80. According to Masters and Johnson's sexual response cycle, which phase is the briefest? a) excitement b) plateau c) orgasm d) resolution 81. How is Kaplan's sexual response model different from that of Masters and Johnsons? a) It includes emotional intimacy. b) It includes a psychological component.

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c) It is true for people of all ages, whereas Masters and Johnson's model only applies to people under 45. d) It can account for multiple orgasms.

82. What is the benefit of Kaplan's three-stage sexual model? a) It acknowledges the importance of psychological processes in sexual response. b) It accounts for sexual dysfunctions and how they affect sexual satisfaction. c) It focuses on the unique experiences of women in long-term relationships. d) none of the above 83. Unlike women, what do men experience after orgasm? a) refractory period b) pleasure c) vasocongestion d) subsequent orgasm 84. According to a study of female university students, which of the following do most women experience? a) post-orgasmic hypersensitivity b) orgasm with penile penetration alone c) multiple orgasms d) a refractory period 85. Alex has just experienced multiple orgasms. Based on this information, which of the following assumptions can you make? a) Alex is more likely to be a female who just masturbated. b) Alex is more likely to be a male who just masturbated. c) Alex is more likely to be a female who just had a penile-vaginal intercourse. d) none of the above 86. Which of the following statements about orgasms is NOT true? a) Some women will never experience orgasms solely from sexual intercourse. b) Males are not able to experience multiple orgasms. c) Men who have had their prostate gland removed are more likely to experience multiple orgasms. d) Women do not experience a refractory period.

87. Tom has just experienced the third phase of Master and Johnson's sexual response cycle: orgasm. Which of the following statements is true? a) Tom is experiencing involuntary muscle spasms. b) The phase has only lasted a few seconds. c) Tom's blood pressure and heart rate have reached maximal levels. d) all of the above 88. Yurick is approaching his fiftieth birthday. Which of the following statements is true? a) Yurick becomes sexually aroused more quickly than when he was younger. b) Yurick has a higher level of testosterone than when he was younger. c) Yurick experiences a faster resolution phase. d) Yurick requires more stimulation to become erect.

89. Which of the following statements about orgasm is false?

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a) Descriptions of male and female orgasms are indistinguishable. b) Females never experience orgasm via sexual intercourse alone. c) Almost 100 per cent of men experience orgasm via sexual intercourse alone. d) About 90 per cent of women are orgasmic from some form of sexual stimulation.

90. Which statement is true regarding brain imaging studies during sexual arousal and orgasm? a) Heterosexual males show increased brain activation in cortical and subcortical areas in response to sexual stimuli, sexual arousal, and orgasm. b) Heterosexual females show increased brain activation in cortical and subcortical areas in response to sexual stimuli, sexual arousal, and orgasm. c) Males and females show similar patterns of brain activation in cortical and subcortical areas in response to sexual stimuli, sexual arousal, and orgasm. d) Males and females show different patterns of brain activation in cortical and subcortical areas in response to sexual stimuli, sexual arousal, and orgasm.

91. The suspensory ligament that attaches the base of the penis to the male's pubic symphysis does not ________. a) help to provide pulsatile pressure to the clitoris during coitus b) help achieve an erection c) act as a spring for the penis during erection and penetration d) help to prevent the penis from slipping out of the vagina (or other orifice) every time the male moves his body upward 92. The major function of the uterus is to ________. a) secrete vaginal lubrication during arousal b) store and release ova c) provide an area for fertilization to occur d) hold and nourish a developing fetus during pregnancy 93. "G-spot amplification" is performed by cosmetic surgeons by enlarging the G-spot region with collagen injections. Which of the following statements is true? a) The procedure purportedly enhances sexual arousal and response. b) The procedure may introduce various complications, including infections, scarring, and pain during intercourse. c) The procedure has a lack of data supporting the effectiveness. d) all of the above 94. ________ ________ is a condition in females where the vulvar vestibule is so sensitive that any touch to the area is painful and unpleasant. a) Inflammatory vestibulosis b) Provoked vestibulodynia c) Clitoral hypersensitivity d) Inflammatory labiaplasty 95. In males, the period of time following orgasm in which another orgasm cannot occur regardless of stimulation received is called ________. a) the refractory period b) the pause period c) the excitement period Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) the plateau period SHORT ANSWER QUESTIONS 1. The ________ in women has the same number of nerve endings as the glans of the penis.

2. Because of health and emotional consequences, female genital mutilation is internationally recognized as a violation of ________ ________.

3. The ________ is a membrane believed to protect the vagina early in life.

4. The vagina produces a chemical environment that is slightly ________.

5. There is growing evidence that the ________ ________ are the female equivalent of the male prostate gland.

6. The innermost layer of the uterus is the ________, which is shed with each menstrual cycle.

7. The two large spongy bodies that run the length of the penis are called the ________ ________.

8. The two involuntary muscles in male genitals that react to temperature changes are ________ around the scrotum and ________ around the spermatic cord and the testes.

9. Castrated males that often served in European choirs were called ________.

10. The third phase in Masters and Johnson's sexual response cycle is ________.

11. Angie had ________ to surgically make her labia minora smaller.

12. A doctor uses a ________ to view the cervix during a gynecological exam.

13. When uterine cells grow outside of the uterus, a woman has a condition called ________.

14. The ________ is the lower third, or neck, of the uterus.

15. Fertilization typically takes place in the ________ of the fallopian tube.

16. When a male is sexually excited, the neurotransmitter ________ ________ causes the smooth muscles in the walls of the arteries in the penis to dilate.

17. In ancient Greece, a statue of a male figure with a large ________ was meant to convey contempt or ridicule.

18. In the Middle Ages, it was believed that the ________ testicle made "boy" sperm and the ________ made "girl" sperm.

19. In both males and females, the ________ sphincter contracts during orgasm.

20. A difference in sexual response between males and females is that males experience a ________ ________ Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

after an orgasm, while females do not.

21. ________ is the term used for a non-erect penis.

22. A pregnancy in which the fertilized egg implants outside of the uterus is called ________ ________.

23. The proper term for sperm production is ________.

24. The ________ ________ release a clear fluid from the tip of the penis when a man is sexually aroused.

25. ________ refers to the pooling of blood in the blood vessels of a bodily region.

26. Fluid from the prostate gland makes up approximately ________ per cent of ejaculatory fluid.

27. ________ is a cosmetic surgery to reposition the remnants of the broken hymen or a small flap of vaginal skin to approximate the hymen.

28. ________ ________ ________ is a bacterial infection of the female reproductive organs that causes lower abdominal pain.

ESSAY QUESTIONS 1. Describe the sexual response cycle proposed by Masters and Johnson. Include details for each stage in the cycle.

2. Discuss differences in the refractory period of males and females.

3. Compare three parts of the female sexual anatomy that are similar in structure and function to parts of the male sexual anatomy.

4. Describe the arguments of those who are for and against male circumcision.

5. What are three explanations for the presence of pubic hair on humans?

6. Why is the hymen sometimes considered to be a controversial topic?

7. How does age affect sexual response in males and females?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. a 2. a 3. a 4. c 5. a 6. d 7. a 8. a 9. a 10. a 11. a 12. a 13. d 14. a 15. d 16. a 17. b 18. a 19. d 20. a 21. d 22. a 23. a 24. a 25. a 26. a 27. a 28. c 29. d 30. a 31. a 32. d

33. b 34. a 35. b 36. a 37. a 38. a 39. a 40. c 41. b 42. a 43. d 44. a 45. b 46. b 47. d 48. a 49. c 50. a 51. a 52. a 53. a 54. b 55. b 56. c 57. b 58. b 59. d 60. a 61. d 62. b 63. a 64. a

65. a 66. a 67. a 68. c 69. a 70. c 71. b 72. a 73. a 74. a 75. c 76. a 77. b 78. c 79. a 80. c 81. b 82. a 83. a 84. a 85. a 86. b 87. d 88. d 89. b 90. c 91. b 92. d 93. d 94. b 95. a

SHORT ANSWER QUESTIONS 1. clitoris 2. human rights 3. hymen 4. acidic 5. Skene's glands 6. endometrium 7. corpora cavernosa 8. dartos; cremaster 9. eunuchs 10. orgasm

11. labiaplasty 12. speculum 13. endometriosis 14. cervix 15. infundibulum 16. nitric oxide 17. penis 18. right; left 19. rectal 20. refractory period

21. Flaccid 22. ectopic pregnancy 23. spermatogensis 24. Cowper's glands 25. Vasocongestion 26. 30 27. Hymenoplasty 28. Pelvic inflammatory disease

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ESSAY QUESTIONS 1. Stage 1: Excitement; characterized by vasocongestion in both males and females.

Stage 2: Plateau; heart rate, blood pressure, and myotonia increase in both sexes, testicular engorgement and elevation become more pronounced in males, and the uterus becomes increasingly elevated in females.

Stage 3: Orgasm; the briefest stage, characterized by muscle spasms in both males and females and ejaculation in males.

Stage 4: Resolution; sexual organs return to their unaroused state.

2. Males usually experience a refractory period, which can last from a few minutes to days. The length of time depends on many factors, such as age (younger men have shorter refractory periods than older men do) and frequency of previous sexual activity (the less frequent, the shorter the refractory period). Females, on the other hand, do not have a refractory period and can more readily experience multiple orgasms. Masters and Johnson (1966) found that orgasms that occur in close succession to one another do not differ physiologically from one another, although the second and subsequent ones typically require less stimulation than the first.

3. Answers will vary but examples include the following: 1. The ovaries are similar to the testes.

2. The Skene's glands are similar to the prostate.

3. The clitoris is similar to the glans of the penis.

4. Proponents of routine circumcision have documented health benefits including the following: a decrease in the incidence of infant and childhood urinary tract infections, a decrease in some sexually transmitted infections (including HIV, the virus that causes AIDS), a decrease in the incidence of adult penile cancer, and a decrease in genital wart infections (Dickerman, 2007). In addition, circumcision can prevent or correct a painful condition called phimosis, in which the penile foreskin is too tight to retract. Other proponents support it because of religious doctrine.

Those who oppose routine circumcision, however, indicate that the procedure entails a number of risks, including hemorrhage, infection, shock, penile mutilation, and psychological trauma; in rare cases, death can also occur. In addition, the procedure is painful. Male infants circumcised without anesthetic were found to exhibit heightened pain responses to vaccinations four to six months post-circumcision.

5. First, pubic hair is believed to play a role in sexual communication through pheromonal signalling, by helping to dissipate volatile compounds (Pagel & Bodmer, 2003). Second, it is assumed to provide protective padding during the friction of intercourse (Ramsey, Sweeney, Fraser, & Oades, 2009). Third, it visually signals sexual maturity. Despite these functions, women have been removing their pubic hair since at least the times of ancient Egypt and Greece, when a lack of pubic hair was likely considered sexually attractive.

6. The hymen and its rupture at first intercourse are a controversial topic. In some cultures that condemn coital sex before marriage, the presence of an intact hymen has been taken as sole evidence of virginity, over and above the word of the woman. As such, some future husbands insist on a pelvic examination to "prove" the woman's virginity before marriage. In some countries, some women seek hymenoplasty, or hymen reconstruction surgery, to hide the fact they no longer have an intact hymen.

7. In general, sexual response decreases with age. Arousal takes longer and the intensity of all aspects of one's sexual response is dampened. In females, the amount of vaginal lubrication is reduced and the walls of the vagina become less flexible. In males, erections take longer to occur and require more stimulation, and the degree of Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

firmness is less than it is in younger males.

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CHAPTER 5

Sex Hormones and Human Sexuality MULTIPLE CHOICE QUESTIONS 1. What provide(s) a connection between the nervous system and the reproductive system? a) fibroids b) hormones c) the spinal cord d) neurotransmitters 2. Why is the word "hormone" misleading? a) The word "hormone" is derived from the Greek word meaning "male needs," but we now know that hormones are expressed by both males and females. b) The word "hormone" is derived from the Greek word meaning "to grow," but we now know that hormones also affect our bodies in other ways as well. c) The word "hormone" is derived from the Greek word meaning "to arouse," but we now know that hormones are related to many other functions in addition to arousal. d) The word "hormone" is derived from the Greek word meaning "in the body," but we now know that hormones originated in the brain.

3. What is uniquely true of all endocrine organs? a) They all release sex hormones. b) They all release hormones. c) They all release chemicals. d) They are all affected by hormones.

4. Which of the following is NOT a hormone associated with sexual development, reproduction, and/or behaviour? a) progesterone b) testosterone c) estradiol d) prolactin 5. In both men and women, what must be produced before estrogens can be synthesized? a) cortisol b) aldosterone c) androgens d) corticosterone 6. The "HPG axis" is an abbreviation for __________. a) hypothalamic-pituitary-gonadal axis b) humoral-pituitary-glandular axis c) hypothalamic-parietal-gonadal axis d) humoral-parietal-gonadal axis

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7. A hormone is considered a sex hormone if it has which of the following characteristics? a) if the amount produced differs between males and females b) if it is essential for reproduction c) if it is only produced by one of the two sexes d) if it plays a role in sexual maturity and reproduction 8. A surge of which sex hormone triggers ovulation by rupturing the follicle that contains an ovum? a) the luteinizing hormone b) the follicle-stimulating hormone c) estrogen d) progesterone 9. Reproductive cycles begin at which point in the life cycle? a) during fetal development b) at birth c) at puberty d) at about age 18 10. When during her cycle does a woman produce the most luteinizing hormone? a) just prior to menstruation b) during menstruation c) after ovulation d) during ovulation 11. Which sex hormone causes the maturation of an egg? a) estrogen b) luteinizing hormone c) follicle-stimulating hormone d) progesterone 12. In the luteal phase of the menstrual cycle, which sex hormone increases the complexity of the endometrium? a) progesterone b) estrogen c) androgen d) the luteinizing hormone 13. __________ may be strongly linked with libido and desire in males, and their insufficiency may cause a decrease in sexual desire in females. a) Progestogens b) Androgens c) The luteinizing hormone and follicle-stimulating hormone d) Estrogens 14. What is the role of the luteinizing hormone in creating sperm? a) It stimulates the testes which them produce sperm. b) It stimulates the pituitary and the pituitary produces testosterone, which then triggers sperm production. c) It binds to cells in the testes, causing them to secrete testosterone, which stimulates the production of sperm. d) It stimulates the production of the follicle-stimulating hormone, which binds to cells in the testes causing them Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

to produce testosterone, which then results in the production of sperm.

15. In both sexes, what physical changes occur at puberty due to increased levels of estrogens? a) cessation of the growth of the long bones b) growth of pubic and axillary hair c) increase in fat tissue d) increase in muscle mass 16. What is the humans' main sex organ? a) the uterus in females and the testes in males b) the brain in females and the testes in males c) the ovaries in females and the penis in males d) the brain in both males and females 17. Changes to the __________, due to exposure to specific hormones prior to birth, leads to male/female differentiation in the brain after birth. a) hypothalamus b) cerebral cortex c) pituitary gland d) thalamus 18. If a male is born with XY chromosomes but without a penis, the child is most likely to have a happy outcome if the parents do which of the following? a) Raise the child as a male. b) Raise the child as a female. c) Do not decide the child's gender for the child. d) Raise the child as asexual, discouraging the adoption of either male or female tendencies.

19. In men and women, where are androgen and estrogen receptors located? a) They are distributed only in the brain. b) They are located only in the hypothalamus. c) They are located only in the gonads. d) They are dispersed widely throughout genital and neural tissues.

20. Subjective sexual arousal in men and women is influenced by which hormones? a) the luteinizing hormone and follicle-stimulating hormone b) androgens and estrogens c) androgens d) estrogens 21. The administration of which hormones have been used to treat sexual dysfunction in both men and women? a) androgens b) estrogens c) the luteinizing hormone and follicle-stimulating hormone d) progestogens 22. What happens to a developing embryo if the SRY gene is not switched on? a) Ovaries will develop.

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b) The indifferent gonads will remain ambiguous. c) Testes will develop. d) Secondary sexual characteristics will not develop in males.

23. In some regions of North Eastern Africa, why is circumcision performed? a) because of the belief that the foreskin is unclean b) because of the belief that to be male is to endure pain c) because of the belief that all children are born part male and part female and the foreskin is the female part on an otherwise male child d) to differentiate sexually mature males from sexually immature males 24. In some regions of North Eastern Africa, why is the clitoris is removed? a) because of the belief that women should not experience sexual pleasure b) because of a belief that a female is born with some male parts that need to be removed for her to be fully female c) in preparation for the pain of childbirth d) to show that a female is ready for marriage 25. Increase in vasopressin is related to which of the following? a) increased aggression b) decreased aggression c) increased affiliation d) increased lactation 26. In humans, where are pheromones primary produced? a) apocrine glands b) external genital area c) pituitary gland d) thyroid gland 27. Researchers have repeatedly found that women prefer the smell of a t-shirt worn by what kind of man? a) a physically strong man b) a man who is genetically similar to them c) a man who is genetically different from them d) a man who produces more testosterone 28. An example of an endocrine organ is __________. a) a testis b) the vagina c) the heart d) the penis 29. What do the testes and the pituitary have in common? a) They are located in a similar part of the body. b) They are made from similar cells. c) They don't grow or change with age. d) They are both endocrine organs.

30. Hormones are released into __________.

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a) the synapses b) the blood c) the muscles d) the spinal cord 31. All of the following are hormones linked to sexual behaviour or development EXCEPT __________. a) insulin b) estradiol c) vasopressin d) testosterone 32. If a hormone level is too low, a feedback signal will tell the __________ to produce more. a) heart b) endocrine organs c) penis d) vagina 33. In which season are women MOST likely to become pregnant? a) spring b) summer c) fall d) winter 34. In which season are women LEAST likely to become pregnant? a) spring b) summer c) fall d) winter 35. There are __________ common patterns for the development and regulation of the reproductive cycles in humans. a) five b) two c) three d) four 36. Polly's reproductive cycles will begin to develop at __________. a) birth b) age eight c) puberty d) adulthood 37. The menstrual cycle involves the buildup and shedding of the __________. a) endometrium b) ova c) follicles d) uterus

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38. Estrogen has stimulated the growth of Ursula's uterine lining. Ursula is in the __________ phase of her menstrual cycle. a) luteal b) follicular c) premenstrual d) menses 39. Which of the following phases occurs before ovulation during the menstrual cycle? a) the follicular phase b) the luteal phase c) the premenstrual phase d) the menses phase 40. Which phase of the menstrual cycle is MOST closely associated with increased progesterone? a) menses b) follicular phase c) luteal phase d) dormant phase 41. Days 0 through 7 of the menstrual cycle comprise __________. a) menses b) the luteal phase c) the proliferative phase d) the secretory phase 42. Estrogen levels rise rapidly during the __________ phase of the menstrual cycle. a) follicular b) luteal c) secretory d) premenstrual 43. The luteinizing hormone levels are highest during __________. a) menses b) the luteal phase c) ovulation d) pregnancy 44. Which area of the brain is extremely sensitive to hormones during gestational development? a) the hypothalamus b) the cerebellum c) the reticular formation d) the lateral geniculate nucleus 45. Some researchers have suggested that variations in sexual orientation may result from different exposures to __________ during a critical developmental period of the sexual brain. a) genes b) hormones c) behaviours Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) social norms 46. Max was born female but is a transgender man. Before he began receiving gender-affirming hormones, his hormone levels would have been similar to __________. a) a straight woman b) a gay man c) a lesbian d) a transgender woman 47. The sense of sexuality is the result of __________. a) nature alone b) nurture alone c) a combination of nature and nurture d) either nature or nurture — it depends on the person 48. Chris has an XX chromosome pattern and congenital adrenal hyperplasia. Chris will MOST likely identify as __________. a) female b) male c) transsexual d) bisexual 49. Where in a man's body can estrogen receptors be found? a) in the testes only b) in the breast tissue only c) throughout the body d) in the brain only 50. Where in a woman's body can testosterone receptors be found? a) in the ovaries only b) in the breast tissue only c) throughout the body d) in the brain only 51. Which of the following hormones can increase genital sexual arousal in both men and women? a) testosterone b) estrogen c) progesterone d) oxytocin 52. Marg is a menopausal woman. What hormone can she take to improve vaginal wall thickness and elasticity, lubrication, and vasocongestion? a) testosterone b) progesterone c) oxytocin d) estradiol 53. Low levels of which hormone are sometimes found to be linked to low sexual desire in women?

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a) androgens b) progesterone c) oxytocin d) vasopressin 54. Which hormone is the major androgen in humans? a) progesterone b) estradiol c) testosterone d) oxytocin 55. Mark and Tina are both receiving the same hormone therapy to treat low levels of sexual desire. What does this therapy most likely consist of? a) progesterone b) oxytocin c) androgens d) estrogen 56. Sexual activity increases levels of which hormone in women? a) testosterone b) estrogen c) progesterone d) vasopressin 57. Amy and Megan are travelling the world together. They are extremely close friends but do not have a sexual relationship with each other. Which hormone level is MOST likely to increase as a result of this intimate relationship? a) estrogen b) progesterone c) estradiol d) testosterone 58. In women, sexual arousal leads to a decrease in __________. a) cortisol b) androgens c) estrogen d) progesterone 59. Ella has just started a new sexual relationship. As a result of sexual activity, Ella is producing more __________. a) cortisol b) estradiol c) oxytocin d) vasopressin 60. Greg is taking part in an experiment where he is being asked to imagine sexual activity. What hormone changes will the researchers likely detect in Greg's blood as a result of this experiment? a) an increase in testosterone Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) a decrease in vasopressin c) an increase in cortisol d) a decrease in estrogen 61. Cora is looking forward to having sex with her boyfriend tonight. Her anticipation is likely resulting in an increase in which hormone? a) estrogen b) progesterone c) testosterone d) oxytocin 62. Alice is viewing erotic stimuli as a part of an experiment. Which hormone's level is likely to increase in her bloodstream as a result of the experiment? a) estradiol b) testosterone c) estrogen d) progesterone 63. Which hormone is strongly related to childbirth and lactation? a) estrogen b) progesterone c) oxytocin d) cortisol 64. Maria has just had a baby and is breastfeeding. What hormone's level will likely be high in her bloodstream? a) oxytocin b) progesterone c) estrogen d) cortisol 65. The higher the level of __________, the greater the level of maternal care in animals. a) oxytocin b) progesterone c) estrogen d) cortisol 66. Which hormone is linked to both cardiovascular regulation and social/sexual functions? a) oxytocin b) vasopressin c) cortisol d) progesterone 67. Which hormone seems to amplify the subjective sense of arousal in women? a) oxytocin b) estrogen c) androgens d) cortisol

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68. Which hormone may be responsible for the sense of contentment a woman feels after an orgasm? a) estrogen b) oxytocin c) vasopressin d) the luteinizing hormone 69. Helen has just had an orgasm and feels very content. This is most likely because her orgasm led to the release of __________. a) progesterone b) estrogen c) estradiol d) oxytocin 70. Which hormone may help people overcome their natural avoidance of being in close proximity to others? a) oxytocin b) progesterone c) cortisol d) vasopressin 71. In an experiment, Talia was administered a hormone, shown images of faces, and asked to rate each face on attractiveness and trustworthiness. She rated faces as more trustworthy than did Ali, who was not administered a hormone before seeing the images. What hormone was Talia most likely administered? a) progesterone b) oxytocin c) estradiol d) vasopressin 72. All of the following have been linked to the feeling of "being in love," EXCEPT __________, a) estrogen b) dopamine c) oxytocin d) vasopressin 73. What do the apocrine glands produce? a) estrogen b) testosterone c) pheromones d) cortisol 74. Dr. Meyer is studying pheromones in humans and needs to collect sweat samples from study participants.

Which area of the human body would NOT provide samples containing pheromones? a) the area under the breasts b) the armpits c) the pubic area d) the area behind the ears 75. All of the following are categories of pheromones in humans, EXCEPT __________. a) food source Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) territorial c) sexual d) maternal-infant 76. Some researchers believe that being able to detect someone's __________ may provide an important survival benefit. a) estrogen b) major histocompatibility complex compounds c) the luteinizing hormone d) testosterone 77. Marsha just had a hot flash. She is most likely experiencing __________. a) menopause b) perimenopause c) premenstrual syndrome d) ovulation 78. Once menstruation has not occurred for __________ months, a woman is considered to be menopausal. a) 6 b) 9 c) 12 d) 15 79. The decline in libido that occurs in perimenopause and menopause is linked to a decline in __________. a) estradiol b) vasopressin c) progesterone d) oxytocin 80. Low levels of __________ may produce low libido in post-menopausal women. a) estradiol and testosterone b) testosterone and progesterone c) progesterone and oxytocin d) oxytocin and estradiol 81. Androgen therapy to increase libido would be most effective for a woman who __________. a) has never been pregnant b) has had ovaries removed c) has had more than four children d) began menstruating before the age of 13 82. Maggie is menopausal and has low libido. She is considering whether androgen therapy will help her. Her doctor says there is a good chance it will because __________. a) Maggie also has never been pregnant b) Maggie also had her ovaries removed c) Maggie also had a tubal ligation d) Maggie also had a Caesarean section

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83. Andropause is caused by a decline in __________. a) cortisol b) pheromones c) testosterone d) vasopressin 84. All of the following changes are related to reduced testosterone levels in older men, EXCEPT __________. a) breast development b) loss of muscle mass c) hair loss d) increased visceral fat 85. What percentage of older men experience sexual problems that last for more than six months? a) 6.2 per cent b) 17.7 per cent c) 27.2 per cent d) 37.9 per cent 86. Which of the following is not considered to be a secondary sex characteristic? a) testes b) facial hair c) voice pitch d) breast development 87. In biological males, what binds to cells in the testes which causes them to secrete testosterone? a) follicle stimulating hormone b) luteinizing hormone c) androgens d) sperm 88. Participants were given doses of oxytocin by nasal spray so that it could quickly enter the brain. Which statement is true? a) the participants were instantly physiologically aroused b) the participants reported having an orgasm c) the participants reported increased levels of perceived genital arousal d) the participants reported that they felt nothing 89. At what age does a woman have the highest level of circulating testosterone in their blood? a) 20 b) 40 c) 50 d) 60 90. ________ are smells that trigger a social response in members of the same species. a) Hormones b) Pheromones c) Progesterones d) Estrogens Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

SHORT ANSWER QUESTIONS 1. The word "hormone" is derived from the Greek word ormao meaning to "__________" or "excite".

2. A part of the body that releases hormones is known as a(n) __________ organ.

3. Hormones are regulated by __________ __________ that indicate the difference between the actual level of a hormone and the expected level of that hormone.

4. In XY embryos, male characteristics begin to develop when the __________ gene "switches on."

5. Sexual arousal decreases the amount of the stress hormone __________.

6. The hormone best known for its involvement in fluid balance and cardiovascular and autonomic regulation is __________.

7. The period of time when a woman's hormone levels wax and wane is referred to as the __________ period.

8. The main regions in the brain that are associated with hormone production are the pituitary and the __________.

9. A woman's body prepares for the implantation of an egg during the __________ phase of her menstrual cycle.

10. Estrogen levels vary across the menstrual cycle and are at their highest level during __________.

11. After ovulation, in the luteal phase, __________ increases the complexity of the endometrium.

12. Paul has congenital adrenal hyperplasia. Paul's sex chromosomes are __________ .

13. Another term for "sex drive" is "__________."

14. Bonding is associated with the hormone __________.

15. Pheromones are produced by the __________ glands.

16. MHC stands for __________ __________ __________.

17. After 12 months without menstruation, a woman is considered __________.

18. Women with low sexual desire respond best to androgen therapy if they have previously had their __________ removed.

19. Allen's testes produce no hormones. Allen has __________.

20. A syndrome in men characterized by low libido, increased visceral fat, decreased energy, and increased irritability is referred to as __________.

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21. Genital organs that are directly involved in reproduction, such as the testes and ovaries, are called ________ sex characteristics.

22. ________ ________ ________ is a mood disorder associated primarily with the luteal phase of the menstrual cycle and characterized by feelings of anxiety, anger, and depression.

23. The second phase of the menstrual cycle, during which a mature egg is released from an ovary is called ________.

24. The ________ is considered the "master gland" that controls the function of most other endocrine glands.

25. The glands (ovaries and testes) in which gametes (eggs and sperm) are produced are specifically termed ________.

26. ________ are smells that trigger a social response in members of the same species.

27. The menstrual cycle repeats approximately every ________ days in human females.

28. The luteal phase of the menstrual cycle is also know as the ________ phase.

29. The HPG axis is a complex set of direct influences and feedback interactions among the pituitary gland, the gonads, and the ________.

30. Rising estrogen levels triggers a surge of ________ ________ which leads to ovulation.

ESSAY QUESTIONS 1. Compare and contrast the roles of the luteinizing hormone and follicle-stimulating hormone in reproduction in males and females 2. Discuss the research evidence related to the interaction between hormones and mood in women.

3. Compare the views on the origin of sexual identity in Western cultures and in the cultures of regions of northeastern (Sahel) Africa.

4. Explain how pheromones are produced and describe two ways in which pheromones from one person are thought to affect the behaviour or physiological processes in another individual.

5. Describe one hormonal change and its effect due to aging in men, and one hormonal change and its effect due to aging in women.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. c 3. b 4. d 5. c 6. a 7. d 8. a 9. c 10. d 11. c 12. a 13. b 14. c 15. a 16. d 17. a 18. c 19. d 20. b 21. a 22. a 23. c 24. b 25. c 26. a 27. c 28. a 29. d 30. b

31. a 32. b 33. d 34. b 35. b 36. c 37. a 38. b 39. a 40. c 41. a 42. a 43. c 44. a 45. b 46. a 47. c 48. b 49. c 50. c 51. a 52. d 53. a 54. c 55. c 56. a 57. d 58. a 59. b 60. a

61. c 62. a 63. c 64. a 65. a 66. b 67. a 68. b 69. d 70. a 71. b 72. a 73. c 74. d 75. a 76. b 77. b 78. c 79. a 80. a 81. b 82. b 83. c 84. c 85. a 86. a 87. b 88. c 89. a 90. b

SHORT ANSWER QUESTIONS 1. arouse 2. endocrine 3. feedback signals 4. SRY 5. cortisol 6. vasopressin 7. perimenopausal 8. hypothalamus 9. follicular 10. ovulation 11. progesterone

12. XX 13. libido 14. oxytocin 15. apocrine 16. major histocompatibility complex 17. menopausal 18. ovaries 19. hypogonadism 20. andropause 21. primary

22. Premenstrual dysphoric disorder 23. ovulation 24. pituitary 25. gonads 26. Pheromones 27. 28 28. secretory 29. hypothalamus 30. luteinizing hormone OR LH

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ESSAY QUESTIONS 1. The follicle-stimulating hormone (FSH) and luteinizing hormone (LH) play major roles in reproduction.

In females, FSH stimulates the growth and maturation of the Graafian follicle and induces enzymes that are required to convert androstenedione to estradiol. LH acts on the cells of the ovary to stimulate the synthesis of steroid hormones, notably androstenedione.

LH is also critical for ovulation, as an LH surge is necessary for rupture of the follicle that contains the egg, and it stimulates the growth of the corpus luteum.

In males, LH activates sperm-producing cells in the testes and the growth of the testes, while FSH plays an important role in driving the early stages of spermatogenesis.

2. Many women tend to report negative mood more commonly during the luteal phase than during the follicular phase or ovulation. Indeed, some mood-related disorders, such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), have been named in relation to phases of the menstrual cycle.

Depression and anxiety can affect desire for, performance of, and experience of sex. Despite reports of a link between menstrual phase and self-reported mood, however, a direct relationship between ovarian hormones and mood is not well established, even in cases of PMDD. For example, studies on the effects of hormones on mood in postmenopausal women have revealed contradictory results: estrogen administration has been shown to reduce, increase, or have no significant effect on negative mood. Progesterone has also been proposed as a treatment, but it has been found to be ineffective for premenstrual mood disturbances. In other studies of randomly recruited, non-help-seeking women, no correspondence was observed between either menstrual phase or ovarian steroids and mood. Rather, it was psychosocial factors—stress and physical health—that were highly correlated with mood. There is no doubt, however, that many women do suffer cyclic mood changes that can significantly impair their quality of life.

3. In Western cultures gender is assumed to be present at birth, so gender is not made but "born." In West African culture gender is assumed to be "made" because children are supposedly born able to assume either gender. The males have the female foreskin that must be removed and the females have the male clitoris that must be removed.

4. In humans, pheromones are produced by apocrine glands, primarily in the axilla (armpit) and pubic areas that become active with puberty. The synthesis of pheromones in both women and men is controlled by androgens.

One way that pheromones from one person can affect the behaviour of another is the phenomenon of one woman's pheromones affecting the menstrual cycle of another woman. Major histocompatibility complex (MHC) compounds convey genetic information about a female, which may make her more appealing to genetically compatible males.

5. In men, testosterone levels decline with age, which could lead to low libido. These decreasing levels of testosterone may lead to a clinical syndrome called "andropause." Symptoms associated with this syndrome include low libido; decreased strength, energy, and/or stamina; increased irritability; and a decreased enjoyment of life.

In women, estradiol levels decline with age, which could also lead to low libido and loss of fertility. The decreasing levels of estradiol eventually leads to the cessation of menstruation, called menopause.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 6

Pregnancy and Childbirth MULTIPLE CHOICE QUESTIONS 1. Prior to fertilization, approximately how many sperm will reach the egg? a) 200 to 300 b) 2,000 to 3,000 c) 20,000 to 30,000 d) 2,000,000 to 3,000,000 2. What physiological structure provides nourishment, transfers oxygen, and produces hormones that help a fetus thrive during pregnancy? a) the placenta b) the umbilical cord c) the amniotic sac d) the uterine walls 3. Which of the following must occur first for fertilization to happen? a) ovulation b) sperm entering the vagina c) sperm entering the correct fallopian tube d) at least 200 to 300 sperm surviving the trip up the fallopian tube 4. Where in a woman's body does fertilization of an egg take place? a) the fallopian tubes b) the uterus c) the ovaries d) the vagina 5. What is the best-known sign of pregnancy? a) a rise in basal body temperature b) the cessation of menstruation c) the detection of HCG d) breast tenderness 6. Maria is pregnant. The first day of her last menstrual period was 15 of March. Using Nägele's rule, what is the expected delivery date of Maria's baby? a) 12 December b) 18 December c) 22 December d) 26 December 7. A doctor notices that the area between Pam's uterus and cervix is soft. What does this most likely indicate?

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a) Pam is pregnant. b) Pam is ovulating. c) Pam is menstruating. d) Pam is infertile.

8. Zhang is pregnant with one baby, and her last menstrual period was 265 days ago. Based on a normal gestation period, when should she deliver her baby? a) in 10 days b) in 15 days c) in 20 days d) in 25 days 9. An ultrasound reveals for the first time a faint, tiny umbilical cord in Anja's unborn baby. Anja is likely in which month of her pregnancy? a) first b) second c) third d) fourth 10. Ann is a primiparous woman who has just felt her fetus move for the first time. Ann is likely how far into her pregnancy? a) 13 weeks b) 16 weeks c) 19 weeks d) 22 weeks 11. Which of the following is a reason for a woman to abstain from intercourse during pregnancy? a) It is very early in her pregnancy and intercourse can cause miscarriage. b) It is late in her pregnancy and semen can rupture the amniotic sac. c) She is midway through her pregnancy and an orgasm can cause preterm labour. d) The amniotic sac has ruptured at the start of labour and sexual activity can increase the risk of fetal infection.

12. Which type of primary caregiver during birth is associated with the highest birth satisfaction rates in Canada? a) an obstetrician b) a family doctor c) a nurse practitioner d) a midwife 13. Hillary has been in labour for three hours. In which stage is she most likely? a) stage 1 b) stage 2 c) stage 3 d) stage 4 14. During the first stage of childbirth, what is the purpose of contractions? a) to dilate the cervix Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) to push the fetus from the birth canal out of the woman's body c) to push the fetus from the uterus and into the birth canal d) to break the amniotic sac, allowing the child to be born 15. Which of the following is true about episiotomies? a) They have no effect on whether or not a woman will have tearing due to childbirth. b) They greatly reduce the likelihood of infection due to tearing during childbirth. c) They speed up the birth process, which is beneficial to the fetus. d) They are more common in the United Kingdom than in North America.

16. Claudette is in labour, and her doctor has determined that her baby is in the breech position. Which of the following is Claudette's doctor likely to perform? a) vaginal delivery b) vacuum extraction c) C-section d) episiotomy 17. Approximately what percentage of obstetricians would choose a C-section for themselves or their partners? a) 42 per cent b) 28 per cent c) 17 per cent d) 8 per cent 18. What is the strongest predictor of paternal depression following the birth of a child? a) having a partner with maternal depression b) having a stressful work environment c) having two or more children in the home d) having a history of depression prior to the birth of the child 19. What does Health Canada recommend for the optimal duration of exclusive breastfeeding? a) three months b) six months c) twelve months d) two years 20. Which of the following can be caused by oxytocin? a) postpartum depression b) sexual arousal during breastfeeding c) dyspareunia d) amenorrhea 21. What is the most common reason for miscarriage? a) a defect in the embryo or fetus b) maternal substance use c) too few pregnancy hormones d) too many pregnancy hormones Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

22. Which of the following is responsible for 6 per cent of all pregnancy-related maternal deaths? a) spontaneous abortions b) ectopic pregnancies c) Rh incompatibility d) anoxia 23. What hormone is released in a postpartum woman's body to stimulate the production of milk? a) prolactin b) oxytocin c) estrogen d) progesterone 24. Reduced sexual interest in lactating mothers may be related to changes in which of the following hormone(s)? a) progesterone b) estrogen c) androgens d) prolactin 25. Laurie and Hannah had their babies on the same day 12 weeks ago and have both decided to wait at least three years before having another child. Laurie is breastfeeding and Hannah is bottle feeding. Which is most likely to be true? a) Laurie is more likely than Hannah to become pregnant soon because the hormones related to breastfeeding encourage ovulation. b) Laurie is less likely than Hannah to become pregnant soon because breastfeeding releases hormones that discourage ovulation. c) Laurie and Hannah are equally likely to become pregnant if neither uses birth control. d) Hannah is less likely than Laurie to become pregnant soon because she has no sex drive; the sex drive is slow to return when you bottle-feed.

26. Bethany had a miscarriage. What is the likelihood that she will experience depression or anxiety as a result? a) 10 per cent b) 25 per cent c) 50 per cent d) 75 per cent 27. Sandra had an alpha-fetoprotein (AFP) test done in the second trimester of her pregnancy, which revealed that her AFP levels were elevated. Which of the following can cause the appearance of elevated AFP levels? a) fetal alcohol syndrome b) neural tube defects c) Down's syndrome d) Tay-Sachs disease 28. Which of the following procedures puts the pregnancy at greatest risk for miscarriage? a) chorionic villi sampling b) amniocentesis Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) tests for alpha-fetoprotein d) chorionic villi sampling and amniocentesis have a similar risk level 29. Dr. Klein is most likely to recommend an amniocentesis to which of the following patients? a) Pauline, who is 28 years old and is having her first child b) Kasia, who is 40 years old and is having her second child c) Lisa, who is 36 years old and has a son with Down's syndrome d) Samirah, who is 29 years old and is having her third child 30. Over the past 20 years, which of the following is attributed to a change in rates of low birth-weight babies? a) an increase in the use of assisted reproductive technology that has resulted in more multiple births b) an increase in the use of assisted reproductive technology that has resulted in fewer multiple births c) improved prenatal care has caused a decrease in low birth weight babies by improving maternal health d) improved prenatal care has caused an increase in low birth weight babies by increasing the odds that a child with a condition that may cause low birth weight will survive pregnancy.

31. Which of the following babies would be considered to be at greatest risk of health and developmental challenges? a) a baby born at 30 weeks who is the normal weight for a baby at 30 weeks b) a baby born at 31 weeks who weighs the normal weight for a baby born at 29 weeks c) a baby born at 32 weeks who is the normal weight for a baby born at 33 weeks d) a baby born at 40 weeks that weighs what is average for a baby born at 38 weeks 32. Which of the following most accurately reflects the trend in infertility cases? a) Infertility resulting from men is more common than from women; in 60 per cent of cases it is the man who is infertile. b) Infertility resulting from men and women is roughly equal, at 40 per cent each. c) Infertility resulting from women is more common than from men; in 60 per cent of cases it is the woman who is infertile. d) There are no obvious trends in the data.

33. When is a male considered to have low sperm count? a) when he is producing less than 10 million sperm per millilitre b) when he is producing less than 20 million sperm per millilitre c) when he is producing less than 40 million sperm per millilitre d) when he is producing less than 80 million sperm per millilitre 34. What did a survey of psychological impacts of infertility on couples find? a) normal marital satisfaction b) normal sexual satisfaction c) normal levels of conflict in the marriage d) normal self-esteem levels 35. Which of the following is NOT prohibited under Canada's Assisted Human Reproduction Act? a) buying and selling human embryos b) research using embryos Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) human cloning d) pre-selecting embryos based on sex 36. Why is a clone not 100 per cent identical to its parent? a) The clone receives some genetic material from the mitochondria of the original egg. b) Genetic mutations are common during the cloning process. c) The clone receives half of its DNA from each parent. d) The clone is 100 per cent identical to its parent.

37. Diego and Sofia are experiencing fertility issues. Which method of assisted reproductive technology is most likely to result in a successful pregnancy? a) using thawed embryos from donor eggs b) using thawed embryos from Sofia's eggs c) using fresh embryos from Sofia's eggs d) using fresh embryos from donor eggs 38. Emilie and Philippe are at the fertility clinic and have chosen the method known as AID. Why might they have chosen this particular method? a) Emilie has obstructed fallopian tubes. b) Philippe has cystic fibrosis. c) Emilie has Turner's syndrome. d) Philippe's sperm count is normal, but they are having trouble conceiving a child.

39. Sarah and Matthew have opted for artificial insemination in an attempt to conceive a child. They have chosen a method where the sperm will fertilize the egg naturally in Sarah's body. Which method did they choose? a) intracervical insemination b) intrauterine insemination c) gamete intrafallopian transfer d) zygote intrafallopian transfer 40. Jasmine is hoping to become pregnant. Assuming a 28-day cycle, on what day of her menstrual cycle is she most likely to ovulate? a) day 10 b) day 14 c) day 18 d) day 22 41. How far can sperm swim in one hour? a) 0.5 to 1 cm b) 2 to 5 cm c) 1 to 3 cm d) 3 to 4 cm 42. The zona pellucida is part of the __________. a) egg b) placenta Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) sperm d) fallopian tube 43. For every 100 XX chromosome zygotes __________ XY zygotes are conceived. a) 95 b) 101 c) 106 d) 110 44. Katie thinks she is pregnant because she hasn't had a period in eight weeks. However, when she takes a pregnancy test, it is negative. What is a likely reason for the negative result? a) Stress can cause a "missed" period. b) It's too early into the pregnancy for a test to be conclusive. c) She is expecting a boy. d) She is vegetarian.

45. The corpus luteum secretes which hormone? a) testosterone b) progesterone c) estrogen d) oxytocin 46. How long after conception can a practitioner begin to feel a soft spot between the uterine body and the cervix (Hegar's sign)? a) two weeks b) one month c) six weeks d) two months 47. Jamie is at the doctor and about to hear her baby's heartbeat for the first time with a stethoscope. She has been at the doctor earlier in the pregnancy but it was too soon to hear the heartbeat. About how far along is Jamie most likely in her pregnancy? a) one or two months b) two or three months c) three or four months d) four or five months 48. Olivia is pregnant and wondering when her baby will develop facial features. Her doctor explains that facial features first appear in __________ of pregnancy. a) the germinal stage b) the first trimester c) the second trimester d) the third trimester 49. Ashley is 10 weeks pregnant and experiencing severe morning sickness. Her doctor reassures her that while it is unpleasant, it predicts that __________.

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a) Ashley is less likely to miscarry b) Ashley is having a girl c) Ashley is having a boy d) Ashley is not having twins 50. Shasta is pregnant, and her doctor notes that she is "primiparous," which means that __________. a) Shasta is carrying only one baby b) Shasta's placenta is blocking her cervix c) Shasta's baby is in the breech position d) Shasta is pregnant for the first time 51. Adrienne is pregnant for the first time and thinks she just felt her baby move for the first time. What week of pregnancy is Adrienne most likely in? a) 13 b) 15 c) 17 d) 19 52. At the end of the __________ month of pregnancy the development of the brain and nervous system is complete. a) fifth b) sixth c) seventh d) eighth 53. Daisha is a healthy full-term baby born just two hours ago. She most likely weighs about __________ grams. a) 2200 b) 3400 c) 4600 d) 5800 54. Andie is overweight and pregnant. Her doctor hopes that she will __________. a) not gain any weight with the pregnancy b) gain less weight than would be ideal for a normal-weight woman c) gain more weight than would be ideal for a normal-weight woman d) gain the same amount of weight that would be ideal for a normal-weight woman 55. When during pregnancy is a woman most likely to be interested in engaging in sexual activity? a) the first trimester b) the second trimester c) the first half of the third trimester d) the second half of the third trimester 56. Which of the following effects of pregnancy can increase sensitivity in many erogenous zones? a) vasocongestion b) oxytocin Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) estrogen d) edema 57. Midwives care for their patients during their pregnancy until __________. a) they give birth b) one week after they give birth c) two weeks after they give birth d) six weeks after they give birth 58. What is a doula? a) a labour coach b) a birthing chair c) a fertility charm d) a surgical procedure 59. What is the term for the process in which a fetus positions the widest part of its head against the mother's pelvic bones? a) effacement b) engagement c) spinal block d) episiotomy 60. Megan is just beginning stage 1 of labour. The contractions she is experiencing are __________. a) helping to dilate the cervix b) moving the baby past her cervix c) helping to dislodge the placenta from the uterine wall d) Braxton-Hicks contractions 61. If a primiparous woman is in labour, about how long will stage 1 last? a) 2 hours b) 4 hours c) 6 hours d) 8 hours 62. A woman's "water breaking" is most closely associated with which of the following? a) the mucous plug b) the amniotic sac c) engagement d) C-section 63. During the early phase of stage 1 of labour the cervix dilates to __________. a) 1 cm b) 4 cm c) 8 cm d) 10 cm

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64. Isla is in the active phase of stage 1 of labour. During this phase her cervix is in the process of dilating __________. a) from 1 to 4 cm b) from 4 to 8 cm c) from 10 to 12 cm d) from 8 to 10 cm 65. During the transition phase of stage 1 of labour, the cervix dilates to __________ cm. a) 2 b) 4 c) 8 d) 10 66. The __________ phase of stage 1 of labour is often the shortest and most difficult. a) early b) active c) transition d) engagement 67. Abbie is in the shortest phase of stage 1 labour. Her doctor refers to this phase as __________. a) the early phase b) the active phase c) transition d) engagement 68. When does stage 2 of labour begin? a) when engagement occurs b) after the placenta is delivered c) after the baby is delivered d) after the cervix is fully dilated 69. When during labour does the baby's head begin to move into the vagina? a) during engagement b) during the active phase c) during transition d) during stage 2 70. A primiparous mother can expect to spend about __________ in stage 2 of labour. a) 20 minutes b) 60 minutes c) 80 minutes d) 100 minutes 71. Which of the following procedures is no longer endorsed for routine deliveries? a) episiotomy b) bearing down Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) anaesthesia d) doulas 72. Which of the following tends to slow down the progress of labour? a) having taken birthing classes b) analgesics c) doulas d) midwife assistance 73. If the baby and mother are well, what is the first thing that should occur after delivery? a) skin-to-skin contact b) naming the baby c) bathing the baby in a warm tub d) removal of the umbilical stump 74. Which of the following is the LEAST common in new mothers? a) no postpartum psychological effects b) postpartum blues c) postpartum depression d) postpartum psychosis 75. Which of the following can be difficult to detect? a) whether a mother is primiparous b) postpartum depression c) breech babies d) expulsion of the placenta 76. What did researchers find when they compared the health outcomes of siblings where one baby was breastfed and the other fed only formula? a) Breastfed babies were healthier. b) Formula babies were healthier. c) There were no differences between the groups. d) Breastfed babies were healthier but also more likely to be obese.

77. When do mothers begin to produce colostrum? a) right after giving birth b) two to three days after birth c) one to two weeks after birth d) after breastfeeding for five days 78. Which of the following causes uterine contractions during breastfeeding? a) progesterone b) androgens c) oxytocin d) vasopressin

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79. Which of the following is a pregnancy complication that can result in convulsions? a) episiotomy b) eclampsia c) effacement d) Rh incompatibility 80. In order to reduce the risk of miscarriage, amniocentesis should be carried out __________. a) after the 20th week of pregnancy b) before the 8th week of pregnancy c) during the 12th week of pregnancy d) before the 20th week of pregnancy 81. Trish and George have conceived several times but have miscarried every time. What type of infertility do Trish and George have? a) primary b) secondary c) tertiary d) psychological 82. If a researcher studied 100 men, approximately how many of those men would be considered to have a problem with fertility? a) 1 b) 10 c) 20 d) 40 83. Regan was identified as having a low sperm count. This means he produces __________ million or less sperm per millilitre of semen. a) 40 b) 30 c) 20 d) 10 84. The most common cause of fertility problems in women relates to __________. a) ovulation b) the shape of the uterus c) high levels of progesterone d) the thickness of the cervix 85. Paige became pregnant after using clomiphene citrate. What is the probability that she will be carrying two or more babies? a) 8 per cent b) 15 per cent c) 20 per cent d) 40 per cent

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86. Laila is expecting twins. She asked her doctor when she will likely give birth. The doctor said that the mean gestational age at birth for twins is __________. a) 30 weeks b) 33 weeks c) 35 weeks d) 37 weeks 87. In order for a sperm to fertilize an egg, it must first penetrate which layer surrounding the egg? a) zona pellucida b) chorionic villis c) amnion d) corpus luteum 88. Approximately how long does it take a fertilized egg to travel from the fallopian tube to the uterus? a) 2 days b) 5 days c) 10 days d) 14 days 89. What structure does the umbilical cord attach the embryo to? a) the amniotic sac b) the uterus c) the placenta d) the mother's stomach 90. In which stage of pregnancy is "morning sickness" most associated as a common side effect? a) first trimester b) second trimester c) third trimester d) all of the above 91. Primiparous refers to which of the following? a) a woman who has been pregnant and given birth only once b) a woman who has not yet been pregnant c) a woman who has not yet menstruated d) a women has had sexual intercourse but has not yet been pregnant 92. A process called external cephalic version is used to do what? a) to see the fetus's brain and spinal cord using an ultrasound b) to check the fetus for neural tube defects c) to check the mother for hypertension d) to try and coax the fetus into a head-down position by pushing on the mother's stomach 93. According to research, which statement is true about trans men and pregnancy? a) Trans men that retain their uterus and ovaries can become pregnant. b) Trans men that become pregnant may struggle with their identity as a man.

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c) Trans men that become pregnant are at risk for feelings of gender dysphoria. d) All of the above statements are true.

94. Stage 3 labour is sometimes referred to as the _________ ________. a) "placental phase" b) "bloody show" c) "crowning phase" d) "lightening phase" 95. ________ ________ is a rare postpartum emotional issue\reaction that affects approximately 0.2 per cent of of women. a) Postpartum infanticide b) Postpartum blues c) Postpartum depression d) Postpartum psychosis 96. One advantage of chorionic villus sampling over amniocentesis is ________. a) chorionic villus sampling can be done earlier in the pregnancy b) chorionic villus sampling carries a lower risk to the pregnancy c) chorionic villus sampling is much more accurate d) the are no advantages to choosing chorionic villus sampling over amniocentesis SHORT ANSWER QUESTIONS 1. Sperm typically live for __________ hours inside a woman's body.

2. The thinning and shortening of the cervix during labour is known as __________.

3. For a few weeks after giving birth, Amanda cried often and was anxious, but after that she was feeling happy again. Amanda was likely suffering from __________ __________.

4. Studies have found that approximately __________ per cent of pregnancies are miscarried by the sixth week after the last menstrual period.

5. Approximately 60 to 80 per cent of deaths of infants without congenital anomalies is related to __________ __________.

6. In the AIH method of assisted human reproduction, sperm from a partner or __________ is used for fertilization.

7. A baby has low birth weight if its weight at birth is less than the average weight for its __________ __________.

8. Julie needs help getting pregnant but does not want a method that involves any fertilized eggs to be frozen or discarded. The best method for Julie to choose in order to conceive is __________ __________ Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

__________(three words).

9. Breastfeeding changes the fertility of the woman by causing __________ __________.

10. The __________ is delivered in the final stage of labour.

11. Most home pregnancy tests detect __________ in the blood.

12. The process of __________ removes the plasma membrane overlying the sperm to allow for greater binding between the sperm and the egg.

13. The normal human gestation period is __________ days.

14. A baby born nearer to the beginning of the __________ month of gestation has about a 90 per cent chance of survival.

15. Monica's cervix is dilating from 8 to 10 cm. She is in the __________ phase of stage 1 of labour.

16. Malin is in labour and has asked for analgesics. An anaesthesiologist injects an anesthetic into a space in Malin's spinal canal. Malin has received a(n) __________.

17. When a fertilized egg implants somewhere other than in the inner lining of the uterus, it is referred to as a(n) __________ __________.

18. An Rh-negative mother who may be carrying an Rh-positive fetus should get an injection of __________ to eliminate the possibility of D-antigen incompatibility.

19. The main symptoms of __________ are high blood pressure, protein in the urine, edema, and swelling.

20. A couple who has never been able to conceive is categorized as having __________ infertility.

21. The first stools passed by a newborn are called ________.

22. ________ is the high-protein, antibody-rich fluid that flows from the breast before the full onset of lactation.

23. A sometimes controversial incision of the perineum to help with the passage of the baby is called a(n) ________.

24. ________ is defined as a biological inability to achieve pregnancy either after one year of frequent, unprotected intercourse if the woman is less than 34 years of age, or after six months if she is over 35 years of age.

ESSAY QUESTIONS 1. Describe the pros and cons of a woman undergoing an elective C-section delivery.

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2. Compare and contrast postpartum blues with postpartum depression 3. Describe two critiques of using pain management during a vaginal delivery.

4. Compare artificial insemination (AI) and zygote intrafallopian transfer (ZIFT).

5. Jackie is 39-weeks pregnant with her first child and is feeling contractions about five minutes apart. Describe how her labour and delivery will most likely progress from this point until her baby is one hour old.

6. Although most people object to the idea of human cloning, and it is illegal in Canada for any purpose, what are some possible benefits?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. a 2. a 3. a 4. a 5. b 6. c 7. a 8. d 9. b 10. c 11. d 12. d 13. a 14. a 15. a 16. c 17. d 18. a 19. b 20. b 21. a 22. b 23. a 24. c 25. b 26. c 27. b 28. d 29. c 30. a 31. b 32. b

33. a 34. a 35. b 36. a 37. d 38. b 39. c 40. b 41. c 42. a 43. c 44. a 45. b 46. b 47. d 48. b 49. a 50. d 51. d 52. c 53. b 54. b 55. b 56. a 57. d 58. a 59. b 60. a 61. d 62. b 63. b 64. b

65. d 66. c 67. c 68. d 69. d 70. c 71. a 72. b 73. a 74. d 75. b 76. c 77. a 78. c 79. b 80. d 81. b 82. b 83. d 84. a 85. a 86. c 87. a 88. b 89. c 90. a 91. a 92. d 93. d 94. a 95. d 96. a

SHORT ANSWER QUESTIONS 1. 48 2. effacement 3. postpartum blues 4. 25 5. preterm birth 6. husband 7. gestational age 8. gamete intrafallopian transfer

9. lactational anovulation 10. placenta 11. HCG 12. capacitation 13. 280 14. eighth 15. transition 16. epidural

17. ectopic pregnancy 18. RhoGAM 19. pre-eclampsia 20. primary 21. meconium 22. Colostrum 23. episiotomy 24. Infertility

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ESSAY QUESTIONS 1. Pros: C-sections allow women to avoid the pain of vaginal delivery, provide control over the timing of their deliveries, and health benefits such as a reduced rate of pelvic floor problems, which can cause incontinence.

However, research has shown that it is mainly the pregnancy that increases the risk of urinary and fecal incontinence, and not the mode of delivery.

Cons: The risks associated with the procedure seem to outweigh the potential benefits. Healthy women who undergo a planned C-section are three times more likely to experience severe maternal morbidity as compared to women who have a planned vaginal birth. In general, C-sections are associated with higher risks of infection, excessive bleeding, scarring, damage to the intestines and bladder, chronic conditions related to childbirth, and even death. In addition, women who give birth by C-section have substantially longer recovery times than do women who give birth vaginally. This longer recovery time can interfere with the mother's ability to care for her baby without considerable assistance, and it can place a significant strain on the health care system.

2. Postpartum blues and postpartum depression differ in both the severity and duration of the depressive symptoms. Postpartum blues are also more common than postpartum depression. The postpartum blues occurs in up to 80 per cent of women and usually resolves within a couple of weeks. Postpartum depression (PPD) occurs in between 20 and 50 per cent of women and can last for months or even years. Postpartum blues consists of mild depression, tearfulness, anxiety, and/or irritability occurring in the first few days after delivery. The experience of PPD may involve extreme sadness or despair, apathy, changes in appetite and sleep, low self-esteem, and difficulty concentrating.

3. Spinal blocks and epidurals can reduce a woman's ability to push the baby out herself and increase the risk of C-section and assisted deliveries (e.g., forceps). Drugs can cross the placental barrier and may have a negative impact on the baby.

4. Artificial insemination involves injecting the sperm directly into the vagina or uterus. Sperm can be from a partner (AIH) or a donor (AID). The egg never leaves the woman's body and fertilization occurs in the woman's body. In zygote intrafallopian transfer, eggs from the mother or donor are fertilized with sperm from the partner or donor outside of the body and inserted into the woman's body after three or four days of development. There are two main differences between the methods. First, in AI, the egg is never donated. Second, in AI, fertilization occurs inside of the body and it is never the case that eggs or zygotes need to be frozen, whereas with ZIFT, eggs are fertilized outside of the body and in some cases the eggs or zygotes must be frozen.

5. Jackie will be in the first stage of labour for about eight hours, where contractions cause the cervix to dilate to 10 cm. The baby can then exit the uterus and begin moving down the birth canal. The next stage lasts about 80 minutes and involves the baby's head exiting the vagina. The nose and mouth are suctioned out and then the baby's body is delivered. The umbilical cord is clamped and cut. The next stage lasts about an hour and involves the delivery of the placenta. Following the delivery of the placenta, Jackie would be sutured if necessary. After delivery the baby is checked and then put skin to skin on the mother as soon as possible. The baby may attempt to breast feed as soon as one hour after delivery.

6. Some possible benefits include; harvesting stem cells to clone only certain tissues or organs that could be used for research into treatment of certain diseases or to develop organs for transplantation. Reproductive cloning could offer another alternative to those dealing with infertility.

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CHAPTER 7

Contraception and Pregnancy Options MULTIPLE CHOICE QUESTIONS 1. In which culture was silphium used as a form of birth control? a) in ancient South America b) in ancient Greece c) in ancient Egypt d) in South Africa 2. Canada's first birth control clinic opened in Hamilton, Ontario, in what year? a) 1922 b) 1932 c) 1952 d) 1962 3. In Canada, the "birth control movement" started in which socio-economic group? a) the wealthiest, best-educated Canadians b) middle-class factory workers c) the poorest Canadians d) middle-class business owners 4. Which of the following legislative actions occurred while Pierre Trudeau was Prime Minister of Canada? a) A law was created making birth control free for all Canadians. b) The use of birth control was removed from the Canadian Criminal Code. c) The birth control pill became legal, but only for use to solve "menstrual problems." d) It became illegal for doctors to refuse to prescribe birth control.

5. The first formal contraception advocacy organization in Canada was formed in 1923 in which city? a) Montreal b) Vancouver c) Toronto d) Winnipeg 6. If a typical couple has sex regularly for one year without using birth control, what are the odds that the woman will become pregnant? a) 25 per cent b) 40 per cent c) 85 per cent d) 95 per cent 7. Nadya has had chronic vaginitis since she started using birth control. What form of birth control is Nadya most likely using?

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a) the birth control pill b) an intra-uterine device (IUD) c) NuvaRing d) condoms 8. Which of the following is NOT a side effect of hormonal contraceptives? a) weight gain b) chronic pelvic pain c) nausea d) breast tenderness 9. Isobel is single and would like to start using a hormonal method of birth control. What method would be most effective for her (assuming typical use)? a) levonorgestrel-releasing intra-uterine system b) Depo-Provera c) NuvaRing d) transdermal contraceptive patch 10. Which of the following is NOT a form of hormonal birth control? a) Depo-Provera b) transdermal contraceptive patch c) cervical cap d) NuvaRing 11. Emily can use her method of birth control "perfectly" but still has a 20 per cent chance of becoming pregnant.

Which of the following is likely true of Emily? a) She is nulliparous and using a diaphragm. b) She is parous and using a diaphragm. c) She is nulliparous and using the sponge. d) She is parous and using the sponge.

12. Melanie has had two children and would like to start using a non-hormonal method of birth control. What method would be most effective for her (assuming typical use)? a) intra-uterine device (IUD) b) diaphragm c) cervical cap d) sponge 13. Which method of contraception is not permanent but lasts five years? a) tubal ligation b) vasectomy c) the intra-uterine device (IUD) d) Depo-Provera 14. Dr. Thorold has recommended that Alexandra switch from using the contraceptive sponge to the birth control pill. What would be the most reasonable cause for this decision?

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a) Alexandra has multiple partners. b) Alexandra is nulliparous and monogamous. c) Alexandra is parous. d) Alexandra is nulliparous.

15. What type of vaginal discharge will Patricia observe when she is most fertile? a) menstrual blood b) thick white mucus c) sticky white mucus d) clear elastic mucus 16. Which is true regarding the sympto-thermal approach to birth control? a) It requires the measurement of basal body temperature each morning. b) It requires the assessment of cervical mucus and position each morning. c) It requires the assessment of cervical mucus and position and basal body temperature each morning. d) It is effective after the first two weeks.

17. Heather is using the calendar method of birth control and has a regular 28-day cycle. If she wishes to avoid pregnancy, on which days of her cycle should she avoid intercourse (with the first day of her menstrual period being day 1)? a) days 8 through 18 b) days 11 through 22 c) days 14 through 25 d) days 12 through 16 18. What is a disadvantage of teaching abstinence as the best and only method for premarital birth control? a) It may lead to risky sexual behaviours because of a lack of knowledge about what is safe. b) Abstinence does not prevent most STIs. c) Abstinence often causes people to be sexually inhibited when they do become married. d) With the abstinence method, oral and anal sex are also usually not allowed so the person has no sexual options.

19. Which of the following methods of natural birth control is most effective assuming normal but not perfect use? a) lactation amenorrhea b) withdrawal c) calendar-based methods d) sympto-thermal method 20. Worldwide, what is the most common form of birth control? a) the birth control pill b) the intra-uterine device (IUD) c) condoms d) female sterilization 21. According to research in Canada, what is the most common reason males cite for not using condoms? a) They do not enjoy sexual sensation when using a condom.

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b) Condoms are inconvenient to use or unavailable at the moment. c) They do not view them as a reliable form of birth control. d) They do not perceive themselves as at risk for contracting a sexually transmitted infection.

22. Which method of birth control is most common for married or in-union people aged 15–49 in Europe? a) male sterilization b) female sterilization c) the contraceptive pill d) condoms 23. Which of the following is NOT a component of Fisher and Fisher's IMB model of sexual health behaviours? a) motivation b) intervention c) information d) behavioural skills 24. Nicole is 16 years old and has just had a baby. She is no longer in a relationship with the father. Which of the following is most likely? a) Nicole will never have another baby. b) Nicole will finish high school. c) Nicole will receive welfare for the first three years of her child's life. d) The father of Nicole's baby will provide about $200 a month to care for the child.

25. According to the Population Reference Bureau, when is the world's population projected to reach 9.9 billion? a) 2025 b) 2040 c) 2050 d) 2065 26. Who is most likely to use birth control effectively and consistently? a) Someone who is impulsive and extraverted. b) Someone who is open to talking about sex. c) Someone who feels guilty about having sex. d) Someone who is in an unstable, abusive relationship.

27. What is Plan B? a) a hormonal birth control injection b) a brand-name intra-uterine device c) an emergency contraceptive pill d) a surgical method of birth control 28. Which event caused the first ever closure of the Canadian Parliament? a) a protest in favour of legalizing abortion b) a bomb threat by pro-life advocates c) a stalemate between political parties concerning whether abortion should be legal d) a bomb threat by pro-choice advocates Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

29. In which situation would Dr. Henry Morgentaler perform an abortion at his Montreal clinic? a) when he determined that the mother's life was in danger b) when a committee determined the mother's life was in danger c) when there was medical evidence that the child would be born with severe medical problems d) when a pregnant woman requested an abortion for any reason 30. What is the main difference between a therapeutic and an elective abortion? a) Therapeutic abortions are legal in Canada and elective abortions are not. b) Therapeutic and elective abortions use different techniques. c) Therapeutic abortions are conducted to protect the mother's health or when the baby has a major birth defect. d) A therapeutic abortion occurs after rape while an elective abortion follows failed birth control.

31. Which country had the highest recorded abortion rate in the early 2000s? a) China b) India c) Russia d) Indonesia 32. Which of the following is true about the trend for abortions worldwide since the 1990s? a) The overall rate of abortions has stayed the same, but the percentage of safe abortions has risen. b) The overall rate of abortions has decreased, but the percentage of unsafe abortions has not. c) The overall rate of abortions has stayed the same but the percentage of unsafe abortions has increased. d) The overall rate of abortions and the percentage of unsafe abortions have both decreased.

33. According to a 2016 poll, more than half of Canadians said they are on which side of the pro-choice––pro-life debate? a) pro-choice b) pro-life c) neither pro-choice nor pro-life d) no opinion 34. Who is most often associated with Canada's pro-choice movement? a) Henry Morgentaler b) Pierre Trudeau c) Mary Anne Jamieson d) A.R. Kaufman 35. What is the least common method of dealing with unwanted pregnancies in Canada? a) surgical abortion b) adoption c) raising the baby d) chemical abortion 36. Which of the following is true in China due to the one-child policy? a) The per-capita net income of families has decreased.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) Life expectancy has increased. c) The incidence of a number of diseases has increased. d) It has prevented nearly one billion births between 1979 and 2010.

37. In which ancient culture was crocodile dung used as a contraceptive? a) China b) Egypt c) Australia d) Greece 38. Ping was born in China and has two healthy older brothers who were also born in China. Ping and her brothers must have been born before which year? a) 1972 b) 1975 c) 1978 d) 1981 39. In general, who suffered the most under China's one-child policy? a) parents b) females c) males d) children 40. Historians believe that the most widely used form of population control among prehistorical people was likely __________. a) infanticide b) abstinence c) condoms made of sheep intestine d) the calendar method 41. Why was contraception frowned upon in 19th century Canada? a) It was too expensive. b) It was too unreliable. c) It was thought to "corrupt morals." d) It was thought to be unhealthy.

42. What brought about increased tolerance of birth control in the 1960s? a) the baby boom b) the civil rights movement c) advances in technology d) concern about sexual infections 43. It is 1969, which group of women could obtain birth control pills from their doctor? a) any woman b) any woman in a serious relationship c) any woman over 30 Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) any married woman 44. What world event caused the Catholic Church to discourage contraception? a) the Irish potato famine b) the plagues c) the Great Fire of London d) World War I 45. Most Canadians are only familiar with which two forms of contraception? a) abstinence and the birth control pill b) the birth control pill and the male condom c) the male condom and the contraceptive sponge d) the contraceptive sponge and abstinence 46. If a sexually active couple choose not to use birth control, what is the probability that they will NOT conceive a child within a year? a) 0 per cent b) 15 per cent c) 50 per cent d) 85 per cent 47. What kind of contraceptive is the NuvaRing? a) hormonal b) barrier c) surgical d) sympto-thermal 48. Which of the following is a non-hormonal method of contraception? a) NuvaRing b) Depo-Provera c) LNG-IUS d) Cu-IUD 49. Which hormonal contraceptive has the same failure rate for perfect and typical use? a) mini pill b) NuvaRing c) Depo-Provera d) LNG-IUS 50. Jessica takes a combination oral contraceptive pill. She feels confident that she will not get pregnant. Under typical use, what is the probability that Jessica will become pregnant in the next year? a) 0 per cent b) 0.3 per cent c) 5 per cent d) 9 per cent

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

51. Of the hormonal contraceptive methods, which is LEAST likely to fail under typical use? a) LNG-IUS b) Depo-Provera c) mini pill d) NuvaRing 52. Neve has never given birth and likes using the contraceptive sponge because it is easy to obtain and easy to use. What is the typical probability that her method will fail her this year? a) 9 per cent b) 12 per cent c) 20 per cent d) 32 per cent 53. Which of the following contraceptive methods is LEAST effective for a woman who has already had a child? a) NuvaRing b) cervical cap c) contraceptive sponge d) mini pill 54. Which of the following methods of contraception has the lowest failure rate? a) female sterilization b) male sterilization c) combination oral contraceptive pill d) an IUD 55. Mailika has a history of chronic pelvic pain and is looking for a method of contraception. What would be a choice that may help reduce the risk of the pain coming back and act as an effective contraceptive? a) NuvaRing b) mini pill c) Depo-Provera d) female condom 56. Miranda wants to know if she can use the standard-days calendar method. Her doctor says it will work if her cycles are between __________ days long. a) 22 and 28 b) 24 and 30 c) 26 and 32 d) 28 and 34 57. Rhea and Ned have switched from no method of contraception to a standard-days calendar method. Assuming perfect use, how likely are Rhea and Ned to avoid pregnancy with this method? a) 20 per cent b) 45 per cent c) 80 per cent d) 95 per cent

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

58. Which method of contraception takes the average length of cycles across a year and uses the length of these cycles to predict days in the cycle when a woman may be fertile? a) rhythm method b) sympto-thermal approach c) standard-days method d) abstinence 59. In which region would a married couple most likely choose male sterilization as a method of contraception? a) Asia b) North America c) Europe d) Africa 60. In which region would a married couple most likely choose an IUD as a method of contraception? a) Asia b) Europe c) North America d) Africa 61. How does the use of the IUD by women worldwide compare to the use of the IUD by women in Canada? a) The IUD is used equally in Canada and worldwide. b) The IUD is used more frequently worldwide than in Canada. c) The IUD is used more frequently in Canada than worldwide. d) The IUD is not used in Canada.

62. Jill and James are married, live in North America, and are both 42 years old. They have completed their family. What method of contraception are Jill and James most likely to use? a) oral contraceptives b) male condom c) male sterilization d) female sterilization 63. Gia and Greg are married, live in Canada and are both 27 years old. They want to wait a few years before starting a family. What method of birth control do they most likely use? a) oral contraceptives b) implants c) withdrawal d) IUD 64. The rate of teenage pregnancy has been __________ in Canada. a) increasing b) fluctuating c) decreasing d) stable 65. In Canada, what percentage of women have never asked their health care provider about birth control?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) 2 per cent b) 18 per cent c) 28 per cent d) 42 per cent 66. According to the IMB model by Fisher & Fisher, sexual risk-taking is less likely when a person has all of the following factors EXCEPT __________. a) access to information at the right time b) a personal attitude that discourages sexual risk-taking c) an ability to discuss birth control with their partner d) a reason to be afraid of becoming pregnant 67. Any method of contraception that is used after intercourse but before an egg can be implanted in the uterus is called __________. a) Plan B b) emergency contraception c) an early-stage abortion d) uterine evacuation 68. Which emergency contraceptive pill contains estrogen and is more likely to induce nausea than other options? a) Yuzpe b) Plan B c) mini pill d) Loestrin 69. Which emergency contraceptive pill has the LEAST negative side effects? a) Yuzpe b) Plan B c) mini pill d) Loestrin 70. In what year did emergency contraceptive pills become available without a prescription in Canada? a) 1996 b) 2000 c) 2005 d) 2009 71. How effective is emergency contraception at preventing a pregnancy if taken within 72 hours post coitus? a) 15-29 per cent b) 45-59 per cent c) 75-89 per cent d) 100 per cent 72. Sarah is 36 and has three children. She and her husband have decided their family is complete. Last night they had unprotected sex. What form of contraception can Sarah begin in the next 7 days to prevent the implantation of a fertilized egg?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) mini pill b) IUD c) Depo-Provera d) NuvaRing 73. Insertion of an IUD can be used as an emergency contraceptive for up to __________ days after unprotected intercourse. a) four b) five c) six d) seven 74. Which of the following describes an elective abortion? a) an abortion to protect the health of the mother b) an abortion because the fetus is unhealthy c) an abortion because a pregnancy is likely to cause mental health problems d) an abortion because the financial burden of a child is too great 75. What is the current legal status of abortion in Canada? a) It is legal in seven provinces. b) It is legal in six provinces. c) It is legal only if a mother's health is at risk. d) It is legal everywhere.

76. A medical abortion can be completed up to the __________ week of gestation. a) seventh b) eighth c) ninth d) tenth 77. In Canada, about how many women put their children up for adoption in a given year? a) a few hundred b) a few thousand c) at least 10,000 d) about 20,000 78. Which of the following describes the pattern of adoption in Canada? a) There are similar numbers of private and public adoptions. b) There are only private adoptions. c) There are more private than public adoptions. d) There are more public than private adoptions.

79. Which of the following types of abortion requires general anaesthetic? a) medical abortion b) manual vacuum aspiration c) vacuum suction curettage Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) dilation and evacuation 80. Which method of contraception was most frequently used by Canadian women as reported by a 2006 study? a) condoms b) oral contraceptives c) withdrawal d) IUD 81. Lactational amenorrhea is ________ per cent effective as a temporary postpartum method of birth control as long as menstruation has not returned, the baby is being nursed exclusively with breastmilk, and the baby is less than six months of age. a) 25 b) 52 c) 78 d) 98 82. A(n) ________ is a type of abortion performed for reasons other than maternal or fetal health. a) therapeutic abortion b) elective abortion c) pro-choice abortion d) pro-life abortion 83. Which of the following is NOT considered to be a surgical abortion technique? a) vacuum suction curettage b) dilation and evacuation c) manual vacuum aspiration d) mifepristone 84. Which of the following statements is false? a) A female cannot get pregnant if the male does not orgasm\ejaculate. b) A female cannot get pregnant the first time she has sex with a male. c) A female cannot get pregnant if she has sex during menstruation. d) All of the above statements are false.

85. With regards to female douching, which of the following statements is false? a) Douching after sexual intercourse is an effective method of birth control. b) Douching after sexual intercourse is not an effective way to prevent STIs. c) Douching after sexual intercourse could lead to infections. d) Douching after sexual intercourse is not an effective method of birth control.

86. Which of the following is NOT considered to be a hormonal contraceptive? a) Cu-IUD b) LNG-IUS c) NuvaRing d) Depo-Provera

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

87. Progestin-only hormonal contraceptives offer which advantage over combination hormonal contraceptives? a) They offer some protection from STIs. b) They eliminate the chances of irregular bleeding. c) They are appropriate for use while breastfeeding. d) They may decrease acne.

88. The sympto-thermal approach to contraception can be as high as ________ per cent effective for perfect users, and __________ per cent effective for typical users. a) 89; 80 b) 99; 80 c) 87; 78 d) 85; 75 89. Statistics on contraceptive use in Canada commonly reflect that ________. a) Canada has access to fewer methods of birth control as compared with other developed countries b) Canada has access to more methods of birth control as compared with other developed countries c) IUDs are the most common form of birth control d) women over 40 are most likely to use contraception 90. Which of the following statements about emergency contraception is false? a) Emergency contracepion is not recommended as a regular method of birth control. b) Emergency contracepion does not have an effect on established pregnancies. c) Emergency contracepion should be used after intercourse and before the time that the fertilized egg can implant in the uterine lining. d) Emergency contracepion is not available over-the-counter in Canada.

SHORT ANSWER QUESTIONS 1. Prehistorically, the most commonly used form of population control was __________, and it remained fairly commonplace in Europe, India, and China until the nineteenth century.

2. When talking about birth control effectiveness, __________ __________ refers to a realistic situation in which some people will inevitably make mistakes in use, perhaps because they are misinformed, intoxicated, tired, or forgetful.

3. When a method of contraception is used 100 per cent correctly, this is termed __________ __________.

4. The hormone-based contraceptive that increases a woman's risk of vaginitis is __________.

5. __________ __________ may prevent pregnancy but has no effect on established pregnancies.

6. On average, the withdrawal method is __________ per cent effective in preventing pregnancy with typical use.

7. Research into the psychological ramifications of abortions is problematic because in many cases, some form of __________ might have interfered with the results.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

8. The effectiveness of post-coital __________ insertion as an emergency method of birth control is close to 100 per cent if done within a week.

9. Jennifer has asked for a(n) __________ abortion because she isn't ready for single motherhood.

10. The least common solution for unwanted pregnancies in Canada appears to be __________.

11. A woman who has never given birth is referred to as __________.

12. Standard-days method is often a more accurate variation of the __________ method.

13. Lactation amenorrhea prevents conception in women who are __________.

14. The most common contraceptive methods worldwide are and the IUD and __________ __________.

15. Impulsivity, extraversion, and neuroticism are traits that are correlated with __________ sexual behaviour.

16. Plan B is an example of a(n) __________ __________ (two words).

17. A __________ abortion is achieved with injections and/or pills.

18. Each year, __________ abortions result in the hospitalization of approximately 5 million women and the death of approximately 70,000 women.

19. A person who is __________-__________ supports a woman's right to choose to terminate a pregnancy.

20. In mammals, the period of time in which a fetus/embryo develops in the uterus, beginning with fertilization and ending at birth is termed _________.

21. A surgical sterilization procedure performed on a male whereby the vas deferens are severed is called a ________.

22. ________ ________ is the sexual practice in which a partner moves their penis between the partner's thighs without any type of penetration.

ESSAY QUESTIONS 1. What are three positive and three negative aspects of China's one-child policy?

2. What are three advantages for disseminating knowledge about birth control around the world?

3. Why do people take sexual risks? What are some measures that are being taken to reduce sexual risk taking in Canada?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

4. Define what is meant by "emergency contraception" and discuss the advantages and disadvantages of two forms of emergency contraception.

5. Describe the history of the male contraception pill and explain some of the possible roadblocks to it being accepted as a valid contraceptive option.

6. What is meant by an internal and external condom? Is one type "better" than the other?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. b 3. a 4. b 5. b 6. c 7. c 8. b 9. a 10. c 11. d 12. a 13. c 14. c 15. d 16. c 17. a 18. a 19. a 20. d 21. b 22. c 23. b 24. c 25. c 26. b 27. c 28. a 29. d 30. c

31. c 32. b 33. a 34. a 35. b 36. b 37. b 38. c 39. b 40. a 41. c 42. a 43. a 44. b 45. b 46. b 47. a 48. d 49. d 50. d 51. a 52. b 53. b 54. b 55. c 56. c 57. d 58. a 59. b 60. a

61. b 62. d 63. a 64. c 65. c 66. d 67. b 68. a 69. b 70. c 71. c 72. b 73. d 74. d 75. d 76. a 77. a 78. c 79. d 80. a 81. d 82. b 83. d 84. d 85. a 86. a 87. c 88. b 89. a 90. d

SHORT ANSWER QUESTIONS 1. infanticide 2. typical use 3. perfect use 4. NuvaRing 5. Emergency contraception 6. 81 7. bias 8. IUD

9. elective 10. adoption 11. nulliparous 12. rhythm 13. breastfeeding 14. female sterilization 15. risky 16. emergency contraceptive

17. medical 18. unsafe 19. pro choice 20. gestation 21. vasectomy 22. Intercrural intercourse

ESSAY QUESTIONS Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Positive aspects: increased access to health care, increased access to education, decreased burden of childcare on women Negative aspects: measures that eliminate female children including abortion and infanticide, long wait periods for some couples who want a child, and a future where there will be more males available to marry than females available to marry them 2. The world may not be able to sustain itself if populations continue to grow at current rates. Reduced family size and population leads to better quality of life for living citizens including better education, better healthcare, and less poverty. In addition, in many countries only unsafe abortions are available and improving access to contraception may reduce health risks to women who choose abortion when they do become pregnant. Birth control may lead more of the world to become "developed."

3. Personality, situational, and relationship factors may influence an individual's decision to engage in sexual risk-taking. Personality factors such as impulsivity, extraversion, psychoticism, and neuroticism are all correlated with risky sexual behaviour, and these correlations occur mainly due to overlapping genetic influences.

Situational factors include poverty, limited access to contraceptives, and substance use/abuse.

Relationship factors also play a role in birth control compliance. Factors that increase the likelihood of sexual risk-taking include abusive relationships, as well as power dynamics, particularly as they pertain to who controls the sexual situations and contraception use.

Sexual risk-taking may be reduced if contraceptive information is easy to understand and accessible in a timely manner. Individuals may also be motivated to reduce risky behaviour by their personal attitudes and/or social norms, and their perceived vulnerability to unwanted pregnancy or STIs. Sexual risk-taking may be reduced if a person feels more self-efficacious and confident when it comes to implementing a birth control strategy; to achieve this goal, individuals must have access to their chosen method of birth control, and they must be able to discuss contraception with their partner(s). One way of achieving these goals is through sexual education that is focused on providing information tailored to individual needs, developing positive attitudes and social norms of contraceptive use, and helping individuals build the behavioural skills they need to make good choices about contraception.

4. Emergency contraception is an action taken after intercourse that can prevent pregnancy but that will have no effect on an established pregnancy. One method is the contraceptive pill, which can be highly effective and can be obtained from pharmacies without a prescription, but must be taken within 72 hours of intercourse to be highly effective. It can cause nausea. A second alternative is the insertion of an inter-uterine device (IUD) within seven days of intercourse. This can be highly effective but requires a visit to the doctor and a prescription.

5. The male contraception pill has been in development since about 1979. It works by preventing sperm from being part of ejaculate. When the correct formulation is used on the correct population, it can be up to 95 per cent effective. Some reasons why the male oral contraceptive has not been adopted may include the perception by pharmaceutical companies that women do not trust men to take the pill, the idea that taking the pill will reduce a male's masculinity, and the argument by some feminists that handing contraceptive control over to men would be a backward step for the women's movement.

6. Internal condoms are placed internally into the body (e.g. vagina or anus) for protection during sexual acts.

External condoms are placed on the outside of a body part (e.g. the penis) for protection during sexual acts.

Pros and cons: Both offer protection from STIs, but the internal condom may offer greater protection from STIs that are transmitted by skin-to-skin contact. However, the contraceptive failure rates for external condoms are Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

slightly lower than for internal condoms. Both are readily available without prescription.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 8

Sexuality Transmitted Infections: At the Junction of Biology and Behaviour MULTIPLE CHOICE QUESTIONS 1. Why is the term "sexually transmitted infection" (STI) preferred over "sexually transmitted disease" (STD)? a) The physiological effects of the sexually transmitted pathogens are technically infections, not diseases. b) The pathogens that are passed from person to person can be asymptomatic. c) Infections are curable and diseases are only treatable. d) Research has shown that young people are more comfortable talking about infections than diseases.

2. Why do we use the term "sexually transmitted infection" (STI) as opposed to "sexually transmitted disease" (STD)? a) because it is the infection of an individual with a sexually transmitted pathogen that concerns us, not whether he or she has evident signs of a sexually transmitted disease. b) because diseases are no longer a consideration for those working in the field of sexual health. c) because there are more STIs in Canada than STDs. d) all of the above 3. Which STI is one of the oldest on record and is sometimes referred to as "English pox" or "French pox"? a) syphilis b) gonorrhea c) chlamydia d) herpes 4. Which of the following protects you from acquiring a sexually transmitted infection? a) being in a monogamous relationship b) avoiding mixing sex and substance use c) being over the age of 25 d) none of the above 5. Which of the following was used as a treatment for syphilis in the 1500s? a) arsenic b) antibiotics c) cyanide d) mercury 6. Why was the Tuskegee experiment considered to be unethical? a) The participants were not paid. b) People were intentionally infected with syphilis. c) The sample was given treatments that were not tested first for possible harmful effects. d) Treatment was eventually stopped on all participants.

7. Which STI was named after a figure in Greek mythology who was cursed with a terrible disease?

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a) syphilis b) gonorrhea c) chlamydia d) moniliasis 8. From 1932 to 1972, the US Public Health Service withheld treatment for syphilis from impoverished African American participants in a study. What was the main issue with this study? a) It was unethical to withhold treatment. b) It was unethical to only study impoverished participants. c) Withholding treatment did not yield any useful results. d) The results of the study were skewed because only African American participants were involved.

9. Which of the following was an obstacle in helping to fight the spread of and treatment of AIDS? a) stigma against same-sex sexual orientation individuals b) fear of contagion c) stigma against intravenous drug use, poverty, and race d) all of the above 10. Kara has an STI that can be treated with antibiotics. Which of the following STIs could it NOT be? a) herpes b) syphilis c) gonorrhea d) chlamydia 11. Which of the following sexually transmitted infections is a virus? a) herpes b) syphilis c) gonorrhea d) chlamydia 12. Which of the following can be successfully treated with antibiotics? a) syphilis b) herpes c) HPV d) HIV 13. Which of the following has been used to treat syphilis? a) arsenic b) mercury c) penicillin d) all of the above 14. What type of STI is herpes? a) viral b) bacterial c) curable Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) retroviral 15. What is the probable origin of HIV? a) simian immunodeficiency virus in primates b) spontaneous generation in the fertile crescent c) resistant micro-organisms found in Haiti d) mucus membranes of west-African mammals 16. During the 1980s and 1990s, what was the number one cause of death among young men in North America? a) HIV/AIDS b) car accidents c) herpes-related infections d) complications from gonorrhea infection treatment 17. Which terms best characterize the early response to the HIV/AIDS epidemic and those living with it in Canada? a) enormous prejudice and discrimination b) reasonable and balanced c) extremely supportive with appropriate treatment and care d) global leader in the fight against AIDS 18. HIV is thought to originate from which type of animals? a) pigs b) primates c) chickens d) cows 19. Which of the following is true about AIDS deaths in the 1980s and 1990s? a) The only group in society that was stigmatized by AIDS were AIDS patients. b) AIDS did not discriminate—all races, socioeconomic classes, and sexual orientations were affected equally. c) AIDS was the leading cause of death in men under 50 in the United States and Canada. d) Politicians were the first activists pressuring pharmaceutical companies to develop treatments for the disease and its symptoms.

20. Before there was a treatment for HIV/AIDS, how long could a patient expect to live after acquiring the illness? a) one to two years b) two to three years c) three to five years d) less than one year 21. When Derek was first diagnosed with HIV, he was told that he can be treated with a new (although very expensive) drug regimen. In what year was Derek diagnosed? a) 1991 b) 1993 c) 1995 d) 1997 Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

22. In the present day, what is the greatest concern about working with HIV/AIDS patients? a) providing them access to affordable medications b) making sure they take the medications that reduce symptoms as prescribed c) preventing mother-to-infant spread of the illness d) reducing the stigma associated with the disease 23. In Canada today, roughly how many people are newly infected with HIV each year? a) less than 1000 b) 2000 to 4000 c) 5000 to 7000 d) more than 8000 24. Which of the following is an obstacle for ARV treatment of AIDS? a) It is an expensive treatment. b) Access to treatment is not widely available in developing nations. c) It is difficult to get patients to adhere to treatment regimens. d) all of the above 25. In which region is HIV/AIDS most prevalent? a) Sub-Saharan African b) Northern Africa and the Middle East c) East Asia d) South America 26. Which of the following is true about early (pre-2006) campaigns to prevent HIV/AIDS transmission? a) Campaigns focused on teaching HIV-negative individuals how to prevent acquiring the disease. b) Campaigns focused on teaching-HIV positive individuals how to prevent transmitting the disease. c) Campaigns focused on teaching HIV-negative people to be tolerant of people with HIV positive status. d) Campaigns focused on building the self-esteem of HIV-positive individuals.

27. What does "prevention with positives" research refer to? a) campaigns geared towards preventing all people from acquiring HIV/AIDS b) campaigns specifically geared towards preventing HIV-negative people from becoming HIV-positive c) campaigns specifically geared towards preventing HIV-positive individuals from developing AIDS d) campaigns geared towards preventing HIV-positive individuals from spreading the infection to HIV-negative individuals 28. Victor's new girlfriend asked him to get tested for sexually transmitted infections. He took the test and the results were positive for an STI. What advice would Victor's doctor give him? a) The doctor's advice would depend on the type of infection and other factors. b) The doctor would advise Victor to contact all sexual partners he has had any sexual contact with during the past five years. c) The doctor would advise Victor to contact partners with whom he engaged in risky sex acts during the past six months. d) The doctor would only advise Victor to contact previous partners if Victor was currently experiencing Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

symptoms.

29. Five years ago, Tanya was diagnosed with a sexually transmitted infection. Currently, she has been trying to get pregnant for almost a year, but has faced infertility issues. Which STI was Tanya likely diagnosed with five years ago? a) hepatitis b) HIV c) chlamydia d) herpes 30. Which sexually transmitted infection is best described by the following symptoms? It is often asymptomatic or presents minimal symptoms such as a mild discharge from the vagina, penis, or anus. Urinary symptoms such as burning or itching are also possible, and some women may experience vaginal bleeding. a) chlamydia b) gonorrhea c) herpes d) syphilis 31. In women, which sexually transmitted infection can lead to pelvic inflammatory disease (PID), which can cause pain with or without intercourse? PID may lead to infertility due to scarring of the fallopian tubes, increased likelihood of ectopic pregnancy, and chronic pelvic pain (CPP). a) chlamydia b) gonorrhea c) herpes d) syphilis 32. Which sexually transmitted infection that is reportable in Canada has the highest prevalence rate? a) HIV b) chlamydia c) gonorrhea d) herpes 33. Jenny has only ever had oral sex with a single partner, but she is experiencing a mild discharge from her vagina and a burning sensation when she urinates. Which STI does Jenny most likely have? a) chlamydia b) syphilis c) gonorrhea d) HPV 34. Which of the following is NOT true of Chlamydia? a) Chlamydia is treated with oral antibiotics. b) People can test themselves for chlamydia. c) Chlamydia infection can spread to the uterus. d) All of the above are true.

35. Tomas noticed a mild discharge coming from his penis. He is sexually active and sometimes doesn't use a Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

condom. What sexually transmitted infection is likely indicated by Tomas's symptoms? a) gonorrhea b) chlamydia c) syphilis d) herpes 36. Liam recently took a vacation and hooked up with one of the locals while he was there. Shortly after he returned, he became aware that something might be wrong because he had a yellow discharge from his penis.

What sexually transmitted infection does Liam most likely have? a) gonorrhea b) syphilis c) herpes d) chlamydia 37. Jaana has flat, warty lesions in the anogenital area, patches of erosions and/or whitish skin in the mouth, and fever and joint aches. What stage of syphilis is she most likely presenting with? a) secondary b) primary c) tertiary d) advanced 38. Which stage of syphilis often affects mental functioning? a) primary syphilis b) secondary syphilis c) tertiary syphilis d) treponemal syphilis 39. Which sexually transmitted infection, if left untreated, affects the blood vessels, heart, and eyes, and may cause sensory or brain damage? a) syphilis b) HIV c) gonorrhea d) hepatitis B 40. Which of the following is NOT true of syphilis? a) Oral sexual contact is the most common way of transmitting syphilis. b) Syphilis can cause brain damage. c) Penicillin is usually used to treat syphilis. d) All of the above are true.

41. Which term means "relating to the region of the anus and/or the genitals"? a) anogenital b) perineum c) vulva d) all of the above

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42. Frank has noticed a painless ulcer on his penis. Which sexually transmitted infection does he most likely have? a) primary syphilis b) secondary syphilis c) chlamydia d) herpes 43. Fatma has a rash on the palms of her hands and the soles of her feet, and all along her trunk. Which sexually transmitted infection does she most likely have? a) secondary syphilis b) primary syphilis c) herpes d) gonorrhea 44. Orolabial herpes or HSV-1 generally presents as __________. a) cold sores b) lesions in the genital area c) skin rash d) anal irritants 45. Why is there no precise information about the prevalence of herpes in Canada? a) It is not a reportable infection. b) It is not detectable through testing. c) It is so rare that it is not worth reporting. d) It is not really considered a sexually transmitted infection.

46. How long do herpes outbreaks typically last? a) several days b) several weeks c) several years d) several months 47. By all estimates, which sexually transmitted infection is the most prevalent in Canada? a) HPV b) HIV c) gonorrhea d) syphilis 48. Nicole is a 23-year-old university student and has just been diagnosed with a sexually transmitted infection, but she did not notice any visible symptoms. Which diagnosis is most probable? a) syphilis b) herpes c) gonorrhea d) HPV 49. Michele is pregnant and has been diagnosed with a sexually transmitted infection but her doctor does not think Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

it is necessary for her to deliver her baby via C-section. What infection does Michele most likely have? a) chlamydia b) gonorrhea c) herpes d) HPV 50. Which of the following sexually transmitted infections cannot be detected through routine screening? a) chlamydia b) HIV/AIDS c) HPV d) syphilis 51. What causes genital warts? a) gonorrhea b) chlamydia c) HPV d) herpes 52. Which of the following sexually transmitted infections cannot be prevented with condom use alone? a) chlamydia b) herpes c) gonorrhea d) syphilis 53. Which of the following is NOT true of HPV? a) Only females can be vaccinated against HPV. b) Genital warts can be treated at home with prescription drugs. c) Many HPV-infected individuals will spontaneously clear the infection without ever showing symptoms. d) All of the above are true.

54. Who is at greatest risk for HIV infection in Canada? a) men who have sex with men b) injection drug users c) people from endemic countries d) all of the above 55. If a person who has been diagnosed with HIV is discussing their viral load with their doctor, what are they most likely talking about? a) measure of the amount of a virus that an infected person has per millimetre of blood b) their susceptibility to viral infections c) the time that they were first infected with the virus d) the sexual means through which they contracted the disease (i.e. oral, penile-vaginal, or anal sex) 56. Which sexually transmitted infection can also be transmitted through infected food? a) hepatitis A b) hepatitis B Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) hepatitis C d) herpes 57. Which of the following sexually transmitted infections is linked to cancer if left untreated? a) hepatitis A b) hepatitis B c) herpes d) syphilis 58. What is true about both pubic lice and scabies? a) They are both caused by parasites. b) They both infect only the external pubic area. c) They can both be treated using antibiotics. d) They are both contracted from genital–genital contact.

59. Priyanka has a genital problem but has never had sexual contact with another person. What type of problem does Priyanka most likely have? a) pubic lice b) chlamydia c) gonorrhea d) trichomoniasis 60. Which sexually transmitted infection is uncommon in most regions of Canada, prevalent in parts of Africa and other areas of the world, and more common among women with multiple sexual partners? a) trichomoniasis b) pubic lice c) HIV d) hepatitis A 61. Contrary to most sexually transmitted infections, this problem can be acquired through non-sexual contact, such as bed sheets or towels. a) scabies b) trichomoniasis c) hepatitis B d) HIV 62. What makes moniliasis different from sexually transmitted infections such as chlamydia and herpes? a) Moniliasis will not go away on its own if left untreated. b) Moniliasis produces symptoms only in men. c) Moniliasis is triggered by sexual activity but caused by a naturally occurring flora in the vagina. d) Moniliasis is transmitted through the genitals but shows symptoms on hands and feet.

63. What causes a fishy odour, vaginal discharge, itching around the vagina, and may result in pain during intercourse (dyspareunia)? a) bacterial vaginosis b) chlamydia Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) moniliasis d) trichomoniasis 64. What vaginal yeast infection is caused by the overgrowth of naturally occurring vaginal organisms and commonly referred to as candidiasis or thrush? a) moniliasis b) bacterial vaginosis c) chlamydia d) trichomoniasis 65. Which sexually transmitted infection cannot be detected by screening? a) HPV/HSV b) chlamydia c) HIV d) gonorrhea 66. Why is it important to communicate with previous partners if you are diagnosed with a sexually transmitted infection? a) Your partner(s) may not know that they are infected. b) Your partner(s) may develop serious complications if their infection goes untreated. c) Your partner(s) may transmit the infection to others. d) all of the above 67. When is sexually transmitted infection (STI) screening instead of STI testing an appropriate measure? a) STI screening is appropriate when there are no visible symptoms but the person has reason to believe they have been exposed to an STI. b) STI screening is appropriate when there are visible symptoms but the person has no reason to think they were exposed to an STI. c) STI screening is appropriate when there are no visible symptoms and the person has no reason to believe they have been exposed to an STI. d) STI screening is appropriate when there are visible symptoms and the person is aware of the fact that a previous partner has tested positive for an STI. 68. What does it mean to be screened for a sexually transmitted infection (STI)? a) to be tested when there are no evident symptoms of an STI b) to be tested when there are symptoms of an STI c) to be immunized against all possible infections d) to be regularly checked by your partners for evidence of STIs 69. When is sexually transmitted infection (STI) testing instead of screening an appropriate measure? a) STI testing is appropriate when the person has no symptoms of an STI but wishes to engage in sex without a condom with their partner. b) STI testing is appropriate when the individual is showing symptoms of an STI. c) STI testing is appropriate when a person has no symptoms of an STI but has had previous sexual partners. d) STI testing is appropriate when a person has no symptoms of an STI but has had an STI that has been treated successfully in the past.

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70. Which of the following is good advice about condom use in a monogamous relationship? a) Use condoms until you have established a routine on oral contraceptives. b) Use condoms until you have gotten to know your partner's history and have determined that he or she was not at high risk for a sexually transmitted infection. c) Use condoms throughout the relationship. d) Use condoms until you both have been tested for sexually transmitted infections and have determined that you both are STI-free and monogamous.

71. What is the best, even though likely not the most practical or realistic, solution for a person to prevent being infected by a sexually transmitted infection? a) Find out about their partner's behaviour patterns. b) Get tested regularly for sexually transmitted infections. c) Use a barrier method for all types of sexual activity. d) Practise abstinence.

72. Jack and Laura are engaging in sexual activity and debating when to put on the condom. What is the best option? a) A condom is most effective at preventing sexually transmitted infections if it is put on just before intercourse. b) A condom is only needed for penile–vaginal intercourse and isn't needed during oral sex. c) A condom should be put in place before the penis is even erect to ensure all sexually transmitted infections are avoided. d) A condom should be put on before any genital–genital touching or oral–genital contact to prevent sexually transmitted infections.

73. Dr. Elliott, a researcher, has launched a well-received campaign in New York State to increase awareness among HIV-positive individuals regarding how to prevent spreading the disease to other people. Dr. Elliott has been asked to advise researchers in South Africa about how to create an effective campaign. What is one difference between New York State and South Africa that may need to be considered if the campaign is to be effective? a) The disease is mostly spread male to male, but most South Africans will deny they engage in homosexual behaviour because it is not culturally accepted. b) Drugs to reduce the severity of symptoms are not readily available in South Africa so the consequences of the disease are more serious than if it is contracted in North America. c) Most HIV/AIDS transmission in South Africa is through heterosexual contact but females, not males, are expected to make decisions concerning contraception, including condom use. d) In South Africa, many people will believe that HIV/AIDS could be treated by natural healers.

74. Where is the best place for Mike to store a condom? a) in his wallet b) in his car c) in his pocket d) in his backpack 75. What mistake do most Canadian couples make regarding preventing sexual transmitted disease transmission? a) They only use condoms until oral contraceptives are being taken regularly; then they stop.

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b) They only get screened, not tested, for sexually transmitted infections. c) They only get tested for sexually transmitted diseases when they are asymptomatic. d) They assume that they are their partner's first partner and have risky sex from the beginning.

76. Stefan doesn't like using condoms because they seem to reduce sensation, but Melissa insists on it. What can Stefan do to improve his sexual experience? a) Incorporate condom application into foreplay. b) Try a non-lubricated condom. c) Try using a water-based lubricant with the condom. d) Try a thicker condom.

77. One common complaint about male condoms is that they reduce sexual pleasure or sensation. What is a possible solution to this issue? a) Put a drop of water-based lubricant or saliva in the tip of the condom or on the glans of the penis prior to putting on the condom. b) Try a thinner latex condom. c) Try different brands. d) all of the above 78. Measures that include signs and symptom awareness, sexually transmitted infection screening and testing, Pap tests, adherence to STI treatment, and partner notification and treatment are known as __________ prevention. a) secondary b) primary c) tertiary d) initial 79. Janna has recently been diagnosed with a sexually transmitted infection. Which of the following actions should she take? a) Notify her previous partners. b) Attend follow-up appointments. c) Get regular Pap tests. d) all of the above 80. Why are sexually transmitted infections (STIs) sometimes called "the gifts that keep on giving"? a) STIs are usually incurable. b) They can be transmitted to other people if undetected or ignored. c) Most people find they learn important lessons about life through dealing with an STI. d) It is possible to transmit an STI even after a person has received effective treatment for it.

81. Gwyneth and Raj have been in a relationship for several months. They have always used condoms and practised preventing sexually transmitted infections (STIs). Now that they know each other better, what is the best course of action? a) It is safer to continue to use condoms and practise STI prevention. b) It is safe to assume neither of them has an STI. c) It is less awkward to ask each other to get screened for STIs. d) They no longer need to use condoms.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

82. Gus has noticed a green discharge from his penis. Which sexually transmitted infection does he most likely have? a) gonorrhea b) HPV c) syphilis d) herpes 83. Charles had oral sex with a new partner and contracted a sexually transmitted infection. Which of the following is it least likely to have been? a) chlamydia b) HIV c) gonorrhea d) herpes 84. After Lara got pregnant, she noticed discharge from her vagina and itching around it. She got worried that she had contracted a sexually transmitted infection, but her doctor said it was not an STI. What was it most likely? a) bacterial vaginosis b) moniliasis c) thrichomonias d) scabies 85. Which of the following sexually transmitted infections cannot be detected by screening? a) HSV b) herpes c) chlamydia d) gonorrhea 86. Which of the following is NOT a primary prevention measure for sexually transmitted infections? a) pap tests b) using a condom c) vaccination d) thinking about safe sex 87. Which of the following is NOT a good place to carry a condom? a) your wallet b) a backpack c) a purse d) an empty dental floss container 88. Which of the following is an example of using the information-motivational-behavioural model to research and prevent the spread of HIV/AIDS? a) addressing the belief that traditional healers can cure HIV b) helping women negotiate condom use in unequal male-female relationships c) dealing with the cultural imperative of having children d) all of the above Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

89. For which of the following sexually transmitted infections is a vaccine available? a) HPV b) gonorrhea c) chlamydia d) syphilis 90. How can hepatitis C be treated by a physician? a) There is no treatment available for hepatitis C. b) with 12 weeks of antibiotic oral medication c) with 12 weeks of antiviral oral medication d) with 12 weeks of antiretroviral oral medication 91. Trichomoniasis is caused by what type of organism? a) protozoa b) virus c) bacteria d) yeast 92. Which of the following genital infections can be treated with a nightly vaginal insertion of clindamycin cream, metronidazole gel, or long-acting vaginal vitamin C tablets? a) chlamydia b) gonorrhea c) bacterial vaginosis d) trichomoniasis 93. Why might people invoke a "theories of risk" strategy that is based on certain personal characteristics? a) to help decide whether they should get screened for STIs b) to help find and avoid partners who might have an STI c) to help decide whether they should get tested for STIs d) to help decide whether they should contact previous partners about an STI diagnosis 94. All of the following sexually transmitted infections are caused by viruses except for ________? a) genital warts b) HIV c) genital herpes d) syphilis 95. Which of the following statements is true with regards to antiretroviral (ARV) therapy and HIV/AIDS? a) ARV therapy can prevent HIV transmission from an infected person to an uninfected person. b) ARV therapy can prevent HIV infection in an uninfected person if taken regularly by uninfected persons at risk. c) ARV therapy can lower an infected person's viral load to such a low count that the virus is not detectable anymore in the blood. d) All of the above statements are true.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

96. Approximately what percentage of Canadians living with HIV are unaware that they are infected? a) 10 per cent b) 20 per cent c) 30 per cent d) 40 per cent 97. Which of the following statements about STI prevalence among Indigenous persons living in Canada is false ? a) Chlamydia is estimated to be almost twenty times higher among Indigenous persons. b) Rates of HIV and AIDS are disproportionately higher among Indigenous persons. c) STI prevalence among Indigenous persons is estimated to be higher than that of the overall population. d) New HIV infections are occurring at a rate that is estimated to be 3.5 times higher than that in the non-Indigenous population.

SHORT ANSWER QUESTIONS 1. Hepatitis B and C are the only sexually transmitted diseases caused by a(n) __________ that are also curable with drugs.

2. During the 1980s and 1990s, __________ was the number one cause of death in men younger than 50.

3. The drugs currently used to treat HIV/AIDS are __________ drug combinations.

4. Worldwide, about __________ million people are newly diagnosed with HIV infection each year.

5. Sexually transmitted infections such as chlamydia and gonorrhea can have lasting effects on females by causing __________ __________ __________ that can lead to fertility problems.

6. Allan notices a single large sore on his penis a few weeks after returning from a vacation to South America. On vacation he engaged in sexual activity with men and women and did not always use a condom. Allan's doctor suspects that he is showing the first stage of __________.

7. Up to 80 per cent of Canadians will be infected by __________ in their lifetime.

8. Although it affects the genitals, __________ __________ is common in pregnant women and is not generally considered a sexually transmitted infection.

9. The most prevalent sexually transmitted infection that is preventable with a vaccine is __________.

10. You might want to get __________ for sexually transmitted infections before becoming intimate with a new partner, even if you don't have symptoms.

11. The __________ experiment was an unethical research project studying syphilis.

12. Sarah has been diagnosed with the most commonly reported sexually transmitted infection in Canada. Sarah Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

has __________.

13. AIDS develops from a virus known as __________.

14. The best way to prevent the spread of AIDS is to promote safer sexual behaviour among HIV-__________ individuals.

15. Most HIV intervention research focuses on people who are HIV-__________.

16. Unless treated with antibiotics, __________ can eventually lead to death.

17. The type of HPV that leads to the development of genital warts is considered __________-risk for the development of cancer.

18. If you have been diagnosed with a sexually transmitted infection, it is critical that you __________ to the recommended treatment.

19. If a person contracts hepatitis B or hepatitis __________ they may develop cirrhosis of the liver.

20. Jess is avoiding wide-spectrum antibiotics because she doesn't want to develop a __________ infection in her vagina.

21. Both syphilis and chlamydia are caused by a ________ infection.

22. The third and final stage of syphilis is called ________ syphilis 23. ________ can be caused by two closely related types of the virus: HSV-1 and HSV-2.

24. More than 120 types of ________ have been identified, and are often labelled as "high-risk" and "low-risk".

25. ________, also commonly referred to as candidiasis or thrush, is a vaginal yeast infection caused by the overgrowth of naturally occurring vaginal organisms.

26. The current extent of a pathogen, infection, or disease (or another condition) in a defined population at a given time is termed ________.

ESSAY QUESTIONS 1. Describe some sociological factors that shaped early research into AIDS prevention and describe how research changed when a treatment for AIDS was discovered.

2. What arguments are often provided for and against administering vaccinations to prevent human papillomavirus (HPV)?

3. Describe and compare the approaches to AIDS prevention in North America and in South Africa.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

4. Discuss three reasons why one partner asking the other about their sexual history does not prevent the transmission of sexually transmitted infections.

5. Deanna has met a man with whom she is starting a monogamous sexual relationship. What five factors related to overall sexual health should Deanna consider to make the most out of her situation? Provide an example of each factor.

6. On average, the age of first sexual intercourse in Canada is somewhere in the later teens, and the average age of first marriage is around 30. During this time, many people have multiple sexual partners. What does your text suggest are some things to think about before engaging in sexual activity?

7. Name three perceived barriers to using male condoms and the possible resolutions to these barriers.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. a 3. a 4. d 5. d 6. d 7. a 8. a 9. d 10. a 11. a 12. a 13. d 14. a 15. a 16. a 17. a 18. b 19. c 20. c 21. d 22. b 23. b 24. d 25. a 26. a 27. d 28. a 29. c 30. a 31. a 32. b 33. a

34. d 35. b 36. a 37. a 38. c 39. a 40. a 41. a 42. a 43. a 44. a 45. a 46. a 47. a 48. d 49. d 50. c 51. c 52. b 53. a 54. d 55. a 56. a 57. b 58. a 59. a 60. a 61. a 62. c 63. a 64. a 65. a 66. d

67. c 68. a 69. b 70. d 71. d 72. d 73. d 74. d 75. a 76. c 77. d 78. a 79. d 80. b 81. a 82. a 83. b 84. a 85. a 86. a 87. a 88. d 89. a 90. c 91. a 92. c 93. b 94. d 95. d 96. b 97. a

SHORT ANSWER QUESTIONS 1. virus 2. AIDS 3. antiretroviral 4. two 5. pelvic inflammatory disease 6. syphilis 7. HPV

8. bacterial vaginosis 9. HPV 10. screened 11. Tuskegee 12. chlamydia 13. HIV 14. positive

15. negative 16. syphilis 17. low 18. adhere 19. C 20. yeast 21. bacterial

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

22. tertiary 23. Herpes

24. Human Papillomavirus OR HPV

25. Moniliasis 26. prevalence

ESSAY QUESTIONS 1. Prior to the development of treatment options, persons with HIV/AIDS were highly stigmatized, not only for having a much-feared communicable disease, but also for being gay and/or drug users in addition to effectively having a "death sentence" with their diagnosis. Researchers feared that conducting research or suggesting interventions that implied that people who have HIV also spread HIV would be cruel and unfair even though HIV-positive individuals are the source of every new infection. After it became possible to treat AIDS, some of the stigma was lifted and AIDS was normalized, allowing researchers to look at how to prevent the spread of AIDS from an HIV-positive individual to an uninfected individual. HIV prevention campaigns now stress the importance of not passing on the disease if you are infected, rather than focusing on not getting the disease if you are not infected.

2. Arguments against include case examples of some children who fell ill soon after being given the vaccination, unknown long term effects of the vaccine, the appropriateness of giving a vaccine related to sexual behaviour to a nine-year-old child, and the need for the vaccine when cervical cancer can be detected by a Pap test and successfully treated. Arguments for the vaccine include the fact that Pap tests don't always detect early signs of cervical cancer, and that Pap tests do not test for other types of cancer caused by HPV. In addition, the pro-vaccine group notes that some groups of women are unlikely to get a Pap test but may be protected from some types of cancer if given the vaccine at school.

3. In North America, the largest group transmitting HIV/AIDS to others are men who have sex with men and intravenous drug users. A campaign that addresses those individuals and gives them tools and skills needed to stop the spread of the infection is most appropriate in North America, mainly through condom use and not sharing needles. In South Africa, however, the main transmitters of HIV/AIDS are heterosexuals, and there are a number of culturally-based beliefs that demand a different approach. For example, many South Africans believe in traditional healers, and many HIV-positive individuals are also expected to produce a family, meaning that they must engage in risky sexual behaviour to appease the cultural norm. In addition, men hold a more powerful status in South African society than women, and that changes what strategies work best to ensure condoms are used. If the North American approach was used in South Africa or vice versa, HIV/AIDS prevention method would not likely be successful. The approach used needs to match the culture in which it is being used.

4. 1. A person's apparent "risky lifestyle" (e.g., drinkers are at a higher risk for STIs than non-drinkers) doesn't reflect whether they actually may or may not have an STI. 2. Many of the behaviours that are highest risk also have social stigmas, so the partner might not be honest about engaging in those behaviours (e.g., IV drug use, men having sex with men).

3. A partner may not know if their previous partners were carrying STIs, and the partner and their previous partner could be infected with a pathogen yet be asymptomatic.

5. Consent, contraception, safer sex, sexual pleasure, and the quality of the interpersonal relationship should all be considered. She should think about whether she has given and received consent for the level of sexual activity she is engaging in. She should consider her contraception choice and make sure it is the best for her health. She should consider whether she is enjoying the sexual activity with her partner and whether there are things she would like to do that they haven't tried, or things that she would like him to stop doing. She may also consider finding out whether he is enjoying their sexual relations. She should also consider whether she is happy with the non-sexual Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

aspect of her interpersonal relationship, whether the relationship is good for her, and whether it is good for her partner.

6. Answers may include some of the following: Think in advance about whether you want to be sexually active with a partner, and to what degree. Think about what's on your sexual-health wish list, including consent ("Have I clarified whether I, and my partner, actually want to do this?"), contraception ("Have I and my partner discussed, or have I personally put into place, acceptable contraceptive precautions?"), and safer sex ("The heck with taking a sexual history—if my partner or I have a sexual history, then we need to use condoms, and discuss STI screening, the limits to screening, and mutual monogamy."). Also, add to your sexual wish list sexual pleasure ("I know my partner believes that he or she is a superior lover, but I've got to figure out how to convey what I like best about what we do sexually together.") and interpersonal relationships ("Is this relationship good for me, and good for my partner?"). Also think about what you need to know—about contraception, safer sex, sexual function, sexual communication, and relationships—and where you can go to get the information you need, and then do your homework! (Good places to start are this textbook and the sexual and reproductive health website of the Society of Obstetricians and Gynaecologists of Canada, sexualityAndU.ca). Also keep in mind that your thoughts on sex may differ from others' thoughts on sex. Conceptions of sex in general—and of such related topics as consent, safer sex, and the promotion of sexual health in particular—tend to differ across cultures and among individuals; it is important to be aware of such differences when you are at home and when you are travelling within North America or overseas.

7. Condoms decrease sexual pleasure or sensation. To resolve this, put a drop of water-based lubricant or saliva in the tip of the condom or on the glans of the penis prior to putting on the condom, try a thinner latex condom, try different brands, or try more lubrication. Condoms decrease the spontaneity of sexual activity. To resolve this, incorporate condom use during foreplay, remember that peace of mind may enhance sexual arousal and response.

Using condoms is embarrassing, juvenile, and "unmanly." To resolve this, remember that being responsible is neither embarrassing nor juvenile, and that it is "manly" to protect oneself and others. Condoms don't fit well. To resolve this, try a smaller or larger condom (different sizes are readily available in many stores and health centres). Using condoms requires prompt withdrawal after ejaculation. To resolve this, remember that a sexual encounter doesn't have to end with withdrawal of the penis, and suggest low-risk post-coital activities such as caressing erogenous areas. Condoms can break, and fear of breakage may lead to loss of enjoyment. To resolve this, keep in mind that condoms generally do not break if used properly. The use of pre-lubricated condoms can help, as can the addition of a water-based lubricant if necessary. Condoms are difficult or unpleasant to use during oral or other non-penetrative sexual activity (use a non-lubricated condom for oral-penile sexual contact). To resolve this, try flavoured condoms. Cut a non-lubricated condom down the middle to form a protective sheet for oral-vulvar and oral-anal sexual contact.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 9

Sexuality over the Lifespan MULTIPLE CHOICE QUESTIONS 1. At what age do children first notice that there are differences between binary genders/sexes of males and females? a) around six months of age b) between the ages of one and two c) between the ages of two and three d) around age four 2. Sophia is two years old and touches her vulva with her blanket at bedtime each night. How does Sophia's behaviour compare to that of a typical two-year-old? a) It is normal. b) It is somewhat unusual but 10 per cent of children do touch themselves. c) It is highly abnormal for children of normal cognitive functioning to touch themselves. d) It is somewhat unusual but about 5 per cent of children do touch themselves.

3. What is the most commonly observed sexually transmitted infection in men over 60 in Canada? a) chlamydia b) gonorrhea c) herpes d) human papillomavirus (HPV) 4. Every time one-year-old Ava cries, her mother immediately rushes to her and picks her up. How might this affect Ava's behaviour when she is sexually mature? a) Ava may expect her partner to soothe her whenever she is upset. b) Ava may not take seriously any physical contact intended to demonstrate love. c) Ava may prefer sexual partners who give her physical space because she felt "smothered" by her mother. d) Ava is likely to have severe anxiety and troubled attachment.

5. Jonah is a preschooler and has discovered masturbation. What is he likely to learn about it? a) It reduces tension and provides physical pleasure. b) He can orgasm easily by rubbing against things, like a blanket. c) He should do it with others to gain the most satisfaction. d) He is ready to initiate sexual intercourse.

6. What motivates young children to engage in sexual behaviours? a) curiosity and exploration b) insatiable sex drive c) confusion and irritability d) modeling parental behaviours

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7. If a child is given some physical contact during infancy but is not allowed to feel safely connected to an adult and thus develops difficulties relating to others, what disorder is likely to be diagnosed? a) attachment disorder b) paraphilic disorder c) securement disorder d) attention deficit disorder 8. When does sexual development start? a) in the fetal stage b) around 12 months of age c) around 7 years of age d) at the same time as puberty 9. When do males start experiencing erections? a) in the fetal stage b) at around 2 years of age c) at around 7 years of age d) at the same time as puberty 10. Which of the following statements is NOT true? a) Sexual development starts in infancy. b) All infants seek love and physical contact from their caregivers. c) Between the ages of one and two, a child begins to notice that there are physical differences between males and females. d) All of the above are true.

11. Which of the following is true of sexual education? a) Sexual education can begin in early childhood. b) Sexual education shouldn't begin until adolescence. c) It is best to avoid discussion of sexuality with children under 12. d) Sexual education in childhood can make children uncomfortable about asking their parents questions later on.

12. Joanne and Thomas strive to be "askable" parents to their young children. What do "askable" parents do? a) They proactively use "teachable" situations to talk to their children about sexuality, rather than waiting for questions. b) They answer any questions their children have about sexuality, but they don't raise the subject otherwise. c) They welcome questions about love and relationships as long as they are not about sexuality. d) They ask their children questions about sexuality to gauge their knowledge and understanding of the subject.

13. If parents discover their child "playing doctor" with a friend, what reaction should they have? a) Parents should take the opportunity to teach the child appropriate expression of sexuality. b) Parents should ignore the child as if nothing ever happened. c) Parents should harshly condemn the child's behaviour to ensure that it does not happen again. d) Parent should separate their child from the friend for at least one year.

14. Maya's mother catches Maya "playing doctor" with a boy named Greg, and both children are undressed from Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

the waist down. What do most psychologists argue is the probable reason Maya is playing this game? a) Maya and Greg are curious about the difference between their genitals. b) Maya and Greg enjoy sexual stimulation and have not yet learned that it isn't appropriate during childhood. c) Maya and Greg have been exposed to explicit sexual activities on television and are simply re-enacting what they have seen. d) Maya and Greg have no idea that their genitals are different and no interest in comparison; they are simply playing doctor because they enjoy pretend play.

15. Hailey is four years old and Hailey's mother catches her touching her vulvar region while watching television and immediately scolds Hailey and tells her to never, ever do that again. How would a psychologist evaluate Hailey's mother's reaction? a) The psychologist would be happy that Hailey's mother reacted this way because early sexual stimulation is linked to hypersexual behaviour in adolescence. b) The psychologist would be unhappy that Hailey's mother reacted this way because children should be free to touch themselves whenever and wherever they please if they are to grow up and have healthy sexual behaviour as adults. c) The psychologist would warn Hailey's mother that punishing sexual behaviour can lead to the person feeling shameful about sexual activity when they are an adult. d) The psychologist would be happy that Hailey's mother punished Hailey because research has shown that punishment is the only way to stop children from inappropriate sexual behaviour before adolescence.

16. Which of the following is an example of an "askable" parent? a) Dana doesn't start conversations about sex with her child but answers all questions when asked b) Nikos is very concerned about his child knowing about sexuality before puberty so he will answer questions with one of three responses: "yes," "no," or "you are not old enough." c) Heather answers all questions about sexuality asked by her four year old with the response "you are not old enough." d) Olga doesn't wait for her children to ask questions to discuss sex; she comments on sexual situations in an age-appropriate manner and also answers questions in an age-appropriate manner when asked.

17. Dina loves playing football, but she's starting to feel like the sport isn't feminine enough. What stage of sexual development is Dina likely in? a) preadolescence b) adolescence c) early childhood d) infancy 18. Jacob is being raised with lots of information about sexuality from his parents. Compared to a child who is raised with no information about sexuality from his parents, what will Jacob's sexual behaviour likely be like when he is an adult? a) Jacob is more likely to be promiscuous when he is an adult. b) Jacob is more likely to feel ashamed about his sexuality when he is an adult. c) Jacob is more likely to make informed decisions about sexuality when he is an adult. d) Jacob has a slightly higher likelihood of being bisexual as an adult.

19. What is considered typical sexual behaviour for a 10-year-old boy?

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a) At age 10, boys have no interest in sex and never have. b) At age 10, boys are curious about gender differences but not physically able to masturbate. c) At age 10, boys are less interested in sex than they were when they were 6. d) At age 10, boys often begin to masturbate and have an increased curiosity regarding sexuality compared to younger children.

20. Research indicates that a child who is well-educated in sexuality will be __________. a) more likely to make responsible, informed decisions related to sexual behaviour b) more likely to engage in sexual behaviours at an earlier age c) more likely to practice abstinence until marriage d) more likely to be promiscuous through teen years 21. What is the difference between primary and secondary sex characteristics? a) Primary sex characteristics are directly related to reproduction, and secondary are not. b) Secondary sex characteristics are directly related to reproduction, and primary are not. c) Primary sex characteristics are dictated by societal norms, and secondary are chosen by the individual. d) Secondary sex characteristics are dictated by societal norms, and primary are chosen by the individual.

22. Marcia's 11-year-old daughter, Tanya, has asked for a skimpy bikini for her birthday because all her friends plan to wear sexy swimwear they saw in Teen Vogue this summer. Marcia sees this request as an effect of widespread sexualization of young girls in the society. How could she respond to the request to counteract this effect? a) She could try to explain to Tanya that she doesn't have to look sexy to be liked by her friends, and that her value as a person doesn't depend on what teen magazines, TV, or the Internet tell her to be. b) She could ground Tanya for the summer, take away her phone and magazines, and disconnect the internet to cut her off from the bad influence. c) She could get Tanya a regular swimsuit for her birthday and tell her that if she wants a sexy bikini, she has to find a summer job and buy it herself, to understand the value of money. d) She could contact all Tanya's friends' mothers and organize an intervention to make the girls understand they bring shame to their families by dressing like little prostitutes.

23. What term is most accurately used to describe the condition where people are made to feel as though their value or worth is inextricably linked to their sexual appeal, where they equate their physical attractiveness to being sexy, where they are sexually objectified, and where sexuality is inappropriately imposed upon them? a) sexualization b) marginalization c) semenarche d) hypersexuality 24. What conditions have been linked to the sexualization of girls? a) eating disorders b) low self-esteem c) depression d) all of the above 25. During the last 10-20 years, there is evidence that puberty is beginning at younger ages. According to the text, Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

what is this attributed to? a) childhood obesity b) hormonal additives in food c) vitamin deficiencies d) genetic modification 26. What is the primary sexual expression among youth during adolescence? a) masturbation b) one-to-one person sex c) sexual play among friends d) sexual exploration through games 27. Levi and Emma recently had their first experiences of sexual intercourse with each other. After, Levi was praised by his peers for having sex, while Emma was questioned by some of her friends as to whether Levi was the right person for her to lose her virginity to. These reactions are an example of __________. a) sexual double standard b) sexual scripts c) gender role expectations d) gender binaries 28. Which sexual characteristics are necessary for reproduction? a) primary sex characteristics b) secondary sex characteristics c) primary and secondary sex characteristics d) primary, secondary, and fertility characteristics 29. Which of the following describes the difference(s) between puberty in boys and puberty in girls? a) In boys, puberty starts earlier and takes longer to complete. b) In boys, puberty starts later and takes longer to complete. c) In boys, puberty starts earlier and takes less time to complete. d) In boys, puberty starts later and takes less time to complete.

30. Which script do partnered sexual activities in adolescent boys and girls typically follow? a) the traditional sexual script b) the adolescent sexual script c) the normal sexual script d) the binary sexual script 31. In Canada, what is the average age for a male or female to have intercourse for the first time? a) 15 b) 16 c) 17 d) 18 32. Which of the following is true? a) Media images of sexualized girls help girls to be more confident about their appearance when they are adults.

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b) SGD teens follow the heterosexual sexual script in adolescence but not in adulthood. c) Sexual adjustment as an adult is not related to early sexual experiences despite "the first time" being seen as a rite of passage. d) Babies born to teenage mothers are at higher risk of being underweight.

33. What has been observed about condom use in teenagers? a) Condom use decreases as teenagers get older because teenagers often switch to other non-barrier methods. b) Condom use increases as teenagers get older because teenagers engage in more intercourse and less oral sex. c) Condom use increases as teenagers get older because teens know their partner will have had more previous sexual partners. d) Condom use decreases as teenagers get older because older teenagers feel using condoms implies they are not in a serious and mature relationship.

34. Which of the following could be a reason for decreasing rates of teen pregnancy in Canada? a) better sex education b) more effective contraceptive use c) shifting social norms d) all of the above 35. Which of the following is a common misconception among teenagers? a) Sexually transmitted infections can be transmitted through intercourse. b) Sexually transmitted infections cannot be transmitted through oral sex. c) Sexual activity without contraception can result in pregnancy. d) It is important to use condoms, even when it is an early sexual experience.

36. Canadian research has found that being a teen mother is correlated with all of the following EXCEPT __________. a) being single b) residing in the western Prairies c) residing in the Maritimes d) low socioeconomic status 37. In Canada, sexually transmitted infection (STI) rates in teenagers have increased in recent years. What maybe be causing this increase? a) a rise in non-barrier contraceptive use b) prioritizing pregnancy prevention over STI prevention c) a belief that STIs aren't transmitted through oral sex d) all of the above 38. Taylor, a 17-year-old boy, has been attracted only to boys since puberty, but he's been going out only with girls. What could be the reasons for his dating practices? a) He lives in a rural community and lacks opportunity to engage in SGD behaviour. b) He wants to explore his sexuality before being in a same-sex relationship. c) His male friends at school call each other "gay" or "faggot" as an insult. d) all of the above

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

39. Which of the following is NOT true of levels of interest in sex? a) Men are more interested in having sex with many different partners than women. b) Some men prefer to have sex only within a monogamous relationship. c) Some women desire a lot of sex. d) All of the above are true.

40. Casual sex among adults __________. a) appears to be increasingly common among single men and women b) is generally shunned in North America and serves only for sexual release c) is about the same in terms of level of acceptance compared to previous years d) is rare among most adults in favour of more traditional models of sexuality, and serves mainly to harm committed relationships 41. What statement is true about the four "types" of casual sex relationships that are identified in the text? a) Females agree with males on all the definitions except the "friends with benefits" category, which females consider to be a possible precursor to a romantic relationship and males do not. b) Males agree with females on all the definitions except for the "fuck buddies" category, which they say is the same as "friends with benefits." c) These types of relationships are distinctly different from one another. d) Females only classify "one night stands" as casual sex and disagree with males on the definitions of the other three types of casual sex.

42. Which of the following is true concerning sexual activity among people with disabilities and their caregivers? a) Sexual activity is usually not possible for people with disabilities. b) Sexual activity can be affected by a lack of privacy that accompanies the lifestyle of many people with physical disabilities. c) It is always the caregiver's responsibility to ensure that people with severe mental disabilities do not engage in risky sexual activity. d) The fact that a caregiver may feel uncomfortable assisting in enabling sexual activity for the disabled person they care for is not an important issue.

43. According to research discussed in your text, what factor seems to influence how likely it is for an Asian-Canadian female to engage in premarital sex? a) level of education b) assimilation with Western culture c) socioeconomic status d) province of residence 44. What impact does level of education have on premarital sex in India? a) Women with less education are more likely to have intercourse before marriage than girls with more education. b) Women with less education are less likely to have intercourse before marriage than girls with more education. c) Education has very little impact on whether a woman has premarital sex in India. d) Education level has an impact on rates of premarital sex for men but not for women in India.

45. In Ethiopia, which people are less likely to participate in premarital sex? a) those who have less traditional values Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) those who are less educated c) those who are older d) those who drink alcohol 46. Researchers at the University of British Columbia surveyed European-Canadian and Asian-Canadian students and suggested that __________. a) young people who identify more strongly with Western culture have more opportunity to increase their sexual knowledge and comfort b) young people who identify more strongly with Western culture are confused about sexual norms without the support of strong conservative values c) young people who identify more strongly with Western culture are more prone to sexual dysfunction and deviant behaviours d) young people who identify more strongly with Western culture more often select sexual partners from among new immigrants 47. Among people aged 25-29, __________ people have more sex than __________ people. a) cohabiting; dating or married b) married or cohabiting; dating c) dating; cohabiting or married d) married; cohabiting or dating 48. Louise is 27 and has been dating John for a couple of years. Her grandmother keeps telling her she should get married because she will soon be past her prime. Her grandmother was married and had two children by the time she turned 27, while Louise is wasting her time on dating. Should Louise listen to her grandmother? a) Louise can tell her grandmother that times have changed. In her grandmother's youth women did indeed get married in their early twenties, but nowadays the average age for marriage is closer to 30. b) Her grandmother is right. Louise is past the current Canadian average, which is the age of 25, for a woman's first marriage. c) Louise should make sure she gets married before she turns 30 because Canadian statistics indicate that couples who marry in their thirties are more likely to divorce than those who marry in their twenties. d) Louise can tell her grandmother that nowadays it is actually better to marry later because studies show that women in their thirties tend to find wealthier partners.

49. What is one possible disadvantage to a common-law union compared to a legal marriage? a) Spouses cannot share health benefits. b) If the relationship ends, the lower-income earner is not entitled to spousal support. c) If the relationship ends and there are children from the relationship, the father has no custody rights. d) Common-law spouses cannot share pensions.

50. Which of the following is true about couples who live together before getting married compared to couples who do not live together before getting married? a) They are less likely to divorce. b) The are more likely to divorce. c) The are less likely to have children. d) They are more likely to have children.

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51. Sexual satisfaction among married couples is closely associated with __________. a) marital satisfaction b) masturbatory satisfaction c) financial satisfaction d) cohabitation satisfaction 52. Frida and Giselle have been married for seven years and report having a happy marriage. Which of the following statements are they most likely to make? a) They want to have sex at the same rate as their partner. b) They have more sex now than when they began their relationship. c) Their sexual relationship has become routine. d) They don't argue.

53. Which of the following models best describes a situation in which marital satisfaction is positive, the rewards outweigh the costs of the relationship, the expectations of the rewards and costs in the relationships are being met, and there is perceived equality between the rewards and costs for each partner? a) interpersonal exchange model b) evolutionary psychology c) social structural model d) social scripts model 54. David and Frieda have been married for 13 years, but they have decided to get a divorce. Which of the following is mostly likely true? a) They are not religious. b) They married young. c) They have both been married before. d) Any of the above is likely to be true.

55. Which of the following correlations best describes marriages? a) People who are happy in their sex lives are happy in their marriages. b) People who are dissatisfied in their sex lives are happy in their marriages. c) People who are happy in their sex lives are dissatisfied in their marriages. d) all of the above 56. What is the general conclusion of research related to long-distance dating relationships (LDDR)? a) Happiness in an LDDR is primarily related to how often the couple sees each other. b) Happiness in an LDDR is primarily related to how geographically close the couple is to one another. c) A couple in an LDDR is more likely to break up than a couple in a geographically close relationship. d) Anxiety and attachment styles may have a significant impact on the success of an LDDR. 57. When married people in Canada are asked what the most important aspect of their relationship is, what do most say? a) The quality of the sexual relationship is most important. b) The quality of the friendship is most important. c) Whether the partner is a good parent and/or provider is most important. d) The similarity in religious views is most important.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

58. What was the result of a 2010 survey conducted by MacIntosh, Reissing, and Andruff, who interviewed married same-sex couples five years after their marriages were made legal? a) The couples reported almost identical positive and negative aspects to marriage as mixed-sex married couples married for the same amount of time. b) The couples reported lower marital satisfaction than was reported for mixed-sex married couples married for the same amount of time. c) The couples reported higher marital satisfaction that mixed-sex couples married for the same amount of time. d) The divorce rate for same-sex couples was the same as the divorce rate for mixed-sex couples, although for couples still married, marital satisfaction was the same.

59. Approximately what percentage of men report non-consensual non-monogamy (NCNM)? a) 2 to 5 per cent b) 5 to 10 per cent c) 23 to 43 per cent d) 23 to 63 per cent 60. Which of the following is a predictor for someone engaging in non-consensual non-monogamy (NCNM)? a) having more education b) having less education c) being more religious d) being female 61. In Canada, what proportion of marriages end in divorce? a) about 25 per cent b) about 40 per cent c) about 55 per cent d) about 70 per cent 62. Which of the following is true about people's responses when they find out about non-consensual non-monogamy (NCNM)? a) Males are more upset by emotional aspects of NCNM and females are more upset by physical aspects of NCNM. b) Females are more upset by emotional aspects of NCNM and males are more upset by physical aspects of NCNM. c) Both males and females are most upset by physical aspects of NCNM. d) Both males and females are most upset by emotional aspects of NCNM. 63. Since same-sex couples have only had the right to marry in Canada since 2005, marital satisfaction is somewhat difficult to measure. Despite this, early research suggests that same-sex couples are experiencing __________. a) higher than average levels of relationship satisfaction b) lower than average levels of relationship satisfaction c) average levels of relationship satisfaction d) significantly lower than average levels of relationship satisfaction

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64. Which of the following is NOT a characteristic of someone who engages in extradyadic sex? a) blue-collar worker b) male c) educated d) less religious 65. For most older adults, sex __________. a) is an integral part of their lives b) is a thing of the past c) happens rarely and therefore is given little consideration as they age d) should not be talked about and should happen infrequently 66. In a global study of the effects of aging on sexual functioning, what change(s) in female sexual functioning did researchers conclude was definitely caused by aging? a) decrease in vaginal lubrication b) decrease in vaginal lubrication and decrease in frequency of orgasm c) decrease in frequency of orgasm and vasocongestion in the genitals d) decrease in vaginal lubrication and decreased interest in sexual activity 67. What is the most common reason dating can be frustrating for people after divorce? a) Dating norms may have changed since the divorcee was last on the dating scene. b) After divorce, most people are less sexually desirable. c) Divorcees rarely understand the risk of STIs. d) There are few people dating after divorce.

68. Which of the following is NOT associated with menopause? a) a complete cessation in sexual activity b) vaginal dryness and decreased lubrication c) fatigue, irritability, and hot flashes d) mood swings and depressive feelings 69. Which of the following is least likely to be associated with men's sexual activity and aging? a) a sudden drop in sexual desire and erectile function b) decrease in testicle size c) less forceful ejaculation d) decreased subjective pleasure with orgasm 70. Alice and Henry have been married for 53 years and are both 75 years old. What is the probability that Alice and Henry have sexual intercourse at least three times a month? a) 5 per cent b) 15 per cent c) 25 per cent d) 50 per cent 71. Which of the following statements best describes sexuality in older adults? a) Many people continue to enjoy partnered sexual activity well into their later years, though with aging there is Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

more of a focus on quality, not quantity. b) Some people continue to enjoy partnered sexual activity well into their later years, though with aging there is more of a focus on avoiding awkward communication with partners. c) All people continue to enjoy partnered sexual activity well into their later years, though with aging there is more of a focus on increasing the frequency of sex to make up for lost time. d) Rarely do people continue to enjoy partnered sexual activity well into their later years, though with aging there is more of a focus on reaching orgasm quickly.

72. Which of the following statements best describes sexual activity in older adults? a) Foreplay becomes the "mainplay." b) Orgasm becomes the focus. c) Foreplay becomes rushed to avoid losing erections. d) Penetration becomes the foreplay.

73. Which of the following is NOT true of sexual activity in older adults? a) Sexual activity is much shorter for older adults. b) Sexual activity is seen as a problem behaviour in nursing homes. c) There is more focus on foreplay. d) All of the above are true.

74. What percentage of older adults over 75 still engage in sexual activity three or more time per month? a) more than 50 per cent b) less than 50 per cent c) less than 10 per cent d) more than 90 per cent 75. What challenges may older adults in assisted-care facilities face in maintaining sexual activity? a) lack of privacy b) poor attitudes by health care workers that may see sex as a problem c) negative or patronizing attitudes d) all of the above 76. What discriminatory factor may healthcare professionals hold against older adults that may interfere with routine screening for sexually transmitted infections? a) ageism b) lack of STI knowledge c) sexual discrimination d) all of the above 77. What factors may contribute to the rise of sexually transmitted infections among older adults? a) no risk of pregnancy b) thinning of the vaginal walls c) lower immune system function d) all of the above 78. Which of the following statements is true with relation to SGD youth and sexuality?

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a) Dating can often be very difficult for SGD teenagers because of lack of opportunity. b) Dating can often be very difficult for SGD teenagers because of social disapproval. c) SGD youth may experience confusion about how their sexual orientation fits (or does not fit) into the social norms of their peer group. d) All of the above are true statements.

79. Which statement best reflects the fact that marital satisfaction follows a trend similar to that of sexual frequency? a) It declines during the first few years of marriage, then rises until mid-life, and then starts to decline again. b) It peaks during the first few years of marriage, then declines until mid-life, and then starts to rise again. c) It peaks during the first few years of marriage, then rises until mid-life, and then starts to decline. d) It peaks during the first few years of marriage, then declines until mid-life, and then starts to decline again.

80. Which of the following statements is not true about divorce in Canada? a) Divorce rates have stayed stable in the past 10-15 years. b) Divorce rates have risen in the past 10-15 years. c) Approximately 40 per cent of Canadian marriages end in divorce. d) People who have been divorced before are more likely to divorce in subsequent marriages.

81. Mary is 46 years old and is feeling fatigued and irritable. Her periods are becoming less regular and she is experiencing vaginal dryness. What life stage is Mary most likely in? a) menopause b) perimenopause c) postmenopause d) menarche 82. Approximately what percentage of youth living in the United States report experiencing sexual intercourse before age 13? a) 3 per cent b) 8 per cent c) 15 per cent d) 20 per cent 83. Which of the following statements is false about sexuality and ageing? a) Men express more concern about sexual difficulties with increasing age. b) Women express more concern about sexual difficulties with increasing age. c) Sexuality in older adults is a complex and multi-determined process. d) Men experience more sexual problems associated with the biological effects of aging.

84. Which theory of sexual satisfaction posits that marriages are happy when the rewards outweigh the costs of the relationship? a) the business model of sexual satisfaction b) the economic model of sexual satisfaction c) the interpersonal exchange model of sexual satisfaction d) the monetary exchange model of sexual satisfaction

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85. We know that attitudes toward virginity and premarital sex vary across cultures. Which of the following statements is incorrect? a) In India, the vast majority of people do not have premarital sex. b) In Ethiopia, the vast majority of people do not have premarital sex. c) Those that participated in premarital sex in India tended to be less educated. d) Those that participated in premarital sex in Ethiopia tended to be younger.

86. Which of the following is true in relation to teenage unplanned pregnancy in Canada? a) Teen pregnancy rates are declining in Canada. b) Teen pregnancy rates are increasing in Canada. c) Teen pregnancy rates are remaining stable in Canada. d) Becoming a teen mother is not related to low socioeconomic status.

87. As a child's manual dexterity improves, they may begin to masturbate. At what age might a child begin to masturbate? a) age 2 or 3 b) age 4 or 5 c) age 6 or 7 d) age 8 or 9 88. People involved in a romantic and/or sexual relationship living together without being married are ________. a) common-law b) cohabitating c) single d) friends with benefits 89. Having sexual intercourse for the first time can affect people differently because of widely held ________ between the binary genders/sexes. a) religious beliefs b) peer pressures c) sexual double standards d) conspiracy theories 90. What is one reason that prevents routine STI testing in older sexually active adults? a) ageism on the part of health care professionals b) lack of knowledge on the part of health care professionals c) lack of access to health care professionals on the part of older adults d) the changing language around sexually transmitted infections SHORT ANSWER QUESTIONS 1. In her 2008 book From Diapers to Dating: A Parent's Guide to Raising Sexually Healthy Children from Infancy to Middle School, Debra Haffner calls parents who initiate talks about sexuality with their child "__________" parents.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

2. The first ejaculation that a male experiences at puberty is known as __________.

3. The most likely cause of a decrease in the age of menarche in girls in recent years is an increase in childhood __________.

4. When a male has sex for the first time, it is seen as positive and "becoming a man," whereas for a female, it is seen as negative and "losing virginity." The term used to refer to this differing view between the value of sexual experience in males and females is the __________ __________ __________.

5. In Canada, the average age for men at the time of divorce is __________.

6. The negative emotion that often results when relationship partners spend increased time on social networking websites is __________.

7. The stage in life when a woman begins producing less estrogen and progesterone is __________.

8. The type of prejudice that may lead health care professionals to provide less information about sexually transmitted infections to older adults is called __________.

9. The term for living together without being married is __________.

10. When people are made to feel as though their worth is extrinsically linked to their sexual appeal, they are subject to __________.

11. The first incidence of menstruation is known as __________.

12. During puberty, the primary and secondary sexual characteristics develop as a result of __________ changes.

13. Puberty typically begins __________ for girls than boys.

14. Typically, puberty lasts about __________ to __________ years 15. Andi and Max are teenagers who are exploring sexual behaviours. Their behaviours will most likely follow the __________ sexual script.

16. The average age of first intercourse for both males and females in Canada is __________.

17. Data suggests that sexually active teens are MOST concerned about preventing __________.

18. Long-distance relationships can be successful if both partners maintain a(n) __________ __________ about the relationship.

19. Marital satisfaction is positively __________ with sexual satisfaction.

20. Features that are not directly related to reproduction that develop at puberty are ________ sex characteristics.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

21. When sex outside of the primary relationship is sometimes permitted or even encouraged, those who engage in this practice may consider themselves ________, which is derived from Greek meaning "many loves".

22. Following menopause, women today spend a significant portion of their lives in what is called ________.

23. Freud's developmental stage referred to as the "latency period" occurs in the period of life between the ages of 8 and 12 most commonly called ________.

24. The main sex organs that are necessary for reproduction are referred to as ________ sex characteristics.

ESSAY QUESTIONS 1. Discuss the topic of sexualization in preteen girls. How does it originate? What are the consequences of sexualization on later sexual development?

2. What are five reasons why North American girls may be choosing to have oral sex instead of sexual intercourse?

3. What are some of the possible reasons for a change in the average age of first marriage between 1972 and 2008?

4. What factors contribute to the likelihood of a divorce?

5. Discuss at least two life situations where caregivers must make ethical decisions about whether to facilitate sexual activity for the people they care for. Discuss the situations and the ethical dilemma. If you feel strongly about what is ethical/unethical, you can discuss your position.

6. Describe the main characteristics of sexuality in infancy.

7. Freud described the preadolescence stage as the "latency period" because he theorized that there was little sexual interest or activity during this period. Discuss more recent research on the matter and possible explanations for why Freud suggested this.

8. Discuss the potential pros and cons of living together before marriage.

9. Compare the physical effects of aging between men and women in relation to sexual behaviour.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. a 3. b 4. a 5. a 6. a 7. a 8. a 9. a 10. a 11. a 12. a 13. a 14. a 15. c 16. d 17. a 18. c 19. d 20. a 21. a 22. a 23. a 24. d 25. a 26. a 27. a 28. a 29. b 30. a

31. c 32. d 33. a 34. d 35. b 36. c 37. d 38. d 39. a 40. a 41. c 42. b 43. b 44. a 45. b 46. a 47. a 48. a 49. b 50. b 51. a 52. a 53. a 54. d 55. a 56. d 57. b 58. c 59. d 60. a

61. b 62. b 63. a 64. a 65. a 66. a 67. a 68. a 69. a 70. d 71. a 72. a 73. a 74. a 75. d 76. a 77. d 78. d 79. b 80. b 81. b 82. a 83. b 84. c 85. d 86. a 87. a 88. b 89. c 90. a

SHORT ANSWER QUESTIONS 1. askable 2. semenarche 3. obesity 4. sexual double standard 5. 45 6. jealousy 7. perimenopause 8. ageism

9. cohabitation 10. sexualization 11. menarche 12. hormonal 13. earlier 14. three, four 15. traditional 16. 17

17. pregnancy 18. positive attitude 19. correlated 20. secondary 21. polyamorous 22. postmenopause 23. preadolescence 24. primary

ESSAY QUESTIONS Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Sexualization occurs when people are made to feel as though their value or worth is inextricably linked to their sexual appeal, when they equate their physical attractiveness to being sexy, when they are sexually objectified, and when sexuality is inappropriately imposed upon them. Evidence for the sexualization of preadolescent girls can be found in the media (television, movies, music, magazines, the Internet, etc.) as well as in consumer products marketed toward girls under 10 (e.g., Bratz dolls, thong underwear). Parents, teachers, and peers can also convey the message that physical attractiveness and sexuality are highly valued in young girls, and the results of this sexualization can be harmful. Self-objectification has been associated with anxiety about appearance and feelings of shame in 12- and 13-year-old girls. Sexualization of girls has also been linked to eating disorders, low self-esteem, and depression. Additionally, girls who are exposed to sexualized media are more likely to endorse sexual stereotypes of women as sexual objects, and they are more likely to place high value on appearance and physical attractiveness.

2. 1. They believe that they are at less risk for sexual transmitted infections.

2. They wish to prevent pregnancy.

3. Oral sex may be more socially acceptable than intercourse.

4. Oral sex is viewed as less intimate than intercourse.

5. Oral sex is an option when you aren't yet ready for intercourse.

3. The average age of first marriage has increased by about seven years for both men and women between 1972 and 2008, from about age 23 to about age 30. There are many possible reasons for this. For one, more people are attending post-secondary education and incurring great debt in the process; as a result, more people are choosing to live at home longer and delay getting married until they are financially stable. In addition, as suggested above, more people are living together first before getting married. Further, women are less financially dependent on men than they were in the past and, as such, are able to be more selective when choosing a mate. Finally, it is much more acceptable today than in the past for women to delay childbearing until their thirties or to have children without being married, so women today likely feel less pressure to get married and start a family at a young age.

4. Age may be a contributing factor, as Canadian couples who marry young may be more likely to divorce than couples who were older at the time of marriage. In addition, religion can have a protective effect on a marriage, as Canadians who attend religious services during the year—even if only just a few—have been shown to be less likely to divorce than those who do not attend such services. Finally, people who have been divorced before are more likely to divorce in subsequent marriages.

5. There are three possible situations discussed in the chapter. One is when caring for someone with a physical disability. The ethical dilemma is the extent to which the caregiver is responsible for helping that person have safe sex. Another scenario is when caring for someone with a mental disability. The ethical dilemmas involved may be whether the person is mature enough for sex and whether the caregiver is responsible for that person not getting pregnant or impregnating someone and not contracting a sexually transmitted infection. Another scenario is when the person is in a senior's home and has little privacy and may not have a partner but may have sexual interest. The ethical dilemma is whether the caregiver must find a sexual partner and make sure they have safe sex.

6. Sexual development starts while the fetus is growing in the womb. Erections have been noted in male fetuses, and male infants may experience reflexive erections beginning shortly after birth. Signs of physiological arousal in female infants, such as vaginal lubrication, are harder to detect but have also been reported. Infants are able to derive physical pleasure from tactile contact with their caregivers and from sucking (e.g., breastfeeding, or Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

sucking on pacifiers, hands, and toys), which is pleasurable because of the heightened sensitivity of the mouth.

They are also able to derive physical pleasure from self-stimulation, and it is common for infants to rub their genitals against something such as a blanket or a toy; this may occur in infants as young as two months old.

7. Preadolescence, which generally occurs between the ages of eight and 12, is the developmental stage that Freud referred to as the "latency period" (see Chapter 2), suggesting that children's interest in sex and sexuality decreases during this stage. While this may be true for some preadolescents, more recent research and observations suggest that children's interest in sex typically increases during this stage, particularly around the age of 10 (Herdt & McClintock, 2000). Masturbation is the primary form of sexual expression among preadolescents, with males being more likely than females to masturbate frequently and to experience orgasm (Schwartz, 1999).

In those children who show a decreased interest in their bodies and sex differences, it may be that parents' negative reactions to earlier open displays of body exploration taught them to hide when exploring their bodies.

Socialization and an effort on the part of the child to adopt appropriate social norms may also result in less overt exploration activities (Friedrich, Grambsch, Broughton, Kuiper, & Beilke, 1991). Toward the end of the preadolescent period, as their interest in dating increases, many children begin to explore their emerging sexuality by playing socially acceptable sexualized games like "spin the bottle".

8. There are advantages and disadvantages to living together before marriage. Cohabiting can give a couple a chance to get to know each other better without making a legal or financial commitment to each other, which may allow them to make a more informed decision about whether or not they want to marry. Another advantage is that cohabiting people between the ages of 25 and 29 have a higher frequency of sex than either dating or married people have. On the other hand, couples who live together may experience conflict if their visions of the future divert, particularly if one would like to marry but the other would not. Canadians who do get married after cohabiting are 50 per cent more likely to get divorced than those who marry without having first cohabited. There may be many reasons for this higher divorce rate among couples who cohabited before marriage; for example, such couples may hold less traditional views of marriage, or they may simply view all relationships, even those formally recognized under the law, as temporary.

9. Women typically enter perimenopause, the life stage in which the ovaries begin to produce less estrogen and progesterone, sometime in their late forties. Initially they might not feel any of the effects of perimenopause, but some women start to feel what are usually referred to as "menopausal symptoms," such as mood swings, depressive feelings, sleep disturbance, fatigue, irritability, hot flashes, and night sweats. Menstrual periods may become heavier, lighter, and/or less regular, and vaginal dryness and decreased lubrication may be noticed.

Around the age of 51, women in the Western world tend to experience menopause, the life stage in which they have their last menstrual period; the time after the last menses is referred to as postmenopause. Women today spend a significant amount of their lives in the postmenopausal stage. Hormone levels continue to fluctuate until about five years postmenopause, at which point levels stabilize and most women no longer experience menopausal symptoms.

In older men, the relationship between the physical effects of aging and sexual impairment appears to be more linear that it does in women, but as with women, there is significant variation in how aging affects an individual's sexuality. Many men find that it takes them longer to have an erection, as the penis tends to become less sensitive to stimulation with age, and their erections are less firm and less reliable. The testicles also decrease in size and ejaculations become less forceful, which can sometimes lead to decreased subjective pleasure with orgasm.

Further, the refractory period after an orgasm, during which most men are unable to have another erection, increases. With regard to sexual dysfunction, older age is associated with increasing degrees of erectile dysfunction, a decrease in sexual desire, and more difficulty having orgasm. A steady decrease in testosterone in Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

the brain and body of older men has also been associated with the decline in sexual function and, in particular, sexual desire. Lifestyle factors (e.g., smoking) can also affect erectile responsiveness, but in general, vascular and nerve damage become more pronounced as men get older.

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CHAPTER 10

Gender MULTIPLE CHOICE QUESTIONS 1. What is suggested by the theory of gender neutrality? a) All fetuses have a neutral gender until they are exposed to male or female hormones in the womb. b) Gender roles are fluid throughout the lifespan with a person being able to switch between one gender and another easily. c) Children are born with neutral genders and they adopt a gender from social cues. d) There are no differences in the behaviours or preferences of males and females at any point in the lifespan.

2. What happened to Bruce Reimer, who was raised as "Brenda" after a poorly executed circumcision, as he/she grew into adulthood? a) She accepted her role as a female, married a man, and adopted two children. b) She joined a convent as a nun. c) He reverted back to the male gender role and became "David," a man who married a woman and raised a son. d) She continued to dress as a female but had lesbian relationships with other women.

3. What best describes the traditional view of what differentiates one's gender identity from one's sex? a) genes b) hormones c) psychology d) biology 4. What best describes the traditional view of the origin of a person's sex? a) several biological factors b) environment after birth c) psychology d) chromosomes 5. What will happen to a fetus with XY chromosomes that does not transmit the SRY gene? a) It will develop normal gonads. b) It will not develop testes and will develop ovaries instead. c) It will not develop testes or ovaries. d) It will develop both testes and ovaries.

6. In what case can a genotype differ from a phenotype? a) The SRY gene is activated in an XY fetus. b) The SRY gene is not activated in an XX fetus. c) The SRY gene is activated in an XX fetus. d) The FOXl2 gene is not expressed in an XY fetus.

7. __________ determines the sex based on the presence of ovaries or testicles, while __________ determines the Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

sex based on levels of estrogens and androgens. a) Gonadal sex; hormonal sex b) Genotype; phenotype c) Genotype; chromosomal sex d) Hormonal sex; gonadal sex 8. What term is used to describe the outward appearance or expression of a set of physical and behavioural traits, determined by genotype and environment? a) phenotype b) gonadal sex c) genome d) hormonal sex 9. Which of the following factors may affect an individual's gender? a) hormonal sex b) gonadal sex c) chromosomal sex d) all of the above 10. What factors inform an individual's gender role? a) gender schemas b) stereotypes c) genotype d) all of the above 11. Julia has a higher conservative attitude towards casual sex than her friend Elliot. Which theoretical framework would attribute this difference in sexuality to the fact that men have a greater physiological capacity to reproduce? a) social learning theory b) evolutionary psychology c) social structural theory d) genetic theory 12. Edith has a higher conservative attitude towards casual sex than her friend Rory. Which theoretical framework would attribute this difference in sexuality to the fact that women are more often primary caregivers? a) social learning theory b) evolutionary psychology c) social structural theory d) genetic theory 13. Candace has a higher conservative attitude towards casual sex than her friend Pharrell. Which theoretical framework would attribute this difference in sexuality to the fact that media often portray women as sexualized objects? a) social learning theory b) evolutionary psychology c) social structural theory d) genetic theory Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

14. Gender __________ are mental frameworks based on understandings of how men and women typically behave, whereas gender __________ are widely held beliefs about the typical characteristics and behaviours of men and women. a) schemas; stereotypes b) stereotypes; schemas c) roles; identities d) identities; roles 15. The theory that suggests that differences in biologically and physiologically determined reproductive roles give rise to differences in gendered psychological processes and behaviour aimed at maximizing the likelihood that children will survive and reproduce is __________. a) evolutionary psychology b) social learning theory c) social structural theory d) biology theory 16. What do evolutionary psychologists suggest is the reason for different genders? a) Different genders result from observing different expectations about gender in our society. b) Different genders arise because offspring are more likely to survive with two distinct gender roles in place. c) Different genders arise because of differences in the workplace roles for different people. d) Different genders arise because we need eggs and sperm to procreate.

17. Which theory supports the idea that gender differences can be affected by factors such as the Internet, television, film, and magazines? a) parental investment theory b) social learning theory c) social structural theory d) reproductive fitness theory 18. Which theory supports the idea that gender differences can be affected by factors such as women being able to produce only a limited number of children? a) parental investment theory b) social learning theory c) social structural theory d) reproductive fitness theory 19. Which theory supports the idea that gender differences can be affected by factors such as who controls resources? a) parental investment theory b) social learning theory c) social structural theory d) reproductive fitness theory 20. According to social learning theory, which of the following is true about female gender compared to male gender?

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a) Male gender is seen as more fluid than female gender. b) Female gender is seen as more fluid than male gender. c) Male gender is seen as more influenced by biology than female gender. d) Female gender is seen as more influenced by biology than male gender.

21. Which theory attempts to explain gender differences as resulting from differences in the workforce? a) social learning theory b) evolutionary theory c) social structural theory d) economic dependence theory 22. Researchers in Sub-Saharan Africa studying the adaptiveness of infant temperaments found that difficult, cranky babies do worse in times of plenty; these children create a lot of stress for their parents and are more likely to be neglected or abused than babies with calm, more even temperaments. In times of drought, however, babies with cranky temperaments are the ones most likely to survive because they demand more attention from their caregivers (de Vries, 1984). This example shows that we can judge the adaptiveness of a baby's temperament only in relation to the environment within which that temperament is expressed. What theory are these researchers most likely using? a) evolutionary psychology b) social learning theory c) social structural theory d) biology theory 23. Exposure to reality dating programs depicting gender-stereotyped romantic and sexual behaviours, such as Who Wants to Marry a Multi-Millionaire is correlated with more permissive sexual attitudes and behaviours.

However, inferring causation requires an experimental design with control conditions; this correlation may reveal that individuals with more permissive attitudes are more likely to seek out media that portray sexuality in a fashion consistent with their attitudes. According to the text, if you were conducting this study, what theory should you employ in your research? a) social learning theory b) social structural theory c) evolutionary psychology d) sociobiology theory 24. Women and men from more gender-egalitarian societies, as indexed by a gender-empowerment measure developed by the United Nations Development Programme (UNDP, 1995), report more similar incidence and frequency of sexual behaviours such as masturbation, vaginal intercourse, anal intercourse, and casual sex (Peterson & Hyde, 2010); yet even in these societies certain gender differences remain, in particular, masturbation and erotica use. What theory does this information support? a) social structural theory b) evolutionary psychology c) social learning theory d) sociobiology theory 25. Contrary to popular media representations of gender (such as Men are from Mars, Women Are from Venus), recent research on gender indicates that __________.

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a) in most ways, men and women are more similar than different b) women are generally more emotional than men and therefore naturally inclined to be nurturers c) in most ways, men and women are far more different than similar d) men, because of their genetic composition, are more inclined to see sexuality as a reproductive function based on hormones 26. When is men and women's sociosexuality likely to be most similar? a) when women are ovulating b) when men and women have created a loving home environment c) when men are single d) when society is not influencing men and women's sexual behaviour 27. According to Janet Hyde's gender similarities hypothesis, which of the following best reflects the differences between males and females in terms of their behaviours and attitudes? a) For most variables, the difference between males and females is small or non-existent. b) For most variables, the difference between males and females is significant. c) For variables related to sexual behaviour, including masturbation and pornography use, there are no differences between males and females, but for variables related to aggression, there are large differences. d) Females show higher scores for behaviour related to compassion, while males show higher scores for behaviour related to decision-making.

28. What did research by Bailey and colleagues find about SGD individuals' gender identity? a) SGD individuals rarely conform to the gender identity expected based on their biological sex. b) SGD individuals sometimes conform to the gender identity expected based on their biological sex and sometimes do not conform to the gender identity expected based on their biological sex. c) SGD individuals all deliberately break gender identity norms that are dictated by their biological sex. d) SGD individuals and heterosexual individuals are all equally likely to conform to gender identity norms based on their biological sex.

29. Graham is much more open to casual sexual encounters than Pietro. These two differ on the basis of what variable? a) sociosexuality b) psychosexuality c) gender stereotyping d) gender phenotype 30. What did research by Bailey and colleagues find about gay men's attitudes about the social status of their partner compared to heterosexual men's attitudes about the social status of their partner? a) Gay men were less concerned about social status than heterosexual men. b) Gay men were more concerned about social status than heterosexual men. c) Gay men and heterosexual men were similarly unconcerned about social status. d) Gay men were never concerned about social status; heterosexual men were only concerned when considered part of a monogamous relationship.

31. What did research by Bailey and colleagues find when preferences were compared between lesbian women and heterosexual women?

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a) Lesbian women preferred more youthful partners; heterosexual women had no preference. b) Lesbian women were more interested in visual erotica than heterosexual women. c) Lesbian women were less interested in committed relationships than heterosexual women. d) Lesbian women placed less importance on the appearance of their lover than heterosexual women.

32. What do social role theorists believe causes gender differences in sexual roles? a) Deviating from norms has negative social consequences. b) Hormones cause hardwired differences in behaviour between males and females. c) Sociosexual pressure creates male and female gender roles. d) Evolutionary forces have led to a tendency for all people to conform to a role that promotes procreation.

33. When sexual preference rates are compared between cisgender men and cisgender women, what do researchers find? a) Men are less likely than women to be sexually attracted to both sexes. b) Women are more likely than men to be exclusively attracted to members of the same sex. c) Men are more likely than women to be exclusively attracted to members of the same sex. d) Men and women are equally likely to be attracted to members of the opposite sex.

34. Numerous gender differences in sexual behaviours between men and women are noted in the text. This may, however, be explained by the way men and women may report (both in formal research settings and in informal personal encounters) that their sexual attitudes and behaviours are consistent with gender norms in order to avoid negative social consequences. According to the text, which theory does this statement best align with? a) social role theory b) evolutionary psychology c) social learning theory d) sociobiology theory 35. James is a cisgender heterosexual male who reports that only women arouse him. He recently participated in a study that involved him watching porn. The study gauged his physiological response. If viewing women in porn primarily aroused James, he would be showing __________. a) sexual concordance b) sexual confusion c) sociosexuality d) sexual discordance 36. Studies repeatedly show that women show lower sexual concordance than men. What is the best explanation for this? a) reporting biases and sexual double standards b) poor study designs c) women's lower rates of sexual arousal d) all of the above 37. According to a survey conducted by Chandra et al., which of the following women is most likely to admit to being attracted to someone of the same sex? a) a Hispanic woman completing the survey in English b) a black woman completing the survey in English Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) a non-Hispanic white woman completing the survey in English d) a Hispanic woman completing the survey in Spanish 38. Leila is participating in a study measuring sexual arousal to stimuli. She displays a genital response to stimuli depicting women as well as stimuli depicting men. What can you assume about her sexual preference? a) Leila is likely homosexual. b) Leila is likely heterosexual. c) Leila is likely bisexual. d) Leila is likely genderqueer.

39. When the specificity of sexual arousal is compared between women and men, what do researchers find? a) There is no difference between heterosexual men and heterosexual women. b) Heterosexual men show higher specificity than heterosexual women. c) Heterosexual women show higher specificity than heterosexual men. d) Women who report being attracted to other women have lower specificity rates than either heterosexual men or heterosexual women.

40. When participants completed a survey about sexual behaviour under anonymous conditions and then under the belief that the researcher would be able to tell whether they were lying, what did researchers find? a) The gender differences in reports of autonomous sexual behaviour were reduced when participants thought lies could be detected. b) The gender differences in reports of number of sexual partners were not affected by whether the participant thought that lies could be detected. c) The gender difference in sexual attitudes was increased when participants thought that lying would be detected. d) Males reported more autonomous sexual behaviours when they did not think that lying could be detected than when they did think lying could be detected.

41. Which of the following is always true of someone who is a true hermaphrodite? a) The person has no testes if genetically male and no ovaries if genetically female. b) The person has both male and female reproductive organs. c) The person has a male genotype and a female phenotype, or vice versa. d) The person has primary sexual characteristics of one sex and secondary sexual characteristics of the other sex.

42. A study by Alexander and Fisher (2003) used the "bogus pipeline" methodology to help control for false accommodation of gender roles (i.e., self-reporting that falsely presents behaviours and/or attitudes as consistent with widespread gender norms). In this study, participants were led to believe that they were attached to a polygraph machine that could detect lies. What impact did this have on self-reported gender differences in sexual attitudes, autonomous sexual behaviours (e.g., masturbation, use of erotic materials), and numbers of sexual partners? a) Gender differences still existed but the gap was smaller. b) There was no change in the reported gender differences. c) There were greater differences than originally anticipated between women and men. d) The threat of discovery caused most participants to drop out of the study.

43. A group of conditions in which the reproductive organs and/or genitals develop differently than expected is known as __________.

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a) disorders of sexual development (DSDs) b) phenotype disorders c) dysplasia d) hypogonadism 44. When might an individual identify as intersex? a) when they have complete male and female reproductive systems b) when they have a disorder of sexual development c) when they are attracted to members of both sexes d) when they have adopted the gender identity of the other sex 45. Liam was diagnosed with Klinefelter's syndrome. What chromosome combination does Liam most likely have? a) XYY b) YO c) XXY d) YY 46. Which of the following is true of males with Klinefelter's syndrome? a) They are usually attracted to females and do not identify as male. b) They are usually attracted to females and identify as male. c) They are usually attracted to males and do not identify as male. d) They are usually attracted to males and identify as male.

47. Angela carries the sex chromosome pair XO. Which disorder of sexual development does Angela have? a) Klinefelter's syndrome b) Turner's syndrome c) congenital adrenal hyperplasia d) androgen insensitivity syndrome 48. Terms such as hermaphrodite or pseudohermaphrodite were used to describe people who were either born with both male and female sex characteristics or developed them later. To avoid the pejorative and stigmatizing effects of these terms, individuals now often identify as __________. a) intersex b) dualistic hermaphrodite c) countersex d) non-heterosexual 49. Which chromosomal disorder is present in 1 in 500 to 1000 males of all ethnic backgrounds and is identified with an abnormal chromosomal complement, with the presence of one Y chromosome and two or more X chromosomes (typically XXY)? a) Klinefelter's syndrome b) Turner's syndrome c) congenital adrenal hyperplasia (CAH) d) androgen insensitivity syndrome (AIS)

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50. Which syndrome is usually not diagnosed until puberty, when boys present with gynecomastia (breast development), small testes, shorter-than-average penises, low testosterone levels, tall stature, verbal cognition problems, and compromised fertility? a) Klinefelter's syndrome b) Turner's syndrome c) congenital adrenal hyperplasia (CAH) d) androgen insensitivity syndrome (AIS) 51. Which syndrome affects approximately 1 in 2500 females and involves abnormalities of the X chromosome that result in a missing second X chromosome, a chromosomal "monosomy"? a) Turner's syndrome b) Klinefelter's syndrome c) congenital adrenal hyperplasia (CAH) d) androgen insensitivity syndrome (AIS) 52. Women with which syndrome tend to have a short stature, broad chest, widely spaced nipples, under-developed female physical characteristics (e.g., breasts), and problems with ovarian development and sex hormone levels, leading to infertility? a) Turner's syndrome b) Klinefelter's syndrome c) 5-alpha-reductase deficiency d) androgen insensitivity syndrome (AIS) 53. Ray identifies as intersex but does not have any chromosomal or hormonal irregularities. What may have caused Ray to identify as intersex? a) penile ablation b) cloacal exstrophy c) penile agenesis d) all of the above 54. Hattie is more aggressive and less nurturing than her peers. Which hormonal variation does she likely have? a) congenital adrenal hyperplasia b) Turner's syndrome c) androgen insensitivity syndrome d) 5-alpha-reductase deficiency 55. Which autosomal recessive genetic disorder affects cortisol synthesis in the adrenal gland, usually causing the fetus to be exposed to elevated levels of androgens produced by their adrenal gland? a) congenital adrenal hyperplasia (CAH) b) Klinefelter's syndrome c) Turner's syndrome d) androgen insensitivity syndrome (AIS) 56. Hannah and Andrew, a genetic girl and boy, both have congenital adrenal hyperplasia (CAH). When observing Hannah and Andrew play, what are you most likely to notice about each child as compared to their peers without CAH? Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) increased aggression in both Hannah and Andrew b) increased aggression in Hannah, no difference in Andrew c) no difference in Hannah, increased tenderness in Andrew d) increased aggression in Hannah, increased tenderness in Andrew 57. What of the following is true about females with congenital adrenal hyperplasia (CAH)? a) They show increased rates of same-sex and bisexual attractions. b) They almost always have same-sex sexual preferences. c) They do not develop uteruses and thus cannot bear children. d) Their sexual preference is not affected by having CAH. 58. Paulina wants to become pregnant, so she has been prescribed the steroid dexamethasone, which prohibits the production of prenatal androgens. Which hormonal variation does she likely have? a) congenital adrenal hyperplasia b) Turner's syndrome c) androgen insensitivity syndrome d) 5-alpha-reductase deficiency 59. Katie has XY chromosomes, but she was raised as a female, appears female, and identifies as heterosexual.

Which hormonal variation does she likely have? a) congenital adrenal hyperplasia b) partial androgen insensitivity syndrome c) complete androgen insensitivity syndrome d) 5-alpha-reductase deficiency 60. A person with complete androgen insensitivity syndrome (CAIS) has what characteristics? a) a male genotype and a female phenotype b) a female genotype and a male phenotype c) female reproductive organs and male secondary sexual characteristics d) some features of male genitalia and some features of female genitalia 61. Jamie is eight years old and has testes that are undescended and genitals that resemble that of a female. Which disorder of sexual development does Jamie most likely have? a) Klinefelter's syndrome b) congenital adrenal hyperplasia c) hermaphroditism d) 5-alpha-reductase deficiency 62. Which disorder of sexual development results in the most people changing gender identity at puberty? a) congenital adrenal hyperplasia b) 5-alpha-reductase deficiency c) complete androgen insensitivity syndrome d) Klinefelter's syndrome 63. Which of the following is the correct order of development of gender in childhood? a) detecting gender, having gender, gender constancy, doing gender Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) detecting gender, doing gender, having gender, gender constancy c) having gender, detecting gender, gender constancy, doing gender d) having gender, detecting gender, doing gender, gender constancy 64. Paul (a biological male) identifies as a male but describes a man with long hair as a woman. What is Paul's approximate age? a) one year old b) two years old c) four years old d) five years old 65. Penny (a biological female) plays with dolls and insists on wearing dresses. What is Penny's approximate age? a) one year old b) two years old c) four years old d) five years old 66. Elise can accurately point to a picture of a "lady" and a "man" but cannot answer the question of whether she is a boy or a girl. What is Elise's approximate age? a) one year old b) two years old c) three years old d) four years old 67. Baby Ann was born in Canada in 1918. What colour would her mother likely have chosen for her first sweater, assuming her mother wanted to "show off" having a daughter? a) pink b) green c) yellow d) blue 68. In a famous study by John and Sandra Condry, in which participants described the reaction of babies to a jack-in-the-box, what did researchers find? a) When participants didn't know the sex of the child, they consistently rated the reactions of male babies as "angry" and female babies as "fearful." b) When participants believed the child was male, they labelled the reaction as "angry." When they believed the child was female, they labelled the reaction as "fearful." c) When participants believed the child was male, they labelled the reaction as "fearful." When they believed the child was female, they labelled the reaction as "angry." d) When participants believed the child was male, they labelled the reaction as "angry." When they believed the child was female, they labelled the reaction as "happy."

69. A person who is transgender differs from a person who is transsexual in what way? a) A person who is transgender prefers the opposite gender role and members of the opposite sex as sex partners; a person who is transsexual prefers the opposite gender role and members of the same sex as sex partners. b) A person who is transgender prefers the opposite gender role and members of the same sex as sex partners; a Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

person who is transsexual prefers the opposite gender role and members of the opposite sex as sex partners. c) A person who is transgender prefers the opposite gender role but has not had gender affirmation surgery; a person who is transsexual has had gender affirmation surgery. d) A person who is transsexual prefers the opposite gender role but has not had gender affirmation surgery; a person who is transgender has had gender affirmation surgery.

70. Sam is a trans man. What was Sam's sex at birth? a) female b) male c) Sam could have been male or female. d) Sam's sex at birth is not related to being a trans man.

71. Around the age of puberty, Pat began to be interested in dressing as the other sex, and as an adult, Pat finds appearing to be the opposite sex sexually arousing. Pat is attracted to members of the opposite sex. Pat is likely which of the following? a) a trans man b) a trans woman c) queer d) a hermaphrodite 72. What is the third stage of the process of gender affirmation? a) psychological and physical evaluation b) hormone replacement therapy c) starting to live as the other sex d) sex reassignment surgery 73. Which of the following people may face the most discrimination from within the SGD community? a) Rae, who is a heterosexual trans woman b) Dmitri, who is a heterosexual trans man c) Jane, who is a lesbian trans woman d) Dana, who is a bisexual trans woman 74. In which population did the term "two-spirit" originate? a) Indigenous people living in North and South America b) Indigenous people living in Australia c) farmers in northern China d) people living in the South Pacific 75. What is the X-linked recessive disorder in which individuals born with XY chromosomes develop typically female physical characteristics, often including external female genitalia and female breasts? a) androgen insensitivity syndrome (AIS) b) 5-alpha-reductase deficiency c) Turner's syndrome d) congenital adrenal hyperplasia (CAH) 76. What disorder of sexual development is described in the following passage?

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"Subject 8 is the youngest of 8 children of a poor farm family and was thought to be a normal female at the time of birth. His mother died when he was age 4 years, and he was raised by an older sister. He says that he felt different from other girls and began to exhibit male behaviour by age 6. By age 11, virilization of the external genitalia was apparent, male secondary sex characteristics began to appear, and he began to have erections; despite the inward feeling that he was a man, he kept a female social sex and worked as a maid. At age 28 he commenced a long-term sexual relationship with a woman, and he sought medical help at age 30. Psychological evaluation revealed that he had a strong male libido and masturbated an average of 3 times a day. After surgery to correct the hypospadias, he married, adopted a child, and describes a satisfactory sexual life." (Mendonca et al., 1996, p. 66) a) androgen insensitivity syndrome (AIS) b) 5-alpha-reducatse deficiency c) Turner's syndrome d) congenital adrenal hyperplasia (CAH) 77. What term is used to describe the following two forms of learning? Observational learning, where children watch and emulate the behaviours and choices of other children and adults, and operational learning or shaping, whereby gender conforming behaviours are reinforced and gender non-conforming behaviours are punished. a) gender socialization b) gender schema c) gender binaries d) gender concordance 78. What is the term used in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose distress from the discrepancy between one's felt gender identity and one's biological sex, and/or the gender one was assigned at birth? a) gender dysphoria b) gender nonconformity c) gender concordance d) gender identity 79. Evan was born a biological female but has a male gender, and has not undergone any transition related surgeries. Evan believes in a continuum of fluid gender. With which term would Evan likely identify most? a) homosexual b) transsexual c) transgender d) genderqueer 80. Devon was born female and feels like a female. She is attracted to other females. Which term would Devon likely identify most with? a) cisgender b) genderqueer c) heterosexual d) transfemale 81. What are possible benefits of the real-life experience stage of gender transition? a) to allow individuals to fully transition into the social role matching their gender b) to ensure individuals are able to function in their felt gender role Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) to potentially find gender support groups to share stories, information, and support d) all of the above 82. What is the third stage of gender transitioning as outline by the World Professional Association for Transgender Health's (WPATH's) Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People? a) hormone replacement therapy (HRT) b) physical and psychological evaluation c) real-life experience d) transition related surgeries (TRSs) 83. According to the research on gender affirmation surgeries, how are the outcomes best described? a) The majority of trans people report satisfaction with their surgery and improvement to their quality of life after transitioning. b) The majority of trans people are unsatisfied with their decision to transition with surgeries. c) The majority of trans people regret their decision and report a desire to return to their "birth sex." d) The majority of trans people are ambivalent about their surgeries and report no change in their overall life satisfaction.

84. Which of the following is NOT true about coming out for trans people? a) It is generally easier for them than it is for lesbian or gay people because sex is covered under the Charter of Rights and Freedoms, therefore eliminating any fear of prejudice. b) It can be as or more challenging than coming out as not heterosexual, particularly since many individuals may have little experience with trans people and may have negative attitudes and actively discriminate against gender minorities. c) It can be more difficult because hate crime and abuse rates are higher for gender minorities than for sexual minorities. d) It can be more difficult because some trans people face discrimination within lesbian or gay communities, particularly if they have transitioned to become a lesbian transwoman or a gay transman.

85. What factors might influence a trans person to not have surgeries related to transitioning? a) rejection of the medical model of transsexuality b) practical reasons such as medical conditions that preclude physical procedures c) rejection of the notion that they must choose one gender, or must possess all physical and psychological traits of one gender d) all of the above 86. What identity is a person most likely to have if they view modern Western culture's binary division of male-female, man-woman as incompatible with their personal experiences of their physical and psychological selves? This view is more consistent with that held by various societies around the world in which gender minorities are more commonly accepted. a) genderqueer b) gender evasive c) gender avoidant d) questioning

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87. 5-alpha-reductase deficiency (5-ARD) affects which of the following people? a) chromosomal females b) chromosomal males c) chromosomal males and females d) only people with a chromosomal trisomy 88. Which of the following diversities of sexual development are caused by chromosomal anomalies? a) Klinefelter's syndrome and Turner's syndrome b) Klinefelter's syndrome and androgen insensitivity syndrome c) Turner's syndrome and androgen insensitivity syndrome d) androgen insensitivity syndrome and congenital adrenal hyperplasia 89. The biological development of sex differences, specifically changes that make a male body different from a female body, is called ________. a) phenotype b) genotype c) virilization d) exstrophy 90. When looking at gender/sex differences, it can be noted that males ________. a) report a higher number of sexual partners b) report a higher use of erotica c) report a more positive attitude towards casual sex d) all of the above 91. Which of the following statements is true regarding sex/gender differences and sexual orientation? a) Cisgender women are no more likely than cisgender men to report some degree of both same-sex and other-sex attraction. b) Women reporting four or more different-sex partners in their lifetime were more likely to report same-sex behaviour than were those reporting fewer numbers of different-sex partners. c) Women are less likely than men to have had same-sex sexual contact. d) Women are less likely than men to report feeling sexually attracted to both women and men.

92. "Although women who are exclusively heterosexual report greater sexual arousal to stimuli depicting men than those depicting women, they show genital responses to sexual stimuli depicting women as well to as those depicting men." What type of research does this statement best reflect? a) research into the diversities of sexual development b) research into the disorders of sexual development c) research into the specificity of sexual arousal d) research into the phenotypical expression of sexual arousal 93. Which of the following is not considered to be a treatment for congenital adrenal hyperplasia in women? a) hormone therapy b) clitoral reduction surgery c) genitoplasty to open the vagina d) cloacal exstrophy Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

94. In research on non-human primates and toy preferences, which of the following statements is true? a) Male monkeys did not prefer stereotypically male toys. b) Male monkeys preferred stereotypically male toys. c) Female monkeys preferred stereotypically male toys. d) Female monkeys did not prefer stereotypically female toys.

SHORT ANSWER QUESTIONS 1. The physiological characteristics a person shows are known as their __________.

2. The idea that gender differences result from the differences in the number of offspring a male and female can each produce is known as __________ __________ __________.

3. Aimee's reproductive organs did not develop like those of a typical female. Aimee may be considered __________.

4. The term __________ of __________ __________ describes the group of congenital conditions that lead to intermediate expression of female and male phenotypes.

5. An individual with Klinefelter's syndrome has the __________ chromosomal pattern.

6. Biological females who identify as males are referred to as __________.

7. People who consider gender on a continuum and do not want to label themselves at a specific point on that continuum will identify as __________.

8. An Indigenous person who has a non-binary sexual identity will identify as __________-__________.

9. A child who is unhappy with his or her current sex may be diagnosed with __________ __________.

10. Genes, hormones, and physiology determine a person's ________ __________.

11. The psychological experience of femaleness or maleness is called __________.

12. The FOXL2, WNT4, RSPO1, and DAX1 genes determine whether __________ will develop.

13. An unborn baby has the SOX9 gene. This means the baby will develop __________.

14. Rai is being raised with a transgender sister and a mother who is genderqueer. According to the __________ __________ theory, Rai will likely develop a more fluid attitude towards gender than a child being raised with cisgender siblings and parents because they will have observed more gender fluidity in day-to-day life.

15. The notion of gendered power inequality is MOST central to the __________ __________ theory.

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16. The extent to which a person is willing to engage in casual sexual activity is known as their __________.

17. Chris (a biological male) was born with complete androgen insensitivity syndrome. Chris will likely identify with the __________ gender.

18. Alex was born with 5-alpha-reductase deficiency, which means that Alex is a chromosomal __________.

19. Sex reassignment surgery is now referred to as __________-__________ surgery.

20. The fear, dislike, and/or intolerance of transgender or gender non-conforming individuals is called ________.

21. A gender ________ is a mental framework based on understandings of how men and women typically behave.

22. The incorrect assumption that all people are cisgender – that is, have a gender identity that matches the sex they were assigned at birth is termed ________.

23. A gender __________ is a widely held belief about the typical characteristics and behaviours of men and women.

24. The learning of behaviour and attitudes considered appropriate for a given gender role is called gender ________.

ESSAY QUESTIONS 1. How may an evolutionary psychologist explain the differences in attitudes about partner age and fidelity between gay and heterosexual men?

2. Describe at least two disorders of sexual development that suggest that hormones make a significant contribution to a person's gender identity.

3. Describe the three processes a child goes through in developing gender.

4. What is Kenneth Zucker's approach to treating children with gender dysphoria? Why is Zucker's approach to treating such children controversial? What evidence is there to support his approach?

5. Describe the four stages involved in transitioning from one sex to the other.

6. Distinguish between gender, biological sex, and gender identity.

7. Discuss the view of social structural theory on gender. Provide one example.

8. How did Jane Hyde in 2005 counter the predominant model of differences between men and women such as those presented in popular culture (Men Are from Mars, Women Are from Venus)?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. c 2. c 3. c 4. a 5. b 6. c 7. a 8. a 9. d 10. d 11. b 12. c 13. c 14. a 15. a 16. b 17. b 18. a 19. c 20. b 21. c 22. a 23. a 24. a 25. a 26. a 27. a 28. b 29. a 30. c 31. b 32. a

33. a 34. a 35. a 36. a 37. c 38. b 39. b 40. a 41. b 42. a 43. a 44. b 45. c 46. a 47. b 48. a 49. a 50. a 51. a 52. a 53. d 54. a 55. a 56. d 57. a 58. a 59. c 60. a 61. d 62. b 63. a 64. b

65. d 66. a 67. d 68. b 69. c 70. a 71. a 72. b 73. c 74. a 75. a 76. b 77. a 78. a 79. d 80. a 81. d 82. a 83. a 84. a 85. d 86. a 87. b 88. a 89. c 90. d 91. b 92. c 93. d 94. b

SHORT ANSWER QUESTIONS 1. phenotype 2. parental investment theory 3. intersex 4. disorders sexual development or diversities sexual development 5. XXY 6. trans men

7. genderqueer 8. two spirit 9. gender dysphoria 10. biological sex 11. gender 12. ovaries 13. testes 14. social learning

15. social structural 16. sociosexuality 17. female 18. male 19. gender affirming 20. transphobia 21. schema 22. cisnormativity

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23. stereotype

24. socialization

ESSAY QUESTIONS 1. An evolutionary psychologist would likely say that heterosexual men can potentially have children through sexual encounters and gay men cannot. Because heterosexual men do not wish to put resources into children that are not theirs, they are very concerned about fidelity. Also, because younger women may be better able to conceive and raise a healthy child, heterosexual men find youth attractive. Age is not a factor related to the success of sex when reproduction is not concerned, so gay men are less selective about the age of their partner.

2. With congenital adrenal hyperplasia (CAH) females with an XX chromosome pair are exposed to more androgen before birth and are more likely to prefer "male" activities and same-sex relationships than females who do not have CAH. Males born with XY chromosomes but complete androgen insensitivity syndrome cannot use androgen produced in the body but can still use estrogen and thus develop female characteristics. Individuals with CAIS identify as female and prefer relationships with men. In both of these cases behaviour and sexual preference seems influences by the hormones the person is exposed to before and after birth and not the sex-linked genes the person inherits.

3. Gender development involves three related processes: detecting gender, or being able to identify the differences between females and males; having gender, or recognizing in oneself characteristics shared by either boys or girls; and doing gender, or matching one's gendered behaviour with female or male gender stereotypes.

4. Zucker's approach is to try to get the child to accept the gender they were born with. This approach is sometimes criticized for silencing gender minorities and discriminating against people who choose a gender other than the one they are born with. However, research has shown that the vast majority of children with gender dysphoria will eventually outgrow the condition and accept the gender they were born with on their own. Zucker's approach is designed to help speed up this process of eventual acceptance.

5. Stage 1: psychological and physical evaluation; determine the mental health of the individual and identify a support network Stage 2: the real-life experience; living as the other gender for at least one year Stage 3: hormone replacement therapy; occurs about one year after the person begins living as the other sex Stage 4: sex reassignment surgery, which may involve multiple operations and should begin after at least one year of HRT 6. Gender - the psychological experience of femaleness and/or maleness.

Biological sex - the biological condition of being male and/or female, as determined by genes, chromosomes, hormones, and physical traits.

7. Social structural theory proposes that gender differences in sexuality, particularly in relation to mate preferences, arise because of a gendered division of power that emerges from a gender-stratified workforce where men control resources. Examples will vary.

8. In 2005, Janet Hyde, an American psychologist at the University of Wisconsin-Madison, contended that the predominant model of differences between women and men was fundamentally flawed (Hyde, 2005). She argued that popular media representations, such as that in John Gray's bestselling Men Are from Mars, Women Are from Venus (1992), bias our interpretations of women's and men's behaviours, attitudes, and aptitudes in the direction Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

of finding differences. In her detailed analysis, she demonstrated that the magnitude of the differences, measured using Cohen's d effect size (Cohen, 1988), was actually quite small; this observation led her to develop the gender similarities hypothesis, which proposes that women and men are more similar than different for most, but not all, psychological variables (Hyde, 2005).

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CHAPTER 11

Sexual/Affectional Orientations and Diversity MULTIPLE CHOICE QUESTIONS 1. In 1835, if a man had sex with another man, how would it affect his perceived sexual identity? a) He would be considered queer. b) He would be considered homosexual. c) He would be considered female. d) It would not challenge his perceived sexual identity.

2. In the mid-twentieth century, which of the following was NOT a common perception of homosexuals? a) They were unhappy. b) They were dependable. c) They were predatory. d) They were promiscuous.

3. What term is used to describe the interaction between affect and cognition such that it produces attraction, erotic desire, and ultimately feelings of love for members of the other sex, the same sex, or both? a) affectional orientation b) sexual orientation c) emotional orientation d) attachment orientation 4. In what year did the term "homosexual" come into common usage? a) 1268 b) 1689 c) 1869 d) 1902 5. On what basis do some researchers criticize the term "sexual orientation"? a) It ignores the fact that people can be attracted to more than one sex. b) It ignores the issue of gender. c) It overemphasizes the sexual aspects of an orientation. d) It emphasizes emotional connections as the foundation for all relationships.

6. The word "homosexual" entered the English language only in 1869 because before then ________. a) everyone in the English-speaking society was assumed to be heterosexual b) the prevalent terms were "men-lover" for men and "Sappho" for women c) the strong Christian church influence prevented any discussion of homosexuality d) the term was taboo considering the rumours surrounding the English royalty 7. What is the main reason why gays and lesbians stopped using the term "homosexual"? a) "Homo" means "man" and therefore the term did not apply to lesbians. b) The word "homosexual" had a very negative meaning within society. c) It did not allow for people to be interested in both sexes.

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d) It assumed that people who were in a relationship and the same biological sex were also the same gender, which is not always true.

8. What does having a gay identity indicate? a) The person has primarily same-sex-oriented cognition, affect, and/or behaviour. b) The person has no sexual preference, worldview, and self-perception. c) The person believes that affectional orientation is innate. d) The person believes that affectional orientation is a result of experience and social constructs.

9. Which of the following is the most important characteristic of an identity label that a person adopts for themselves? a) It describes their behaviour. b) It is a well-known label in their culture. c) The label has personal significance. d) The label differentiates them from groups with which they do not wish to be associated.

10. Max holds a social constructionist view of identity labels and dislikes them. He has always had physical and emotional relationships with other men and is not interested in having physical or emotional relationships with women. When describing himself, what identity group is Max most likely to choose? a) queer b) gay c) undecided d) man who has sex with men (MSM) 11. If you want to avoid implying that a person's sexual/affection preferences are the same as a person's essence, how should you describe a woman who has romantic and sexual relationships and fantasies only with other women? a) "She is a lesbian." b) "She is a lesbian woman." c) "She is a homosexual." d) "She is queer."

12. In order to differentiate between a person's identity and a person's essence, words such as "gay" or "lesbian" are best used as which part of speech? a) noun b) verb c) adjective d) adverb 13. Why do many women with a same-sex attraction prefer the term lesbian over gay? a) It carries with it certain political allegiances to female solidarity and feminist ideology. b) It refers to sexual behaviours rather than the spectrum of attractions and affections. c) It is more historically accurate, dating back to the 18th century. d) It reinforces desired stereotypes associated with the feminine mystique.

14. Which of the following is most accurate regarding sexual identities? a) The sexual identity labels people give themselves may change over the course of their lives. b) The sexual identity one adopts during early adolescence is immutable.

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c) The sexual identity of gay, lesbian, or bisexual does not change once someone has engaged in sexual activity with a member of the same sex. d) all of the above 15. Why would someone adopt a sexual identity different from their sexual behaviours or sexual attraction? a) social acceptance b) psychological dysfunction c) immutable sexual identities d) cognitive dissonance 16. Why would someone adopt a queer sexual identity? a) Sexual identities are entirely socially constructed and may not accurately reflect individual experience. b) Sexual identities other than heterosexuality are historically rooted in sexual deviance and therefore more accurately reflect individuals. c) Sexual identities are theoretical and based on sexual behaviours alone, and this identity more accurately reflects behaviours. d) Sexual identities are more accurately reflected in this description because it suggests that there is no variation in sexual identity categories.

17. In a study by Lori Brotto of UBC, asexual men reported lower sexual response than is indicated by available normative data, yet they masturbated __________. a) with the same frequency as the normative data b) more frequently than the normative data c) less frequently than the normative data d) almost never in comparison to normative data 18. Which orientation best describes people who have the capacity to fall in love romantically with another person, even if they do not feel sexual desire for that person? a) asexual b) bisexual c) queer d) two-spirited 19. Approximately what proportion of British people self-identified as asexual in the research study discussed in your text? a) 1 in 10,000 b) 1 in 1000 c) 1 in 100 d) 1 in 50 20. Based on Lori Brotto's study of self-identified asexual individuals, what is the best way to conceptualize asexuality? a) as a lack of sexual opportunities b) as a lack of all sexual activity c) as a lack of affectional orientation d) as a lack of sexual attraction to others 21. HIV-prevention efforts typically target which group of people?

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a) men who have sex with men b) gay men c) bisexual men and women d) lesbian women 22. Steven and Emily met through a dating site for asexual people and have been in a loving relationship for several months. They cuddle a lot but don't touch in a sexually arousing way. One day Emily catches Steven masturbating. She accuses him of lying to her about his asexuality. Was he necessarily lying? a) No. Asexual individuals feel little or no sexual attraction, but they still masturbate as frequently as normative individuals. b) No. Asexuality means little or no sexual attraction to certain partners, but normative attraction to other potential partners, usually of the same sex. c) Yes. Asexual individuals feel no sexual desire and no physiological arousal, so they never masturbate. d) Yes. Asexuality is a temporary condition, and masturbation means that the individual is again feeling normative sexual desire.

23. Sharon believes that her attraction towards men is inborn and unchangeable, independent from where she grew up and what people around her think is attractive and what is not. What viewpoint does she represent? a) essentialism b) social constructionism c) social reductionism d) absolutism 24. Alex and Lee call themselves "queer," which means that __________. a) they don't want to be labelled with any sexual identity b) they have undergone gender reassignment surgery c) they are pansexual d) both B and C 25. At a frat-house party Jenny saw her crush, Tom, make out with another guy. She was confused because Tom never said he was gay or bi, and he talked about hot girls a lot. Was his behaviour unusual? a) No. Studies show that there are often discrepancies among sexual identity, sexual behaviour, and sexual desire. b) Yes. Studies show that once sexual identity is formed in adolescence, people tend to be attracted exclusively to one gender. c) No. Studies show that most men who self-identify as heterosexual regularly engage in sexual relations with other men. d) Yes. Studies show that discrepancies among sexual identity, sexual behaviour, and sexual desire are extremely rare.

26. Which term refers to an identity status that is intended to not label one's sexuality? a) queer b) bisexual c) lesbian d) gay 27. What term is used to describe the fear, dislike, and/or intolerance that gay and lesbian individuals may feel toward themselves and/or others with a same-sex orientation, often resulting from negative social influences? a) internalized homophobia Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) homonegativity c) biophobia d) heterosexism 28. What social condition is best described by the following excerpt? "Despite the fact that research has shown variations in affectional orientation, sexual identity, and gender identity to be normal, non-heterosexual individuals continue to suffer from varying degrees of prejudice, discrimination, and oppression world-wide.

Same-sex sexual relationships remain illegal in over 70 countries, and in some places offenders are flogged or even put to death. Even in countries in which such relationships are legal, gay, lesbian, and bisexual individuals frequently face negative consequences in their daily lives. All too often, the prejudices they face take the form of hate speech. Indeed, research consistently finds that the vast majority of gay and lesbian individuals have been verbally abused at some point in their lives." a) homophobia, biphobia, queerphobia b) heterosexism c) internalized homophobia d) conversion therapy 29. Which term refers to the belief that heterosexual people are superior to SGD people? a) homophobia b) heterosexism c) homonegativity d) queerism 30. Salma is part of a culture where people who show attraction to people of the same sex are shunned and forbidden from ever contacting their family members again. Salma is afraid to admit she is attracted to other women, so she marries and has children. Salma's limited choices in life are the result of what aspect of her culture? a) homonegativity b) homophobia c) queerophobia d) heterosexism 31. Robert Spitzer claimed that sexual orientation could be changed if the people who wanted to change really wanted to change. What did Spitzer do 10 years after he made his claim? a) Spitzer stood by his claim and showed that 10 years later the "converted" men were still in heterosexual relationships. b) Spitzer extended his claim to suggest that same-sex attraction is the result of neurotoxins found in many brands of house paint. c) Spitzer apologized to the gay community. d) Spitzer admitted that he was gay and openly married another man.

32. Eric has always been attracted to other men but abstains from sexual activity and loathes himself for his preference. What term describes Eric's feelings towards himself? a) homophobia b) internalized homophobia c) internalized homophilia d) internalized asexuality

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33. What term refers to prejudice and discrimination against individuals of other sexual orientations and genders, based on the implicit assumption that heterosexuality is the norm? a) heterosexism b) biphobia c) heterocentrism d) homophily 34. Anna has been invited with a plus-one to her cousin's traditional Polish wedding in a Toronto suburb. Anna isn't dating any man at the time, so she wants to RSVP with her best friend, Judy, as Judy has never been to a Polish wedding. Anna's mother is aghast at the idea, explaining that everyone would assume that Anna and Judy are lesbian perverts and it would be a great shame and disgrace for Anna's mother to be suspected of having brought up a homosexual under her Catholic roof. She orders Anna to bring a male date or not to come at all. What attitude does Anna's mother display? a) heterosexism b) homophobia c) homonegativity d) all of the above 35. Elisa started a new job and was excited to meet her new co-workers. During the orientation one of the team leaders asked her if she had a boyfriend. Elisa did not know what to answer, since she was currently dating another woman. Which of the following best describes Elisa's experience? a) heterosexism b) homonegativity c) heterocentrism d) internalized homophobia 36. Nate is an openly gay man. What is the probability that during his life, Nate will be a victim of physical violence because he is gay? a) 5 per cent b) 10 per cent c) 20 per cent d) 50 per cent 37. According to a recent American study, which of the following is the strongest predictor of hate-crime victimization of SGD individuals? a) media portrayals of SGD individuals b) beliefs about the morality of same-sex sexual behaviours c) an SGD individual's openness about their sexual orientation d) an SGD individual's physical appearance 38. Lucy grew up in a community where homosexuality was considered a disgusting sin. She has been attracted to women but dated men to fit in. She recently moved to Vancouver and met several openly lesbian women, but she's still struggling with shedding the guilt of the immorality of her attractions. Her new friends recommend __________ therapy to help her see her identity as positive. a) SGD affirmative b) conversion c) psychoanalytic d) hormonal Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

39. According to Kitzinger and Wilkinson, what causes a person's sexual attractions to be one way or another? a) Sexual attraction is mostly the result of biological factors. b) Sexual attraction is mostly the result of environmental factors. c) Sexual attraction is probably the result of both biological and environmental factors. d) The question is pointless to research because it cannot be tested with methods currently available.

40. What type of therapy used to attempt to change an individual's sexual orientation to heterosexual has been labelled unethical? a) conversion therapy b) motivational therapy c) affirmative therapy d) heterosexist therapy 41. Conversion therapy is ethically problematic because __________. a) it targets only individuals with same-sex orientations b) its goal is essentially to "fix" a minority population that is deemed to have undesirable traits c) it is out of line with guidelines to "avoid bringing harm to the client" that every reputable mental health professional is obliged to follow d) all of the above 42. Antoine and Mathieu are identical twins. Mathieu is gay. What is the likelihood that Antoine is also gay? a) 12 per cent b) 27 per cent c) 37 per cent d) 52 per cent 43. What field of study has most consistently found that the causality of same-sex sexual/affectional orientation was hand preference and fraternal birth order? a) biological b) psychological c) social d) environmental 44. Researchers have found notable differences in the size of which of the following brain regions in gay men and heterosexual men? a) the thalamus b) the hypothalamus c) the pituitary gland d) the thyroid gland 45. According to Blanchard et al., gay men are more likely than straight men to be which of the following? a) the oldest sibling b) left handed c) highly religious d) a twin

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46. What type of study revealed the following finding regarding male same-sex sexual orientation? "Where at least one twin was homosexual, 52 per cent of monozygotic twins and 22 per cent of dizygotic twins were both homosexual. (By comparison, in cases in which at least one adoptive brother was homosexual, 11 per cent of these brothers were both homosexual.) " a) genetics b) anatomy c) hormones/neural processes d) sociobiological 47. Patrick is a gay man who's never seen himself as unique because of his sexual preference. He usually dismisses statements about non-sexual differences between gay and straight men as factoids, so he was surprised to learn that there is actual research evidence that gay men __________ compared to heterosexual men. a) are more frequently left-handed b) are much worse at whistling c) have much less body hair d) are more frequently colour-blind 48. Liam's mother reveals that although she'd never hid from him that he was adopted, she did hide that he had an identical twin brother in another province. As Liam, a gay man, tries to track his brother down, he wonders what the chances are that he will be gay as well. What is the probability? a) It is better than chance as studies show that where one twin is gay, 52 per cent of identical twins are both gay. b) It is almost certain, as studies show that where one twin is gay, 93 per cent of identical twins are both gay. c) It is very low, as studies show that where one twin is gay, 7 per cent of identical twins are both gay. d) It's impossible to tell as there has been no research on siblings and sexual/affectational identity development.

49. When the effect of prenatal exposure to androgen was hypothesized as a factor contributing to whether a female fetus will grow to be a lesbian woman, what did researchers find? a) Androgen exposure had no effect on sexual attraction or identity in lesbian women. b) There was a strong positive correlation between androgen exposure and affectionate orientation. c) Androgen exposure may play a role in masculine lesbian women but not in feminine lesbian women. d) There was a small negative correlation between androgen exposure and affectionate orientation.

50. What condition is required to hold true the research finding that men are more likely to have a same-sex affectional orientation if they have older brothers? a) right-handedness b) colour blindness c) older sisters d) high testosterone 51. Which of the following is true regarding same-sex affectional orientation? a) An individual's affectional orientation is not dependent on the affectional orientation of her or his parents. Most gay and lesbian people were raised by heterosexual parents, and most children raised by same-sex parents turn out heterosexual. b) Although childhood sexual abuse can cause psychological damage and lead to confusion regarding one's sexual identity, there is no evidence that such trauma can alter one's affectional orientation. c) Although same-sex oriented individuals may question their sexual identity to a greater extent at some point in their lives than do their heterosexual counterparts, most gay men believe they always had a strong sexual/affectional orientation to men.

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d) all of the above 52. In June, the Pride month in Canada and USA, Mindy changed her Facebook profile picture to include a rainbow-coloured filter over the photo of herself. She soon got a comment from a distant relative that "the gay lobby is spreading the gay propaganda and raising more gays by adopting innocent children." What facts can Mindy cite to counter this statement? a) Most gay and lesbian people were raised by heterosexual parents, and most children raised by same-sex parents turn out heterosexual. b) Research suggests that children raised in strongly homophobic families turn out homosexual twice as frequently as those raised in open-minded households. c) While culture and society can shape the understanding and expression of our gender, there is no clear evidence that the same factors influence who we are romantically attracted to. d) both A and C 53. According to the ecological model of SGD identity, which of these two gay men could potentially have developed the most similar sexual identities? a) Atheist Terry from Toronto, Canada, and New Age Lance from Los Angeles, USA b) Atheist Terry from Toronto, Canada, and Catholic Marek from Warsaw, Poland c) New Age Lance from Los Angeles, USA, and Muslim Sharif from Teheran, Iran d) Muslim Sharif from Teheran, Iran, and Catholic Marek from Warsaw, Poland 54. Although Canada, with its anti-discrimination legislation, is much more accepting of the SGD community than many countries around the world, even here SGD individuals might not want to disclose their sexual identity.

Why? a) Dependent children who disclose their identity might end up homeless, rejected by the family. b) They may be deeply connected to communities in which homophobia is highly prevalent. c) They may be passed over for promotion at work because of their employer's bias. d) all of the above 55. Which of the following is NOT true of sexual identity disclosure? a) Studies have found that gay men and lesbian women who disclose their sexual identity to others experience worse mental health outcomes. b) The general trend over the past few years is that non-heterosexual individuals are both self-identifying and disclosing their identities at younger ages than in the past. c) Self-identifying as gay, lesbian, or bisexual and disclosing this identity to others is associated with having better physical and mental health. d) In studies of gay and bisexual men, the incidence of diseases such as cancer, pneumonia, bronchitis, sinusitis, and tuberculosis was higher among the men who hid their gay identity from others than among men who did not.

56. What is viewed as the biggest barrier to developing a positive SGD identity? a) internalized homophobia b) cultural bias c) fear of violence d) lack of opportunity to interact with other SGD individuals 57. In which country, as described in the textbook, were marchers attacked at a Gay Pride parade in 2001? a) Iran b) Serbia Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) Russia d) Hungary 58. Laura and Mark have a positive attitude towards same-sex affectional orientations. Their 12-year-old son David has always preferred "feminine" activities and conveys a somewhat feminine persona when speaking. He has shown no interest in developing romantic relationships in middle school, though many of his peers are "dating." Laura and Mark suspect David is a gay adolescent. What is their best course of action? a) They should assume David is a gay adolescent and impose the identity on him by talking to him "as though they already know" to help him be less fearful of "coming out." b) They should wait and allow David to disclose his sexual identity on his own. c) They should wait until David is 16 years old, but encourage him to speak to a therapist about his sexual identity before he becomes sexually active. d) They should discourage David from adopting a gay sexual identity because this will likely lead to his being teased and ostracized.

59. When analyzing research with members of the SGD community, one should be aware of __________. a) the sample bias: the research covers only those who chose to participate, excluding closeted or secretive members b) the confirmation bias: researchers who study the LGBTQ+ community want to portray it in a positive light and favour results that confirm their agenda c) the heteronormativity bias: the majority of researchers identify as heterosexual and treat other orientations as diverging from the norm d) none of the above 60. Ten-year-old David has been spending a lot of time reading fashion magazines and making clothes for his dolls. He prefers celebrity gossip with his sisters to playing sniper videogames with his brother. David's parents worry that such behaviour might mean that he will grow up to be gay, but their friend says such thinking is just an ugly stereotype. Who's right? a) Research supports that many males who display highly effeminate behaviour in childhood later experience same-sex attraction. b) There is anecdotal evidence that many males who display highly effeminate behaviour in childhood later experience same-sex attraction, but it has not been proven in research. c) Extensive research shows beyond a doubt that boys' childhood behaviour has no reflection in their later sexual/affectational orientation. d) Research is inconclusive whether a boy's highly effeminate behaviour in childhood will result in experiencing same-sex attraction later in life.

61. According to research, which couple type reports the highest level of relationship satisfaction? a) gay couples b) heterosexual couples c) opposite-sex couples where one or both partners is bisexual d) lesbian couples 62. When compared to same-sex couples, which is true about mixed-sex couples? a) They are more likely to stay friends after the end of the relationship than same-sex couples. b) They are more likely to come from the same socioeconomic demographic than same-sex couples. c) They have less hostility at times of conflict than same-sex couples. d) Their relationship is more likely to end than a same-sex relationship.

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63. Why do some researchers suggest that divorce rates will likely be higher among same-sex couples compared to mixed-sex couples? a) More mixed-sex couples admit to staying together for the children. b) Same-sex couples are less likely to be monogamous. c) Same-sex couples have more alternative partners available to them. d) Mixed-sex couples have been shown to take marriage more seriously than same-sex couples.

64. What limitation is present in most research on SGD people since many members of this community may be secretive or closeted, and the people who take part in research are more likely to be "out" and open? a) sample bias b) social desirability bias c) survey reliability d) replicability 65. Which of the following is a reason that lesbian couples report greater relationship satisfaction than do either gay or heterosexual couples? a) their desire for and achievement of equality in their relationships b) the high value placed on emotional intimacy c) the social support they garner for their lives together d) all of the above 66. One of the differences between mixed- and same-sex relationships is that __________. a) same-sex couples tend to use fewer hostile tactics during times of conflict compared to mixed-sex couples b) mixed-sex relationships have a higher likelihood of ending compared to same-sex relationships c) same-sex oriented individuals are more likely to seek partners of similar age, race, and socioeconomic status to their own compared to mixed-sex oriented individuals d) mixed-sex partners are more likely to stay friends after they break up compared to same-sex partners 67. Which of the following is NOT true regarding same-sex relationships? a) Despite legalization, most same-sex couples do not report the desire to get married. b) Same-sex partners are more likely than mixed-sex partners to remain friends after relationship dissolution. c) Same-sex oriented individuals are less likely to seek partners whose demographic characteristics, including age, race, and socioeconomic status, are similar to their own. d) Gay and lesbian couples tend to be less controlling and to use fewer hostile tactics during times of conflict compared to mixed-sex couples.

68. According to Freud, if we lived in a society where there was no difference in sexual orientations, we would likely all be ____________. a) bisexual b) asexual c) heterosexual d) homosexual 69. Which of the following is a factor that influences who we actually have sex with? a) personal values b) the availability of members of the preferred sex/gender c) ability to attract desired sexual partners Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) all of the above 70. According to Freud, we are all bisexual to some degree. What process best explains why bisexuality fails to manifest in most people after adolescence? a) socialization b) physiology c) evolutionary psychology d) manifest destiny 71. What is one relationship obstacle that research has shown to be particularly problematic for gay men compared to heterosexual men and lesbian women? a) Gay men prefer to have multiple partners, but prefer partners who are monogamous. b) Gay men have increased difficulty with interpersonal rejection. c) Gay men are more likely to be unfaithful after promising to be monogamous. d) Gay men do not like to discuss their feelings.

72. According to Rust, which of the following is true about both bisexual men and bisexual women? a) Most were more emotionally attracted to women and more sexually attracted to men. b) Most were more emotionally attracted to men and more sexually attracted to women. c) There was no difference in emotional and sexual attraction to men and women. d) Most were interested in serial monogamy and alternating the sex of the partner.

73. What percent of the male population self-identifies as bisexual? a) less than 1 per cent b) 2 per cent c) 3 per cent d) 5 per cent 74. Members of which group have the most sex? a) asexuals b) mixed couples c) gay men d) lesbian women 75. Members of which group tend to become less monogamous as a relationship progresses? a) gay men b) lesbian women c) mixed couples d) mixed couples where one member identifies as bisexual 76. Which of the following is the most common sexual activity among gay men? a) anal intercourse b) anilingus c) oral sex d) mutual masturbation 77. Which of the following is a major challenge faced by bisexual-identified people? a) isolation, because a substantial bisexual community does not exist Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) displeasure in their relationships, because they are more frequently engaged in non-monogamy c) identity confusion, because they cannot decide which sex they are more attracted to d) greater sexual fulfillment, because they hedonistically pursue pleasure with everyone 78. In what order do the following couple arrangements have the most sex? a) gay men couples; straight couples; lesbian couples b) straight couples; gay men couples; lesbian couples c) lesbian couples; gay men couples; straight couples d) gay men couples; lesbian couples; straight couples 79. David and Hugh, both men in their early fifties, have been in a stable relationship with each other for several years. David asked Hugh how many men he'd slept with before their relationship and was shocked to hear a number of about 30. David accused Hugh of having been exceptionally promiscuous. Was the number of Hugh's past partners far above the average? a) No. He was under the average of 42.8 sexual partners that gay men have over a lifetime. b) No. He was right around the average of 30.4 sexual partners that gay men have over a lifetime. c) Yes. He was over the average of 16.5 sexual partners that gay men have over a lifetime. d) Yes. He was over the average of 4.6 sexual partners that gay men have over a lifetime.

80. Which type of couples' relationship is most likely to become non-monogamous over time? a) gay men b) lesbian women c) straight couples d) all of the above 81. What is typically the last type of sexual activity explored by both adolescent gay male couples and adolescent lesbian female couples? a) anilingus b) anal-dildo penetration c) tribadism d) "rimming" 82. Which of the following is true? a) Sexual orientation has no bearing on parents' capacity to provide a safe, healthy, and nurturing environment for children. b) Sexual orientation has a strong influence on the ability of parents to provide a safe, healthy, and nurturing environment for children. c) Sexual orientation of the parents strongly determines the sexual orientation of the child. d) Sexual orientation is noted in the literature as being harmful to children, especially since the prevalence of adoption has increased with marriage equality.

83. Two Canadian couples, Julia and Anna and Mark and Laura, want to adopt a child. Who, on average has a better chance of adoption in Canada, and why? a) Mark and Laura, because mixed-sex couples are more likely to be matched to children than same-sex couples. b) Julia and Anna, because female-only couples are considered safer for adoptive children than mixed-sex or male-only couples. c) Mark and Laura, because adoption by same-sex couples is illegal in Canada. d) Julia and Anna, because there are on average twice as many same-sex than mixed-sex couples waiting to adopt Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

children in Canada.

84. Zalina and Charlotte are expecting their first child, conceived with an anonymous donor's sperm. Zalina's parents hold conservative views about family structure and worry that a child raised by two mothers won't be able to become a fully-formed adult. They pressure her to either marry a man or become a single mother. Is there any evidence that Zalina can quote to counter their argument? a) Some research has shown that children raised from birth by lesbian mothers show fewer behavioural problems than children from mixed-sex families. b) Available research shows that parental sexual orientation is unrelated to the outcome regarding the socialization of children. c) Research suggests that psychological outcomes for children are better when they are raised by two parents rather than by only one, regardless of the parents' sexual identity. d) all of the above 85. Which of the following children would be most likely to develop psychological problems? a) Abe, who is raised by his mother alone b) Klaus, who is raised by a lesbian couple c) Tasha, who is raised by two parents who are not married d) Gianna, who is raised by her biological parents, although her father has recently identified as bisexual 86. A gay man that assumes the role of penetrator in an anal sex is often referred to as the ________ a) bottom b) top c) versatile d) anilingus 87. With regards to sexual identity labels, which of the following identities has the lowest self-identification? a) heterosexual b) gay/lesbian c) bisexual d) asexual 88. When considering same-sex sexual behaviour, which is the correct order in which sexual activities occur for girls that have sex with girls? a) vaginal-digital penetration, oral sex, anilingus, vaginal-dildo penetration, and anal-dildo penetration b) vaginal-digital penetration, oral sex, vaginal-dildo penetration, anilingus, and anal-dildo penetration c) oral sex, vaginal-digital penetration, anilingus, vaginal-dildo penetration, and anal-dildo penetration d) oral sex, anilingus, vaginal-dildo penetration, vaginal-digital penetration, and anal-dildo penetration 89. Which country has recently enacted a law that provides prison sentences of between three months and two years for engaging in same-sex sexual behaviour? a) Chad b) India c) Tanzania d) Turkey 90. What was the main conclusion from a 2018 study that found structural and functional changes in the brains of transgender individuals?

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a) The brain differences were regarded as predisposing factors. b) The brain differences were regarded as consequences/adaptations. c) Nothing conclusive could be drawn from their findings. d) The structural and functional brain differences were very hard to detect.

91. Which of the following statements is true regarding conversion therapy? a) Most people that were converted maintain their new heterosexual affectional orientation. b) Conversion therapy does not increase anxiety and depression. c) Conversion therapy decreases levels of internalized homophobia. d) Most professional organizations for mental health practices state that it is unethical.

SHORT ANSWER QUESTIONS 1. Researchers have begun replacing the term "sexual orientation" with the term "__________ __________."

2. __________ __________ theory suggests that all aspects of our sexuality are constructed as a result of interactions among historical, social, and psychological variables and contexts.

3. Peter fears and dislikes people who are gay or lesbian. Peter is __________.

4. "Pray away the gay" is a common catch phrase associated with __________ therapy.

5. A person is more likely to commit a violent act towards a person who is gay or lesbian if sexual attraction is presented as a(n) __________ issue.

6. Blanchard's research indicates that a man is more likely to identify as gay if he has a greater number of __________ __________.

7. The sexual practice in which a woman rubs her vulva against any part of her partner's body is called __________.

8. The majority of self-identified bisexuals prefer to live a __________ lifestyle.

9. In terms of affectional orientation, Sigmund Freud believed that we are all constitutionally __________.

10. Max wants to avoid a sexual identity label and thus most likely self identifies as __________.

11. Research suggest that asexuals can fall in love, and thus they have a(n) __________ orientation.

12. Prejudice against individuals of other sexual orientations is known as __________.

13. Explicit negative attitudes towards gay and lesbian people are known as __________.

14. Sarah is struggling with her same-sex sexual/affectional orientation. The best therapy for Sarah is likely SGD __________ __________.

15. The two most consistent findings supporting a biological root of same-sex sexual/affectional orientation are Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

fraternal birth order and __________ __________.

16. The __________ of gay and lesbian individuals express the desire to get married at some point in their lives.

17. In addition to fear of interpersonal rejection, __________ __________ can also impede a man's ability to establish and maintain a gay relationship.

18. When boys explore having sex with other boys, the first sexual activity they engage in is usually __________ __________.

19. A person that has an attraction to people of all genders/sexes and/or those that are intersex, identify as trans or genderqueer could be considered ________.

20. A gay man who is willing to assume either the top or the bottom role in anal sex is often referred to as ________.

21. A ________ identity label is an identity status denoting individuals who have come to identify themselves as having both different-sex- and same-sex-oriented cognition, affect, and/or behaviour.

22. ________ is the fear, dislike, and/or intolerance of members of the SGD community in general.

23. According to researchers, affectional orientation is substantially more ________ for women than it is for men.

24. The process of coming to accept for oneself a particular sexual and/or gender identity label(s) is called ________.

25. ________ is the proper term used to describe oral stimulation of the anus, perineum, and surrounding area (also known as "rimming").

ESSAY QUESTIONS 1. Discuss two ethical problems with "conversion therapy." Describe an alternative therapy for SGD individuals who are unhappy.

2. What are three criticisms of existing research into the "source" of sexual identity that may have confounded the results?

3. Discuss two positive factors associated with disclosing a non-heterosexual affectionate orientation and two negative factors that may make this disclosure difficult or impossible.

4. Discuss three findings that suggest that sexual/affectional orientation has a biological component.

5. Discuss research investigating the impact of sexual/affectional orientation on parenting.

6. Compare and contrast sexual orientation and affectional orientation.

7. What is heterosexism and how can it impact non-heterosexual people? Provide one example.

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8. Why is the development of affectional orientations and sexual identities difficult to determine? In other words, why is it challenging to assess what causes someone to be gay, straight, lesbian, or other sexual identity?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. d 2. b 3. a 4. c 5. c 6. a 7. b 8. a 9. c 10. a 11. b 12. c 13. a 14. a 15. a 16. a 17. a 18. a 19. c 20. d 21. a 22. a 23. a 24. a 25. a 26. a 27. a 28. a 29. b 30. a 31. c

32. b 33. a 34. d 35. a 36. c 37. b 38. a 39. d 40. a 41. d 42. d 43. a 44. b 45. b 46. a 47. a 48. a 49. c 50. a 51. d 52. d 53. a 54. d 55. a 56. a 57. b 58. b 59. a 60. a 61. d 62. b

63. a 64. a 65. d 66. a 67. a 68. a 69. d 70. a 71. b 72. a 73. a 74. c 75. a 76. d 77. a 78. a 79. a 80. a 81. b 82. a 83. a 84. d 85. a 86. b 87. d 88. c 89. a 90. b 91. d

SHORT ANSWER QUESTIONS 1. affectional orientation 2. Social constructionist 3. homophobic 4. conversion 5. moral 6. older brothers 7. tribadism 8. polyamorous 9. bisexual

10. queer 11. affectional 12. heterosexism 13. homonegativity 14. affirmative therapy 15. hand preference 16. majority 17. internalized homophobia 18. oral sex

19. pansexual 20. versatile 21. bisexual 22. Queerphobia 23. fluid 24. self-identification 25. Anilingus

ESSAY QUESTIONS Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Conversion therapy targets only individuals with same-sex orientations, and its goal is essentially to "fix" a minority population that is deemed to have undesirable traits. Further, conversion efforts seem out of line with guidelines to "avoid bringing harm to the client" that every reputable mental health professional is obliged to follow. It is difficult to believe that conversion therapists are following this ethic given the ample research evidence demonstrating the negative consequences associated with conversion therapy: increased suicidality; increased anxiety and depression; decreased self-esteem and increased feelings of shame and self-loathing; increased levels of internalized homophobia and distorted perceptions of same-sex sexuality; intrusive imagery; sexual dysfunction; preoccupation with speech, mannerisms, and gender-role expression; loss of family connections, religiosity, and spirituality; phobic anxiety toward attractive members of one's own sex; increased aggression and hostility; feelings of inauthenticity; slowing of the self-identification process; social isolation and loss of same-sex partners; irrational fear of being a child abuser (as a consequence of the once-prevalent stereotype that "homosexuals" are pedophiles); and difficulty in establishing intimate relationships.

For individuals who struggle with their same-sex sexual/affectional orientations, a more positive and helpful form of guidance may come from SGD affirmative therapy. Standing in stark contrast to conversion therapy, this form of therapy is offered by people who view SGD individuals as being equal and as deserving of equal rights to those sharing the dominant discourse (usually heterosexuality). SGD affirmative therapists may hold and practise from any theoretical orientation (e.g., psychodynamic, behavioural): the important aspect is that their attitudes and behaviours are affirming of SGD individuals.

2. 1. Most studies assume heterosexuality is the default and that something must "go wrong" for any other orientation to develop.

2. Most studies group people based on self-identified sexual identity.

3. Most studies look at people's identity at a point in time and ignore the fact that the identity could be different at a different point in that person's life.

3. Positive factors include better physical and mental health. Negative factors include repercussions from one's family, workplace or society. For example, dependent children who feel that their parents might react very negatively to such a disclosure might choose not to confront the issue until they are older and able to support themselves. Indeed, many homeless SGD youth have ended up on the streets because they were rejected by their families (Hunter, 2008). Some adults may also choose not to disclose their sexual identity to their coworkers for fear that they may be denied advancement opportunities. Despite legislation meant to prevent discrimination based on sexual identity, some employers continue to favour those who fit the dominant cultural discourse (most often, able-bodied, heterosexual males). Identity disclosure may also be particularly difficult for SGD individuals who are deeply connected to communities in which homophobia is highly prevalent. This is often the case for Black and Latino men in Canada and the United States, who may feel that disclosing an other-than-heterosexual identity will lead to their being ostracized from their community.

4. Students should discuss three findings from the following: twin studies show identical twins more likely to share affectionate orientation than non-identical twins, evidence for genes shared with gay male brothers not shared by heterosexual male brothers, differences in the structure of the hypothalamus in gay men and heterosexual men, difference in pheromone responses for gay men and heterosexual men.

5. Research has shown no ill effects on the psychological well-being of children raised by same sex couples compared to heterosexual couples. The affectional affiliation and sexual identity of the parent have no impact on the child. Research has found that the number of parents in the home, and not the affectionate orientation of those parents, is the biggest predictor of psychological health or distress. Thus research indicates that same-sex couples are equally able to raise children who are psychologically healthy.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

6. When discussing people's intimate, sexual, and romantic attractions to others, most researchers and laypersons alike focus on the sexual aspects of such attractions, using the term "sexual orientation" to refer to an individual's tendency to be attracted to men and/or women. Yet many have noted that this term is too limited, as it overemphasizes the sexual aspects of an orientation and thus oversimplifies what an orientation is. As a result, there is growing support for rejecting the term sexual orientation in favour of the more inclusive term affectional orientation. Indeed, most current researchers recognize that an orientation has a significant emotional attachment component. Affectional orientation is the interaction between affect and cognition such that it produces attraction, erotic desire, and ultimately feelings of love for members of the other sex, the same sex, or both.

7. Today, negative views of same-sex sexual behaviours persist, to varying degrees, in most societies around the world. Such views also often lead to prejudices against individuals who engage in same-sex behaviour, or anyone who is deemed to not fit neatly into the category of "heterosexual." Heterosexism, whether it occurs consciously or unconsciously, minimizes non-heterosexual people, either by assuming that they do not exist or by projecting a belief that they are somehow inferior to their heterosexual counterparts. It is a continual process that manifests itself in nearly every setting (e.g., at home, at work, and at school).

8. Questions about what causes us to develop the way we do are fraught with difficulty. It is especially in these lines of inquiry that we see full enactment of the nature-versus-nurture controversy: is our development caused by biological, physical, and genetic factors, or by environmental, social, and psychological factors? As Kitzinger and Wilkinson (1995) state, the question is moot: it cannot be answered through the quantitative and qualitative methodologies available to researchers. When researchers do attempt to provide an answer—at least, in relation to conditions that have a psychosocial component to them—they invariably find that the way we develop is a combination of nature and nurture.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 12

Attraction, Intimacy, and Love MULTIPLE CHOICE QUESTIONS 1. What is the number one reason undergraduates give for wanting to have sexual intercourse with someone else? a) attraction b) intimacy c) love d) boredom 2. Olivia has been attending university class for the whole semester. She is seated next to Eduardo, who noticed her from the beginning of the course. He found her moderately attractive but thought nothing more of it. By the end of the semester, however, Eduardo felt increased attraction to Olivia and asked her if she would like to watch Netflix and chill some time. What concept is demonstrated in this anecdote? a) mere-repeated-exposure effect b) homophily c) assortative mating d) attachment 3. Attraction is an important part of meeting potential sexual and intimate partners. According to the text, what makes it more likely that people will be repeatedly exposed to one another and provides an opportunity for people to meet and develop attraction to one another? a) proximity b) homophily c) ancestry d) all of the above 4. What concept suggests that the tendency through persistent contact with a stimulus (e.g., another person) increases our preference for the stimulus? a) mere-repeated-exposure effect b) homophily c) assortative mating d) attachment 5. Mariko is an undergraduate student who recently saw an advertisement for a speed-dating event with other undergrads. Mariko attended the event and ended up connecting with James. According to the research on attraction, what was the most likely factor to initially bring them together? a) physical attraction b) intelligence c) honesty d) self-loathing 6. Which of the following is a difference noted between genders when it comes to attractiveness? a) Men place more emphasis on physical attractiveness than women. b) Women place more emphasis on physical attractiveness than men.

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c) Men and women place equal emphasis on physical attractiveness. d) none of the above 7. Katherine uses an app for finding other Christian singles in her area because she is interested in someone with the same beliefs as her. Which term best describes this? a) homophily b) mere-repeated-exposure effect c) assortative mating d) assertive mating 8. Sarah's friend Julie invites her to a party. Julie tells Sarah that two attractive men she knows, Jake and Mike, will be there, and that both men have seen pictures of Sarah, and Jake thought Sarah "was really cute." Sarah asked Julie what Mike thought of her, and Julie admitted that Mike didn't comment on Sarah's picture. Based on research on attraction, who do you think Sarah will find more attractive when she meets the two men? a) She will think that Jake is more attractive than Mike. b) She will not find either man attractive. c) She will think that Mike is more attractive than Jake. d) She will decide which man is more attractive when she meets them.

9. In general, people are attracted to those who feel the same way about them. Simply stated, "attraction breeds attraction." What concept does this demonstrate? a) reciprocity b) mere-repeated-exposure effect c) homophily d) assortative mating 10. "Birds of a feather," or being attracted to someone similar, is called __________. a) homophily b) reciprocity c) mere-repeated-exposure effect d) proximity 11. Students were asked to read an attitude scale that they were told was completed by a stranger (but that in actuality was manipulated to display attitudes similar or dissimilar to those of the students). There was a strong association between attraction and proportion of attitudes shared with the "stranger": those whose attitudes were more similar to the stranger's reported that they would enjoy working with the stranger. What concept is illustrated in this excerpt? a) assortative mating b) reciprocity c) mere-repeated-exposure effect d) proximity 12. Though most research suggests that people are attracted to those who are similar to them, there is evidence of one exception. What is that exception in relation to? a) immune system b) social status c) fertility d) hormone levels Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

13. Women's preference for males with masculine facial traits during the fertile portion of their menstrual cycle is thought to be related to which assumption? a) that masculine traits predict fertility b) that masculine traits predict willingness to engage in sexual activity c) that masculine traits predict increased immunity d) that masculine traits predict financial success 14. Single men hoping to meet a woman are most successful with which approach? a) funny pick-up lines b) a third-party introduction c) directly stating their interest in the woman d) direct compliments 15. Women find masculine men's faces more attractive during which phase of their menstrual cycle? a) the follicular phase b) the luteal phase c) the secretory phase d) the menstrual phase 16. Which of the following do researchers use as evidence supporting the phrase "opposites attract"? a) People are more attracted to people whose faces are dissimilar to their own. b) People are more attracted to people whose attitudes are different from their own. c) People are more attracted to people who have a different MHC than they do. d) People are less attracted to people who have a different MHC than they do.

17. Which of the following correlations between menstrual cycle and attraction is true? a) Attraction can vary depending on where in her menstrual cycle a woman is. b) Women prefer men with more masculine facial features when they are more fertile. c) Men rate women's body odour as more sexy during ovulation. d) all of the above 18. Which of the following pick-up lines is most likely to receive a positive response? a) Can I buy you a drink? b) Did it hurt when you fell from heaven? c) Your place or mine? d) Is it hot in here or is it just you?

19. Which of the following pick-up lines is most likely to receive a positive response? a) Do you like this band? b) You must be a broom, ‘cause you just swept me off my feet. c) Your place or mine? d) You don't need keys to drive me crazy.

20. When two people who are genetically similar marry, which of the following is more likely? a) The female is likely to be less responsive sexually. b) The female is likely to be more responsible sexually. c) The female is likely to ovulate less frequently.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) The female is likely to ovulate more frequently.

21. Aaron is at a singles dance and approaches Andrea, who is standing by herself. Which of the following "pick-up lines" will Andrea prefer? a) Do you have a sunburn or are you always this hot? b) I'm not a photographer but I can picture you and me together. c) You don't need keys to drive me crazy. d) What do you think of singles dances?

22. Which of the following is NOT true of major histocompatibility complex (MHC), the set of genes in vertebrates that are used by the immune system to distinguish self from non-self factors (e.g., infection agents)? a) People generally prefer MHC genes that are similar to their own. b) Dissimilar MHC produces offspring with better immunocompetence. c) Dissimilar MHC avoids inbreeding and the associated negative genetic consequences. d) People generally prefer odours of individuals who are dissimilar to them with regard to MHC. 23. Which of the following is associated with intimacy? a) psychological well-being and happiness b) social support c) increased physical health d) all of above 24. What does it mean to experience a level of commitment and positive affective, cognitive, and physical closeness with a partner in a reciprocal (although not necessarily symmetrical) relationship? a) to be intimate b) to be married c) to be honest d) to be reciprocal 25. According to Bartholomew's attachment theory, what style is associated with positive views of both the self and others? a) secure b) preoccupied c) fearful d) dismissing 26. Brooklyn is compulsively self-reliant, distant in relationships, and downplays the importance of intimate relationships. What would Kim Bartholomew (1990) predict was Brooklyn's model of himself and his model of others? a) Brooklyn has a positive model of himself and a positive model of others. b) Brooklyn has a positive model of himself and a negative model of others. c) Brooklyn has a negative model of himself and a positive model of others. d) Brooklyn has a negative model of himself and a negative model of others.

27. Laney is overly invested and involved in close relationships, dependent on others for self-worth, and has a demanding, needy, approach orientation toward others. What would Kim Bartholomew (1990) predict was Laney's model of herself and others? a) Laney has a positive model of herself and a positive model of others.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) Laney has a positive model of herself and a negative model of others. c) Laney has a negative model of herself and a positive model of others. d) Laney has a negative model of herself and a negative model of others.

28. According to Kim Bartholomew (1990), what attachment pattern will a person who has a positive model of themselves but a negative model of others have? a) secure b) dismissing c) fearful d) preoccupied 29. When attachment is thought of in terms of avoidance of intimacy and anxiety about rejection, a securely attached person would be which of the following? a) low on avoidance and low on anxiety b) high on avoidance and low on anxiety c) low on avoidance and high on anxiety d) high on avoidance and high on anxiety 30. According to Bartholomew's attachment theory, what style is characterized by a negative view of the self and a positive view of others? a) preoccupied b) secure c) fearful d) dismissing 31. According to Bartholomew's attachment theory, what style involves a negative view of both the self and others? a) fearful b) preoccupied c) secure d) dismissing 32. According to Bartholomew's attachment theory, what style is characterized by a positive view of the self and a negative view of others? a) dismissing b) fearful c) preoccupied d) secure 33. According to Bartholomew and Horowitz (1991), what attachment style do most young adults have? a) secure b) preoccupied c) fearful d) dismissing 34. Geena and Sooyoung have a very close relationship and tend to resolve their conflicts constructively. Which attachment style does Geena most likely have? a) secure Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) preoccupied c) dismissing d) fearful 35. Caroline has been in a relationship with Orest for six months. She already feels very close to Orest and is often the one initiating conversations and get-togethers. Which of the following is probably true? a) Caroline has a negative model of self. b) Caroline has a positive model of self. c) Caroline has a negative model of other. d) none of the above 36. Which of the attachment styles best describes the following statement?

"I don't need a close emotional relationship to feel satisfied. In fact, I enjoy not having to depend on anybody but myself." a) dismissing b) fearful c) preoccupied d) secure 37. Which of the attachment styles best describes the following statement?

"If I allow myself to get close to somebody, they will just end up hurting me." a) dismissing b) fearful c) preoccupied d) secure 38. Which of the attachment styles best describes the following statement?

"I like being completely emotionally intimate with others." a) dismissing b) fearful c) preoccupied d) secure 39. Which of the attachment styles best describes the following statement?

"I think I value my partner more than they value me." a) dismissing b) fearful c) preoccupied d) secure 40. Which of the attachment styles best describes the following statement?

"I'm okay with having someone depend on me." a) dismissing b) fearful c) preoccupied d) secure 41. Which of the attachment styles best describes the following statement?

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"I worry about being alone." a) dismissing b) fearful c) preoccupied d) secure 42. When researchers studied the sexual behaviour of individuals who had developed an anxious attachment to their caregivers, what did they find was more common in anxiously attached individuals than securely attached individuals? a) fidelity in interpersonal relationships b) earlier age of first intercourse c) fewer sexual partners d) recent use of oral contraceptive 43. Camila is uncomfortable getting close to others. She wants emotionally close relationships, but she finds it difficult to trust others. Which of Bartholomew's attachment styles best characterizes Camila's experience? a) dismissing b) fearful c) preoccupied d) secure 44. Oscar is comfortable being without close relationships, but he sometimes worries that others don't value him as much as he values them. Which of Bartholomew's attachment styles best characterizes Oscar's experience? a) secure b) preoccupied c) fearful d) dismissing 45. What is the best conclusion regarding less secure attachment and condom use? a) Less secure attachment security sometimes leads to more condom use because of multiple partners, and sometimes leads to less condom use in an attempt to increase intimacy in the relationship. b) Less secure attachment sometimes leads to less condom use because of a lack of empathy for other people, and sometimes leads to more condom use because of a lack of trust in other people. c) Less secure attachment sometimes leads to more condom use because of an earlier age of first sexual intercourse, but sometimes leads to reduced condom use because of lower socioeconomic status and less access to condoms. d) Less secure attachment sometimes leads to less condom use because of self-hatred and a desire to contract sexually transmitted infections, and sometimes leads to an increase in condom use out of fear of having a child that would be unloved like the insecure person was.

46. "Hooking up" is different from dating in many ways. Which of the following is NOT a typical example of this statement? a) Most people hook up as a means to find a long-term romantic partner. b) People who hook up often do so after they have been drinking alcohol. c) Hooking up is not indicative of emotional intimacy or commitment between the sex partners. d) The encounter between the hook-up partners is typically short term.

47. When researchers compared the rates of casual sex encounters among students on university campuses in Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

Canada to Canadian students celebrating Spring Break in Daytona Beach, what did they find? a) Casual sex rates were the same on campus and on Spring Break. b) Casual sex rates were higher on campus than on Spring Break. c) Casual sex rates were lower on campus than on Spring Break. d) Casual sex rates were higher for men than women both on campus and on Spring Break.

48. A woman completes a survey listing all the traits she is looking for in a mate. She is matched with a man who has all the traits but she does not know him well enough to know how she feels about him. When asked if she will marry him anyway she says "yes." What country is the woman most likely from? a) India b) The United States c) Australia d) Serbia 49. Passionate love is based on which of the following? a) comfort and trust b) connection and friendship c) affection and tenderness d) longing and preoccupation 50. Which of the following seems to share brain patterns with cocaine-induced euphoria? a) sexual intimacy b) emotional intimacy c) compassionate love d) passionate love 51. Isaac has a powerful feeling of love toward a fellow senior undergraduate classmate. He has been friends with this person since the beginning of university but has felt that this person did not feel the same way. In fact, he has described his experience as unrequited love. What type of love has Isaac experienced? a) passionate love b) companionate love c) fatuous love d) empty love 52. What type of love is best described as affection and tenderness felt for someone with whom one's life is deeply connected? a) companionate love b) passionate love c) infatuated love d) empty love 53. Which of the following is NOT one of the three basic components of Sternberg's triangular theory of love? a) cognition b) intimacy c) passion d) commitment 54. Which of the following is NOT a component of love, according to Sternberg's triangular theory of love?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) commitment b) compatibility c) intimacy d) passion 55. The type of love that incorporates all three components of Sternberg's triangular theory of love? a) consummate love b) companionate love c) romantic love d) infatuation 56. Monica and Raja met at a party, had intense physical attraction to each other, and eloped in Las Vegas three weeks later. Their relationship at the time they are married would best be described as which type of love? a) fatuous love b) companionate love c) consummate love d) romantic love 57. Tyrone and Lily have been married for 10 years and don't feel the sexual attraction for each other that they used to feel. They are committed to their marriage and are close friends but sex is not a big part of their lives.

Which of Sternberg's categories of love best describes Tyrone and Lily's relationship? a) empty love b) companionate love c) consummate love d) romantic love 58. Angelo met Dylan about four months ago and began a sexual relationship with him. After two months, the sexual side of their relationship was frequent and intense, so they signed a one-year lease and moved into an apartment together. Once they had moved in together, the sex continued, and they had made a year-long commitment to each other. Angelo, however, was unsure if he actually liked Dylan as a person and began to avoid intimate times with him. What type of love from Sternberg's theory best describes Angelo's experience? a) fatuous love b) romantic love c) companionate love d) empty love 59. Layla and Theodore met 25 years ago and, after dating for three years, got married. They live together with their three cats and share a very close bond, sharing almost all of their thoughts and feelings with each other. Over the last few years, however, there have been few sexual encounters. What type of love from Sternberg's theory best describes their situation? a) companionate love b) empty love c) romantic love d) fatuous love 60. "Love at first sight," which tends to involve signs of physical arousal, such as a rapid heartbeat, is best described as which type of love? a) infatuated love Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) empty love c) fatuous love d) consummate love 61. How many love styles did John Lee identify? a) four b) five c) six d) seven 62. Which of Lee's types of love is an altruistic love that is characterized by giving rather than receiving? a) ludus b) storge c) agape d) pragma 63. Kaori has begun dating Sam and recently told her friend, "When Sam doesn't pay attention to me, I feel sick."

Which of Lee's types of love is Kaori exhibiting? a) ludus b) manic c) agape d) eros 64. Which of Lee's types of love would conservative individuals be least likely to endorse? a) ludus b) pragma c) storge d) agape 65. Which of Lee's types of love styles best describes the following statement?

"My partner and I were friends for years before we became romantic." a) storge b) eros c) pragma d) ludus 66. Which of Lee's types of love styles best describes the following statement?

"I don't tell my partner everything—what they don't know won't hurt them." a) ludus b) eros c) pragma d) mania 67. Which of Lee's types of love styles best describes the following statement?

"When I met my partner, we both had a really strong, passionate attraction to each other." a) storge b) eros c) pragma Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) ludus 68. Which of Lee's types of love styles best describes the following statement?

"I want my family and friends to approve of my partner." a) mania b) eros c) pragma d) ludus 69. Which of Lee's types of love styles best describes the following statement?

"I would do anything for my partner—I would take a bullet for them." a) agape b) eros c) mania d) ludus 70. Grayson and Raewyn have been in a committed relationship for a number of years. When asked to describe how they have stayed together, they simply say that there seems to be the right "chemistry" between them. What love style are they expressing? a) eros b) storge c) mania d) agape 71. Kostas recently became sexually involved with Claire. After two encounters, Kostas felt that he was in love with her. He began texting her as often as he was thinking about her (which was most of the time) despite the fact that she almost never texted him back. Even though his friends warned him to take it slow, Kostas couldn't help himself, and when Claire stopped communicating with him altogether, he felt sick all over. What style of love is Kostas experiencing? a) mania b) eros c) storge d) agape 72. What term is used to describe the situation in which a person misinterprets physiological arousal stemming from unrelated feelings such as fear and believes that it is love? a) misattribution of arousal b) love as a story c) objectùm sexuality d) fantasy encounters 73. Duana loves a doll she has had her whole life and even though she is 25 years old she takes the doll everywhere. Duana is not interested in romantic relationships with men or women but would marry her doll if she could. Duana is showing an extreme case of what? a) objectùm sexuality b) objective sexuality c) bisexuality objectùm d) anthropomorphic sexuality Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

74. Erika Eiffel, who changed her last name after marrying the Eiffel Tower, has a form of love best described as ___________. a) objectùm sexuality b) misattribution of arousal c) empty love d) ludus 75. Peggy Kleinplatz researched optimal sexuality and found that the key element to an optimal sexual event, without which the event could not be optimal, was which of the following? a) novelty b) intimacy c) risk-taking d) mutual respect 76. Xiao and Feng have a fun sex life. They care for each other and are frequently trying new things, although they have been together so long they are not as attracted to each other as they once were. Last year Feng had a casual sexual encounter that Xiao later found out about, but she decided to stay in the relationship. According to Peggy Kleinplatz's research, what may be a barrier to optimal sexual pleasure for Xiao? a) trust b) lack of attraction c) low arousal d) resentment 77. According to Peggy Kleinplatz, which of the following has the most impact on whether a person experiences optimal sex? a) manual stimulation b) penile–vaginal penetration c) sex toys d) a strong interpersonal bond 78. Kyle noticed that his girlfriend, Ariadne, has started to flirt with Tim. Kyle is extremely jealous. What is one other emotion Kyle is most likely feeling? a) depression b) nostalgia c) shame d) fear 79. Dr. Raymond is an evolutionary psychologist. Which of the following theories of jealousy is she most likely to support? a) Jealousy is the result of social embarrassment. b) Jealousy is the result of classical conditioning to fear of being alone. c) Jealousy originated in older human societies where some groups would have food and others would not. d) Jealousy serves to ensure that resources are not wasted on offspring that are not biologically related to the male.

80. Recent years have seen the development of social networking sites (SNSs) such as Facebook and Instagram.

These sites have become a popular way to maintain relationships that began offline. With the advent and increasing popularity of SNSs, anecdotal information and media reports point to these sites as a potential trigger Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

for what experience in relationships? a) jealousy b) eros love c) intimacy d) depression 81. When people in mixed-sex relationships were asked about how jealous they would be if their mate had a same-sex affair, what were the responses? a) Men were three times more likely to be jealous of a same-sex affair. b) Men were twice as likely to be jealous of a same-sex affair. c) Women were twice as likely to be jealous of a same-sex affair. d) There were no differences between the sexes in jealousy ratings.

82. Aisha is in a relationship with Sergey and has become jealous. She knows about comments he made to people that seem to imply he likes to party without her, he seems to still have relationships with ex-girlfriends, and other women are always commenting on what he is doing. Which of the following is most likely true about Aisha and Sergey? a) They are both on Facebook. b) They are making wedding plans. c) They are living in different cities. d) One partner lives in a group setting such as a dorm.

83. What percentage of married couples have at least one partner who monitors the other person's Internet activity? a) 25 per cent b) 33 per cent c) 50 per cent d) 66 per cent 84. Which of the following has been found to be associated with higher levels of Facebook jealousy? a) attachment anxiety b) companionate love c) dismissive attachment d) passionate love 85. Roman was recently chatting with someone online and the conversation got very sexual. His current partner found the conversation and got very upset with him. They had explicitly set out rules for what was acceptable and not in their relationship when the other person was online. What principles did Roman fail to follow? a) proper netiquette b) rules of fidelity c) the "green-eyed monster" d) all of the above 86. From on online study of 900 North Americans on sexual infidelity, what percentage of people admitted that they had cheated on their partner? a) 5 per cent b) 10 per cent c) 20 per cent Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) 30 percent 87. Many partners of people who were greatly involved in cybersex report which of the following? a) sexual inadequacy b) sexual problems c) a sense of betrayal d) all of the above 88. Sternberg's duplex theory of love integrates which two previously separate theories of love? a) the triangular theory of love and the theory of love styles b) the triangular theory of love and the theory of love as a story c) the theory of love styles and the theory of love as a story d) the two-factor theory and the theory of love as a story 89. When individuals viewed a photo of their ex-partner, areas of the brain associated with motivation and reward were activated. According to this study, what was the primary neurotransmitter associated with these brain areas? a) dopamine b) epinephrine c) serotonin d) norepinephrine 90. Which of the following statements is NOT related to the prominence of a "hook-up culture" among undergraduates? a) Experimenting with sexuality through hooking up may damage the establishment of a sexual identity . b) More permissive attitudes toward sexuality developed in the latter half of the 20th century. c) Better contraceptive methods leads to reduced likelihood of pregnancy. d) None of the above are related to the prominence of a "hook-up culture" among undergraduates.

91. To what model/theory do the four styles of attachment belong? a) the model of the self b) The Theory of Love Styles c) the two-dimensional model of adult attachment d) the model of the other 92. Of the four attachment types outlined by Bartholomew, a sample of young adults indicated that between 47 to 51 per cent reported this type of attachment style? a) secure b) fearful c) dismissing d) preoccupied 93. How many types of intimacy are commonly assessed by the Personal Assessment of Intimacy in Relationships (PAIR) measure developed by Schaefer and Olson? a) 3 b) 4 c) 5 d) 6 Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

SHORT ANSWER QUESTIONS 1. When we want to describe the fact that people tend to socialize with and be attracted to people who are similar to themselves we use the term __________.

2. The __________ attachment style is associated with the highest levels of satisfaction in a romantic partner.

3. Helping your partner clarify their thoughts is an important part of __________ intimacy.

4. People from __________ societies are less likely to feel that romantic love is required for marriage.

5. Brain areas activated when a person thinks about someone they feel passionate love for are the same areas that activate when a person uses the drug __________.

6. According to Sternberg's triangular theory of love, __________ is the component of love most difficult to sustain in the long term.

7. Jealousy is thought to evoke two other emotions, anger and __________.

8. The Capilano Bridge experiment demonstrated that __________ can be misattributed as attraction.

9. Having sexual experiences that are (subjectively) extraordinary is called __________ __________.

10. According to the triangular theory of love, love that is characterized only by intimacy is referred to as __________.

11. The idea that "attraction breeds attraction" is called __________ of attraction.

12. The tendency for people to marry partners who are similar to them is called __________ __________ .

13. Men have been found to rate women's faces as more attractive when the women are in the __________ phase of their menstrual cycle.

14. Parents with __________ dissimilarity may produce offspring with better immunocompetence.

15. The ranking the statement "my partner listens to me when I need someone to talk to" may be used to measure the level of __________ intimacy in the relationship.

16. Paulo is uncomfortable with close emotional relationships because he likes to retain his independence. Paulo likely has a __________ attachment style in relationship.

17. Audrey is in a relationship with Micah. Micah isn't as close to her as she would like him to be, and she worries he doesn't really value her. Audrey appears to have a __________ attachment style.

18. Sternberg's theory of love posits three types of love: intimacy, passion and __________.

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19. Sternberg refers to the absence of commitment, intimacy, and passion as __________.

20. ________ is also know as "the green-eyed monster."

21. Rules outlining acceptable and unacceptable Internet activities, such as monitoring a spouse's online activity without their knowledge, is often termed ________.

22. The emotional and physical attraction to and love for an object or objects is called ________ sexuality.

23. "I would rather suffer myself than let my lover suffer" would best describe the ________ style of love.

24. Sexual ________ occurs when increased accessibility to a partner and predictability in sexual interactions leads to reduced sexual interest.

25. ________ is often defined as the "level of commitment and positive affective, cognitive, and physical closeness one experiences with a partner in a reciprocal (although not necessarily symmetrical) relationship."

26. "Is it hot in here or is it just you?" is an example of a verbal statement made by someone in order to initiate a romantic and/or sexual encounter commonly called a ________-________ ________.

ESSAY QUESTIONS 1. Describe the five types of intimacy identified by Schaefer and Olson (1981), providing an example of each.

2. Describe the model of attachment described by Kim Bartholomew (1990) and the attachment styles that go with the model.

3. There are four attachment styles in the two-dimensional model of adult attachment. List and describe two.

4. Discuss the positive and negative effects of casual sexual encounters.

5. Describe in detail the characteristics of the components of Sternberg's triangular theory of love.

6. Discuss how research suggests the phrases "birds of a father flock together" and "opposites attract" may both be true statements.

7. Describe the theory of "love as a story." Provide one example.

8. Hendrick and Hendrick (1986) provided six styles of love on their "love attitudes scale." List and describe three.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. a 2. a 3. a 4. a 5. a 6. a 7. a 8. c 9. a 10. a 11. a 12. a 13. c 14. b 15. a 16. c 17. d 18. a 19. a 20. a 21. d 22. a 23. d 24. a 25. a 26. b 27. c 28. b 29. a 30. a 31. a

32. a 33. a 34. a 35. a 36. a 37. b 38. c 39. c 40. d 41. c 42. b 43. b 44. b 45. a 46. a 47. b 48. a 49. d 50. d 51. a 52. a 53. a 54. b 55. a 56. a 57. b 58. a 59. a 60. a 61. c 62. c

63. b 64. a 65. a 66. a 67. b 68. c 69. a 70. a 71. a 72. a 73. a 74. a 75. b 76. a 77. d 78. d 79. d 80. a 81. d 82. a 83. b 84. a 85. a 86. c 87. d 88. b 89. a 90. a 91. c 92. a 93. c

SHORT ANSWER QUESTIONS 1. homophily 2. secure 3. intellectual 4. collectivist 5. cocaine 6. passion 7. fear 8. fear 9. optimal sexuality

10. liking 11. reciprocity 12. assortative mating 13. follicular 14. MHC 15. emotional 16. dismissing 17. preoccupied 18. commitment

19. nonlove 20. Jealousy 21. netiquette 22. objectùm 23. agape 24. habituation 25. Intimacy 26. pick-up line

ESSAY QUESTIONS Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Emotional: "My partner listens to me when I need someone to talk to."

Social: "Having time together with friends is an important part of our shared activities."

Sexual: "Sexual expression is an essential part of our relationship."

Intellectual: "My partner helps me clarify my thoughts."

Recreational: "We enjoy the same recreational activities."

2. The model is based on how people view themselves (a scale going from positive and self-confident to negative and anxious) and how people view others (a scale that goes from positive and seeks intimacy to negative and avoids intimacy).

A person has secure attachment if they have a positive model of themselves and others. They are comfortable with intimacy and autonomy in close relationships, and they are self-confident and resolve conflict constructively.

About 54 per cent of the population are in this category.

A person has dismissing attachment if they have a positive view of themselves and a negative view of others.

They are compulsively self-reliant, distant in relationships, and downplay the importance of intimate relationships. About 18 per cent of people have a dismissive style of attachment.

A person who has a negative view of themselves and a positive view of others has a preoccupied style of attachment characterized by being overly invested and involved in close relationships, dependent on others for self-worth, and having a demanding, needy, approach orientation toward others. About 10 to 14 per cent of the population has a preoccupied attachment style.

Finally, people with a negative view of themselves and others will have a fearful attachment style characterized by being dependent on others but avoiding intimacy due to fear of rejection, and having low self-esteem and high attachment anxiety. About 15 to 18 per cent of the population has a fearful attachment style.

3. Secure: It is easy for me to become emotionally close to others. I am comfortable depending on others and having others depend on me. I don't worry about being alone or having others not accept me.

Preoccupied: I want to be completely emotionally intimate with others, but I often find that others are reluctant to get as close as I would like. I am uncomfortable being without close relationships, but I sometimes worry that others don't value me as much as I value them.

Fearful: I am uncomfortable getting close to others. I want emotionally close relationships, but I find it difficult to trust others completely, or to depend on them. I worry that I will be hurt if I allow myself to become too close to others.

Dismissing: I am comfortable without close emotional relationships. It is very important to me to feel independent and self-sufficient, and I prefer not to depend on others or have others depend on me.

4. Students who have participated in hooking up report a range of both positive and negative emotions associated with their experiences. Examples of reported positive emotions include happiness or excitement, whereas examples of negative emotions include confusion or disappointment. Young adults, particularly women, may also feel pressured to participate in the hook-up culture and, as a result, may engage in unwanted sexual experiences.

As well, women may struggle with the sexual double standard that exists, whereby women who hook up are often viewed more negatively compared to their male counterparts.

5. The three components are intimacy, passion, and commitment (decision). In this theory, intimacy involves feelings of closeness and connection to a loved one and includes feelings that lead to warmth in a relationship.

Passion involves physical arousal and attraction and often is characterized by a drive to be sexual with one's partner; at the same time, other strong needs, such as a need to be nurtured by one's partner, may also add to the experience of passion in a relationship. Passion is often the earliest of the components to emerge in a romantic relationship, and, given that it is the component that is least under conscious control, it is the most difficult to sustain. Commitment, in the short term, is the decision that one person loves another; in the long term, it is the Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

decision to maintain that love. The short- and long-term aspects of commitment do not always go together, as one can love someone in the short term yet not be committed to the relationship over a long period of time, or vice versa 6. Birds of a feather: people are more attracted to people who are similar to them in many ways, including culturally, physically, and socioeconomically.

Opposites attract: people with different MHS are more attracted to each other.

7. The theory of "love as a story" tries to explain how different types of triangles and love develop. It states that we are exposed to various stories about what love is—by watching other people or movies, or reading fairy tales, for example—and eventually develop our own love stories based on our own personalities and experiences. The theory also suggests that we strive to fulfil these stories, and that relationships are most satisfying when partners' stories are closely matched—indeed, research has found that the greater the similarity between love stories, the more likely partners are to be satisfied in their relationship.

8. Eros: My lover and I have the right physical "chemistry" between us. Storge: The best kind of love grows out of a long friendship. Ludus: I believe that what my lover doesn't know about me won't hurt him/her. Pragma: A main consideration in choosing a lover is how he/she reflects on my family. Mania: When my lover doesn't pay attention to me, I feel sick all over. Agape: I would rather suffer myself than let my lover suffer.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 13

Sexual Communication MULTIPLE CHOICE QUESTIONS 1. Which of the following negative communication behaviours is being described below? Carlotta's long-time partner is bringing up her smoking habits... again. Carlotta has tried to quit to please her partner, but she just can't do it, and she doesn't really want to quit. As soon as her partner starts bringing up the health risk factors of smoking, Carlotta rolls her eyes. a) contempt b) criticism c) defensiveness d) stonewalling 2. Which of the following negative communication behaviours is being described below? Jimmy and Reya are arguing about whose turn it is to do the laundry over the weekend. Jimmy works a full-time job while Reya is a stay-at-home mom. Jimmy calls Reya lazy for not finding time to do the laundry during the week. a) contempt b) criticism c) defensiveness d) stonewalling 3. Which of the following negative communication behaviours is being described below? Donald is upset with his boyfriend Farouk for flirting with another man at a bar they went to last night. When he brings it up, Farouk brushes it off and says, "But you do it too." a) contempt b) criticism c) defensiveness d) stonewalling 4. Which of the following is an example of contemptuous communicative behaviour? a) saying "I can't stand it when you go out with the guys and ignore me!" b) storming out of the room during an argument c) saying "That is the stupidest thing I have ever heard, but it shouldn't surprise me because you said it!" d) saying "Your constant criticism is the reason I'm angry all the time!"

5. Maria and Mohamed got into an argument, and Maria ran out of their apartment and turned off her phone. What negative communicative behaviour is Maria exhibiting? a) criticism b) contempt c) defensiveness d) stonewalling 6. Kyle and Yi-Hsiu are arguing and Kyle calls Yi-Hsiu a "bitch." Yi-Hsiu is enraged and locks herself in the bedroom, crying. Kyle responds by going to the bedroom door and saying, "I wouldn't have called you a bitch if you didn't start this fight." What communicative behaviour is Kyle exhibiting at the bedroom door? a) criticism Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) contempt c) defensiveness d) stonewalling 7. Paul and Kate are in a distressed relationship. Jenna and Lisa are in a non-distressed relationship. Which of the following statements is likely to be true? a) Paul and Kate are more likely than Jenna and Lisa to have lower empathy for each other. b) Kate is less likely than Lisa to be defensive in an argument. c) Paul is more likely than Jenna to criticise his partner. d) Paul and Kate are less likely than Jenna and Lisa to have lower levels of validation towards each other.

8. Which of the following behaviours is likely to be most harmful during a couple's argument? a) shrugging the shoulders b) using a dismissive tone c) criticizing your partner d) All of the above could be equally harmful.

9. Dana is arguing with his wife. His arms are crossed and he refuses to make eye contact. Dana is ____________. a) stonewalling b) defensive c) offensive d) critical 10. Your friend has been having a lot of arguments with his boyfriend lately, but they always end the arguments by agreeing to disagree. He asks you if you think this is an indicator of a poor relationship. What can you tell him? a) If both partners are agreeing to disengage from the argument, than it is not necessarily a negative aspect of their relationship. b) Arguing too much is a definite indicator that there is something wrong with the relationship. c) If they have too many differences that are causing problems, then maybe they need to rethink the relationship. d) There are strategies the two of them can learn if they want to continue their relationship and argue less.

11. Approximately what percentage does non-verbal communication account for the information exchanged in an interpersonal interaction? a) 35–40 per cent b) 45–50 per cent c) 60–65 per cent d) 70–75 per cent 12. Which of the following is the strongest predictor of relationship satisfaction? a) the quality of verbal communication b) the quality of non-verbal communication c) the number of criticisms exchanged on an average day d) the frequency of defensive remarks by either partner 13. Pepito and Daria have been in a relationship for two years. Pepito often wants to spice up their sex life by trying out new things, but Daria is reluctant to do so. Whenever Pepito tries to discuss it with her, he finds it very difficult to get Daria to be open about it. Instead, she gets very shy and withdrawn. What argument could Pepito make to try and convince Daria about the importance of talking through their issues?

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a) Being open when discussing their sex lives could bring them closer together emotionally. b) If they keep avoiding their sexual incompatibilities, they might start to resent each other. c) Exploring each other's sexual desires can increase sexual satisfaction for both of them. d) any of the above 14. What role does incompatibility play in sexual relationships? a) Incompatibility is part of every relationship. b) Incompatibility exists in about 75 per cent of relationships. c) Incompatibility is an issue for about 50 per cent of relationships. d) Incompatibility occurs mostly in long-term relationships.

15. Which of the following couples is most likely to have a distressed relationship? a) Amina and Carl; Amina wishes they had sex more often and often criticizes Carl for being "unmanly" when they argue about it. b) Theodore and Roger; Roger makes less money than Theodore and often walks away when Theodore tells him he is spending too much. c) Singh and Leslie; whenever they get into an argument, Leslie brings up how much she hates Singh's family. d) All of the above couples are equally likely to have a distressed relationship.

16. Which of the following disagreements most accurately predicts relationship distress? a) an argument over spending habits b) an argument where one spouse accuses the other of being "too passive" when arguing c) an argument about child rearing d) an argument about a couple's sexual relationship 17. Roya wants to discuss with her husband a problem in their sexual relationship. Which emotion would be best for Roya to express in that conversation? a) disgust b) embarrassment c) anger d) frustration 18. Jasmin and Chris are having an argument. Chris says, "Sometimes you make me so angry," and then hugs Jasmin closely. What is Jasmin most likely to feel about this communication? a) angry because verbal communication is more important than non-verbal communication b) angry because non-verbal communication is more important than verbal communication c) good because non-verbal communication is more important than verbal communication d) good because verbal communication is more important than non-verbal communication 19. Dr. Simmons is studying the correlations between non-verbal behaviour and relationship satisfaction. If Dr. Simmons compares the correlation between non-verbal communication quality and relationship satisfaction to correlations between verbal communication quality and relationship satisfaction, what will she most likely discover? a) a stronger positive correlation b) a weaker positive correlation c) a stronger negative correlation d) a weaker negative correlation

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20. Trina's solution to her arguments with Mandeep over their household budget is to leave the house and drive to her sister's home. What behaviour is Trina displaying? a) criticism b) contempt c) defensiveness d) stonewalling 21. Rolling one's eyes in response to what a partner said during an argument is an example of __________. a) criticism b) contempt c) defensiveness d) stonewalling 22. Which of the following cannot occur unless there is clear communication between two people? a) self-report b) sexual consent c) stonewalling d) orgasm 23. When assessing differences in couples' communication styles across cultures, in which country do university students prefer to use non-verbal signals to indicate sexual interest? a) Norway b) Canada c) South Africa d) Vietnam 24. When assessing differences in couples' communication styles across cultures, in which country did married women rely heavily on non-verbal strategies to reject their husbands' initiations of sex? a) Norway b) Canada c) South Africa d) Vietnam 25. Research has found that a partner's responsiveness to communication efforts in a relationship are important for sexual desire. More specifically, what has this research found? a) That perceived partner responsiveness is more important for sexual desire. b) That actual partner responsiveness is more important for sexual desire. c) That perceived partner responsiveness is equally as important as actual partner responsiveness for sexual desire. d) That perceived partner responsiveness is not important for sexual desire.

26. Touching, facial expressions, gestures, and eye contact are all examples of what type of sexual communication? a) stonewalling sexual communication b) verbal sexual communication c) non-verbal sexual communication d) contemptuous sexual communication

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27. Talking about sexual likes and dislikes, exclamations made during sex, talking about past sexual experiences, and discussing sexual problems are all examples of what type of sexual communication? a) stonewalling sexual communication b) verbal sexual communication c) non-verbal sexual communication d) contemptuous sexual communication 28. In Canada, when must you legally disclose your STI status to a partner? a) Never. There is no law that states that you must disclose your STI status to a partner. b) Always. The law states that you must always disclose your STI status to a partner. c) Sometimes. The law states that you must disclose your STI status to a partner if having sex constitutes a significant risk of serious bodily harm. d) Sometimes. The law states that you must disclose your STI status to a partner only if you know you are infected with any STI. 29. Do the benefits of open sexual communication with regards to relationship satisfaction stay consistent or change over the course of a heterosexual relationship? a) It changes. Open sexual communication is more important for men's relationship satisfaction in the early stages of a relationship. b) It stays the same. Open sexual communication is just as important at the beginning of a relationship as it is later in the relationship for both partners. c) It changes. Open sexual communication is more important for women's relationship satisfaction once the relationship progresses beyond the early stages. d) both A and C 30. In a study of 63 heterosexual young adults, approximately what percentage of the initiation of sexual activity was non-verbal? a) 40 b) 60 c) 75 d) 90 31. Which of the following statements was a finding in a 2004 study that examined non-verbal sexual communication in SGD samples? a) There were no differences in the use of non-verbal communication to initiate sex in men who had sex with men (MSM) or women who had sex with women (WSW). b) Men who had sex with men (MSM) used more non-verbal communication when responding to communication meant to initiate sexual activity. c) Women who had sex with women (WSW) used less non-verbal communication when responding to communication meant to initiate sexual activity. d) All of the above were findings.

32. Which of the following statements is false regarding non-verbal sexual communication during sexual activity? a) The use of non-verbal communication during sex is linked with higher sexual satisfaction. b) The use of non-verbal communication during sex can communicate likes and dislikes as sexual experiences unfold. c) SGD adults make little use of non-verbal communication during sex. d) The use of non-verbal communication during sex can communicate a great deal about our interest and Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

enjoyment.

33. Effectively communicating one's sexual preferences and desires to one's partner can result in ________ sexual and general relationship satisfaction. a) increased b) decreased c) stagnant d) none of the above 34. In studies of communication in relationships, which of the following statements is true? a) The quality of verbal communication between partners is a stronger predictor of relationship satisfaction than is the quality of their non-verbal communication. b) The quality of non-verbal communication between partners is equally as strong as a predictor of relationship satisfaction as the quality of their verbal communication. c) The quality of non-verbal communication between partners is a stronger predictor of relationship satisfaction than is the quality of their verbal communication. d) There are currently no studies that have assessed verbal and non-verbal communication in relationships.

35. According to your textbook, flirting relies heavily on which type of sexual communication? a) verbal b) contemptuous c) stonewalling d) non-verbal 36. Which of the following is true regarding sexting patterns in a US sample of teenagers ranging from 13-18 years of age? a) Lower rates of sexting were found in SGD individuals. b) Those in relationships sexted more than singles. c) Males sent and received more sexts than females. d) Heterosexual teens reported the highest rate of sexting.

37. When considering a 2019 Canadian study on how partners respond to sexual talk, which of the following was NOT a finding from that study? a) If both partners are especially responsive to sexual talk, then mutualistic talk was associated with lower sexual distress. b) If both partners are especially unresponsive to sexual talk, then mutualistic talk was associated with higher sexual distress. c) If both partners are especially responsive to sexual talk, then individualistic talk was associated with greater sexual satisfaction. d) If both partners are especially responsive to sexual talk, then individualistic talk was associated with less sexual satisfaction.

38. Why do partners report that they are less likely to talk about sexual, as compared to nonsexual, problems in their relationships? a) Some believe that they do not have the skill to discuss sexual issues. b) Some consider sex a taboo topic even between sexual partners. c) People often worry about their partners' responses. d) all of the above Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

39. According to one 2017 study, approximately what percentage of women experiencing sexual problems disclosed this information to their partner? a) 15 per cent b) 34 per cent c) 56 per cent d) 69 per cent 40. What was the main finding from a 2016 intervention study in which 59 mixed-sex couples where the man had been diagnosed with erectile dysfunction following treatment for prostate cancer participated in a 3.5 hour workshop designed to increase sexual communication skills? a) Both the men and their partners reported improved relationship satisfaction and sexual functioning. b) Both the men and their partners reported improved relationship satisfaction alone. c) Both the men and their partners reported improved sexual functioning alone. d) Both the men and their partners reported improved relationship satisfaction but decreased sexual functioning.

41. Which of the following is NOT mentioned in the textbook as something that makes someone a good sexual communicator? a) choosing an appropriate time to engage in sexual communication b) using a clear, calm, and captivating tone of voice c) using non-judgmental language d) being a receptive listener 42. Breakups have been linked to all of the following outcomes except? a) increased substance abuse b) a loss of self-esteem c) increased risk of depression d) increased risk of certain cancers 43. Which break up strategy are adolescents making greater use of according to recent research? a) breakups using friends to relay the message b) breakups using digital technology/text messages c) breakups face-to-face d) breakups by speaking on the telephone 44. Paul wants to break up with his partner so, without warning, he cuts off all electronic communication with them and avoids them. This extreme form of avoidance during a breakup is typically called ________. a) ghosting b) disappearing c) jetting d) snaking 45. When are people most likely to break up with someone using digital means? a) when the level of intimacy between partners is high b) when there is a lot of overlap in the couple's social networks c) when the partners are similar to each other in many ways d) when the level of intimacy between partners is low

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46. Which of the following is not an advantage to using technology to convey a break up? a) You do not have to deal with a partner's emotional reaction. b) People are significantly less affected by digital breakups. c) You do not have to generate explanations. d) It allows time to craft a reaction, or avoid one altogether.

47. Five key motivations emerged from a study of 99 young adults that involved interviews about breaking up via technology. Which of the following motivations would fit with the statement "I wanted to avoid confrontation."? a) convenience b) lack of attraction c) expectation of a negatively-valenced interaction d) relationship state 48. Five key motivations emerged from a study of 99 young adults that involved interviews about breaking up via technology. Which of the following motivations would fit with the statement "It was easier."? a) convenience b) lack of attraction c) expectation of a negatively-valenced interaction d) relationship state 49. Five key motivations emerged from a study of 99 young adults that involved interviews about breaking up via technology. Which of the following motivations would fit with the statement "It wasn't serious enough to warrant face-to-face interaction."? a) convenience b) lack of attraction c) expectation of a negatively-valenced interaction d) relationship state 50. Five key motivations emerged from a study of 99 young adults that involved interviews about breaking up via technology. Which of the following motivations would fit with the statement "We had only gone on two dates and I didn't want to lead them on, so I stopped talking to them."? a) safety b) lack of attraction c) expectation of a negatively-valenced interaction d) relationship state 51. Five key motivations emerged from a study of 99 young adults that involved interviews about breaking up via technology. Which of the following motivations would fit with the statement "They were being creepy and I was worried they would go crazy if I told them in person."? a) safety b) lack of attraction c) expectation of a negatively-valenced interaction d) relationship state 52. What is problematic about focusing on purely verbal consent for permission to engage in sexual activities? a) Verbal consent places the burden on the target of the sexual advance. b) Many sexual interactions lack verbal exchange. c) It is sometimes difficult to know exactly when and how to verbally communicate in a way that leaves no Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ambiguity to one's message, but also preserves the relationship. d) all of the above 53. How are men most likely to communicate their own sexual consent and/or interpret the sexual consent of others? a) cajoling b) nagging c) verbally d) non-verbally 54. How are women most likely to communicate their own sexual consent and/or interpret the sexual consent of others? a) cajoling b) nagging c) verbally d) non-verbally 55. Which of the following situations would be considered non-consensual if sexual activity were to occur? a) A man fondles his wife's genitals while she is sleeping. b) A woman touches her husband's penis while he is severely intoxicated. c) A partner complies with repeated requests for sex. d) All of the above are non-consensual acts.

56. Which of the following situations would be considered non-consensual if sexual activity were to occur? a) A man has sex with a heavily intoxicated man. b) A woman sulks until her partner gives in to sexual intercourse. c) A partner complies with repeated requests for sex. d) All of the above are non-consensual acts.

57. A current, integrative view of consent highlights the importance of which of the following? a) Along with continuous verbal exchange, non-verbal messages and situational factors are emphasized. b) Along with continuous verbal exchange, non-verbal messages and sexual willingness are emphasized. c) Only continuous verbal exchange is necessary. d) Only non-verbal messages need to be taken into account.

58. Which statement about sexual consent is false? a) Sexual consent does not generalize to future sexual encounters. b) A person can consent to one sexual act but refuse all others. c) Sexual consent does not apply to a person's spouse. d) Sexual consent can be withdrawn at any time.

59. Which of the following types of communication specifically addresses issues relevant to the functioning of partnerships if they take place within an established relationship context? a) sexual communication b) relationship communication c) diverse communication d) defensive communication

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60. Which of the following types of communication specifically involves exchanges related to sexual matters? a) sexual communication b) relationship communication c) diverse communication d) defensive communication 61. From a large-scale study of 14,946 adolescents (aged 11 to 16 years) that analyzed sexting experiences across 20 European countries, from which country were boys were more likely to sext as compared to girls? a) Czech Republic b) Norway c) Finland d) Italy 62. From a large-scale study of 14,946 adolescents (aged 11 to 16 years) that analyzed sexting experiences across 20 European countries, from which country were there were no gender/sex differences in sexting? a) Czech Republic b) Germany c) Finland d) Italy 63. From a large-scale study of 14,946 adolescents (aged 11 to 16 years) that analyzed sexting experiences across 20 European countries, from which country did girls report sexting more than did boys? a) Czech Republic b) Germany c) Finland d) Italy 64. What did researchers find when they asked the question, "How is the communication between partners in distressed relationships different from the communication between partners in non-distressed relationships?" a) People in distressed relationships tend to engage in more negative communication behaviours. b) People in distressed relationships tend to engage in fewer positive communication behaviours. c) There were no differences in communication behaviours. d) Both A and B are true.

65. A negative communication behaviour in which someone protects themselves from a perceived verbal assault by denying responsibility, making excuses, or counter-complaining is called? a) criticism b) contempt c) defensiveness d) stonewalling 66. A negative communication behaviour that entails refusing to engage in the discussion at hand is called? a) criticism b) contempt c) defensiveness d) stonewalling

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67. A negative communication behaviour that entails putting down, or being hostile or disrespectful toward one's partner is called? a) criticism b) contempt c) defensiveness d) stonewalling 68. A negative communication behaviour that involves attacking a partner's character or personality is called? a) criticism b) contempt c) defensiveness d) stonewalling 69. Statements such as "No, I didn't" or "But you do it too" would be best described as which type of negative communication behaviour? a) criticism b) contempt c) defensiveness d) stonewalling 70. Behaviours such as eye-rolls, mean humour, and name-calling would be best described as which type of negative communication behaviour? a) criticism b) contempt c) defensiveness d) stonewalling 71. Calling somebody "uptight" or "prude" would be best described as which type of negative communication behaviour? a) criticism b) contempt c) defensiveness d) stonewalling 72. Walking away from a discussion or pretending that you are asleep when your partner wants to talk would be best described as which type of negative communication behaviour? a) criticism b) contempt c) defensiveness d) stonewalling 73. We know that how a person communicates is important, but so is how the person responds to communication.

What has recent research found regarding a partner's responsiveness to communication efforts? a) Responsiveness is associated with greater relationship well-being. b) Responsiveness is associated with greater sexual well-being. c) Responsiveness has no effects on sexual well-being.

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d) Both A and B are true.

74. John was recently diagnosed with HIV. He has not started drug treatment and has decided to keep his HIV status a secret from his sexual partner that he recently started seeing. They have a very active sex life and do not practise safer sex. Is John under any obligation to disclose his HIV status to his partner? a) No. It is up to John what he wants to do. b) Yes. He is obligated under Canadian law to disclose his STI status if there is a significant risk of serious bodily harm. c) Maybe. It would be morally right, but not legally required. d) none of the above 75. Gina and Fred are in a very close, loving relationship. Fred has been having difficulty with reaching orgasm during sexual activity for the last two weeks. Which of the following would be the best course of action to try and fix the problem? a) Fred should stop all sexual activity, it isn't working anyways. b) Fred should engage Gina in sexual communication. c) Fred should find a different partner with whom he is sexually compatible. d) Fred should be silent and just keep trying to fulfill his and Gina's needs.

76. A 2010 study looked at non-verbal behaviours that young heterosexual people used to flirt in places such as bars and coffeeshops. What behaviours did they find that women used to signal a man? a) self-grooming b) holding a gaze for an extended period c) smiling d) all of the above 77. A 2010 study looked at non-verbal behaviours that young heterosexual people used to flirt in places such as bars and coffeeshops. What did the researchers report about men that had been signalled by a women? a) Men who had been signaled were highly likely to approach the woman using more direct contact. b) Men who had been signaled were highly unlikely to approach the woman using more direct contact. c) Men were generally unaware that they had been signalled in the first place. d) Both A and C are correct.

78. Which of the following is a possible advantage of flirting using non-verbal communication? a) Flirting should never be attempted using non-verbal communication. b) It can give a cover of "plausible deniability" if the expression is rejected. c) Non-verbal communication is always non-ambiguous. d) Both A and C are correct.

79. What is a possible disadvantage of technology-based communications? a) Many technology-based communications allow you time to craft your responses. b) Many technology-based communications do not allow a full picture of a partner's non-verbal reactions. c) Many technology-based communications do not allow you to incorporate other communication elements such as touch and scent. d) Both B and C are correct.

80. Technology-based communication incurs an accelerated or amplified intimacy compared to intimacy levels for interactions that take place in-person only. Consequently, this effect may reflect the intense level of Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

self-disclosure and rapid rate of exchange that these technologies allow. What is the name given to this effect? a) hyperpersonalization effect b) hyperinteraction effect c) hyperdisclosure effect d) hyperexchange effect 81. Bill loves to talk dirty to his partner Jeff. Jeff really does not like dirty talk. According to research in the area of sexual talk, what should Bill do? a) Continue. Jeff will likely come around to the dirty talk after a while. b) Continue. As long as one partner enjoys the dirty talk, the other will be unaffected. c) Stop. Jeff is unresponsive to dirty talk and the relationship could suffer. d) Stop. Dirty talk always has negative effects on sexual relationships.

82. Ben and Cathy are in a long-term relationship and just had sex. Ben had an orgasm and was satisfied with the encounter, but Cathy was left unsatisfied. She immediately tells Ben, "I'm glad you're satisfied, but I haven't had an orgasm during sex in four weeks. We need to fix this." Ben does not take this news well and rolls over to go to sleep. How could Cathy have approached this situation differently to hopefully garner a more positive response? a) She should have been more to the point and offered Ben a solution right then and there. b) She should have waited until later to have this conversation with Ben. c) She should have waited until Ben was asleep and masturbated to orgasm. d) There is nothing she could have done differently—Ben would likely have reacted the same no matter what.

83. Which of the following examples are part of effective communication? a) being reflective b) being an active listener c) being non-judgmental d) All of the above 84. Johan is going to break up with his partner Becky. He "unfriends" her from Facebook and changes his number.

What has Johan just done? a) Johan has "ghosted" Becky. b) Johan has "unfollowed" Becky. c) Johan has "deleted" Becky. d) Johan has "snaked" Becky.

85. Which of the following is not one of the key motivations to breaking up via technology? a) lack of attraction b) convenience c) availability d) safety 86. Which statement is true regarding breaking up with someone via technology? a) It is often done for convenience. b) It is often done because of lack of attraction. c) It is often done for safety reasons. d) All of the above are reasons.

87. Tanya and her partner Rico are making out in her apartment. Rico asks Tanya if he could touch her breasts.

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She says that it would be OK. Rico then proceeds to unbutton her pants and attempts to touch her genitals instead.

Tanya jumps up and asks Rico to leave. He is confused and says "I asked for consent and you agreed." What flaw did Rico make in his reasoning? a) Although he asked for consent, it was for a different sexual act. b) Rico did not make any flaw—consent is consent. c) Rico committed sexual assault. d) none of the above 88. The extent to which someone views their partner's verbal and nonverbal responses to be accepting, validating, understanding, and caring is called ________. a) stonewalling b) perceived partner responsiveness c) verbal sexual communication d) sexual communication 89. ________ is "self-focused" sexual talk that relates to one's own sexual experience and pleasure. a) Individualistic talk b) Mutualistic talk c) Pump up talk d) Sharing talk 90. Which is NOT a positive sexual rejection behaviour? a) reassuring your partner that you are attracted to them b) trying to talk to your partner c) displaying frustration toward your partner d) offering alternative forms of physical contact SHORT ANSWER QUESTIONS 1. Indicating that a partner is selfish during an argument is an example of __________, one of four negative communication behaviours according to John Gottman.

2. Screaming an obscenity towards a partner during an argument is an example of __________, one of four negative communication behaviours according to John Gottman.

3. Denying responsibility is an example of __________, one of four negative communication behaviours according to John Gottman.

4. An example of __________ would be leaving the room in the middle of an argument.

5. Studies have shown that the majority of the information exchanged in an interpersonal interaction is done through __________-__________ communication.

6. Communication of sexual words or images, typically of oneself, via technology, such as mobile phones and the Internet is called __________.

7. According to you textbook, an ongoing exchange between the members of a relationship that unfolds over time Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

and consists of verbal, behavioural, and affective exchanges is called ________ communication.

8. The extent to which someone views their partner's verbal and non-verbal responses to be accepting, validating, understanding, and caring is called ________ ________ ________.

9. Verbal, behavioural, and affective exchanges concerning sexual matters (e.g., sexual preferences, attraction, sexual problems, consent, pleasure) by which individuals navigate sexuality with others is called ________ communication.

10. Sexual communication through words (e.g., talking, sexting) is called ________ sexual communication.

11. Sexual communication behaviours that do not involve words, including voice qualities, facial expressions, touching, and gestures is called ________ sexual communication.

12. ________ is a form of communication that involves conveying sexual interest in someone, and which often relies heavily on non-verbal communication.

13. The act of freely and willingly agreeing to participate in sexual activity which is imperative for all sexual encounters is called ________ ________.

14. Effectively communicating one's sexual preferences and desires to one's partner can result in ________ sexual and general relationship satisfaction.

15. Verbal sexual communication that occurs during sexual interactions and that is specific to the sexual interaction is called ________ ________.

16. An extreme form of avoidance of face-to-face communication whereby you break up with someone by cutting off electronic communication, usually without any warning, is called "________."

17. Sexual activity or interaction that occurs without consent is considered ________ ________ and is punishable under the Criminal Code of Canada.

18. When assessing what makes someone a good sexual communicator, using ________-________ language can improve communication.

19. Technology-based communication often reveals a "________ effect," which refers to an accelerated or amplified intimacy compared to intimacy levels for interactions that take place in-person only.

20. In Canada, the law requires that an STI be revealed if having sex constitutes "a significant risk of ________ ________ ________."

ESSAY QUESTIONS 1. Should you reveal everything about your sexual self to a partner? Discuss the reasons why and why not to disclose this info.

2. Why is effective sexual communication important?

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3. Discuss the positive outcomes of communicating about sexual problems and challenges with your partner. Give an example where possible.

4. List 5 points that makes someone a good sexual communicator?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. a 2. b 3. c 4. c 5. d 6. c 7. a 8. d 9. a 10. a 11. c 12. b 13. d 14. a 15. a 16. d 17. b 18. c 19. a 20. d 21. b 22. b 23. c 24. d 25. a 26. c 27. b 28. c 29. d 30. d

31. a 32. c 33. a 34. c 35. d 36. c 37. d 38. d 39. d 40. a 41. b 42. d 43. b 44. a 45. d 46. b 47. c 48. a 49. b 50. d 51. a 52. d 53. d 54. c 55. d 56. d 57. a 58. c 59. b 60. a

61. d 62. c 63. a 64. d 65. c 66. d 67. b 68. a 69. c 70. b 71. a 72. d 73. d 74. b 75. b 76. d 77. d 78. b 79. d 80. a 81. a 82. b 83. d 84. a 85. c 86. d 87. a 88. b 89. a 90. c

SHORT ANSWER QUESTIONS 1. criticism 2. contempt 3. defensiveness 4. stonewalling 5. non verbal 6. sexting 7. relationship

8. perceived partner responsiveness 9. sexual 10. verbal 11. non-verbal 12. Flirting 13. sexual consent

14. increased 15. sexual talk 16. ghosting 17. sexual assault 18. non judgmental 19. hyperpersonalization 20. serious bodily harm

ESSAY QUESTIONS 1. Overall the answer is complex and personal.

Here are some common reasons not to disclose: Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Not all private details of our past may be relevant today.

2. We might not feel safe (physically or emotionally) disclosing certain information to our partner.

3. Some details are just meant to be private.

Here are some common reasons to disclose: 1. If a matter has important consequences for the sexual partner and should be revealed; for example, STI status.

You likely should feel morally obligated to disclose this information if the partner's health could be at risk, but if the STI can cause serious bodily harm, you are legally obligated to disclose this information (e.g. HIV/AIDS status).

2. If it something you would want to know from your partner, you should disclose it.

3. Disclosure of your past can be a show of trust in your partner.

2. Effective communication about sexuality with one's partner is important because it is associated with positive outcomes for partners, including both relationship and sexual satisfaction. Open discussions about sexual interests and differences can lead to greater closeness and intimacy. Effectively communicating one's sexual preferences and desires to one's partner can also result in significantly increased sexual and general relationship satisfaction.

3. When people can talk about sexual problems with their partners, both they and their partners tend to be more satisfied with their sexual and romantic relationship, have better sexual functioning, and feel less distressed about the sexual aspects of their relationship.

For example, in one intervention study, 59 mixed-sex couples in which the man had been diagnosed with erectile dysfunction following treatment for prostate cancer participated in a 3.5 hour workshop designed to increase sexual communication skills. They found that both men and their partners reported improved relationship satisfaction and sexual functioning.

4. 1. A person's sexual attitudes and beliefs play a huge role in how well they communicate about sex with a partner.

2. The expectations that an individual has about how their partner is likely to behave during an upcoming discussion, as well as how their partner actually responds, play an important role in determining how the discussion will unfold.

3. The listener should set aside their own agenda to really hear what the other person is saying. Without a receptive listener, communication will break down.

4. Choosing an appropriate time to engage in sexual communication can also make a difference.

5. Using non-judgmental language can improve communication.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 14

Sexual Behaviours and Relationships MULTIPLE CHOICE QUESTIONS 1. What features of sexual activity do the most heterosexual Canadians agree are necessary criteria if an encounter is to be defined as "having sex"? a) penile penetration of any orifice b) penile penetration of the vagina c) penile penetration of the vagina resulting in orgasm d) mutual genital stimulation 2. What is the most significant health benefit of sex educators teaching a very broad definition of "having sex"? a) It will reduce the likelihood of unintended pregnancy. b) It will reduce the likelihood of the spread of sexually transmitted infections through sexual activity other than penile-vaginal intercourse. c) It will reduce the number of young people who want to consider themselves virgins from engaging in oral or manual sexual activity. d) It will encourage people to explore more sexual options than penile-vaginal intercourse.

3. One-quarter of students identify which of the following as "having sex"? a) kissing b) masturbating c) oral contact with the partner's genitals d) touching the partner's genitals 4. Which of the following has NOT been linked to a later age of first intercourse? a) having an older partner b) positive emotional connection with family members c) academic achievement and participation d) greater parental control 5. You work for a blood donation clinic and screen potential donors for risks of infectious diseases. Your donor questionnaire asks, "In the past 12 months, have you had sex with a person who has hepatitis?" You are screening a 19-year old female. What should you keep in mind when analyzing her answer to this question? a) Many young people don't consider oral-genital stimulation as having sex, so she may not report it even though she could have gotten infected that way. b) Many young people tend not to report sexual activity during which they used a condom since they assume there could have been no infection anyway. c) Females are generally ashamed of their sexual activity and tend to underreport it, so she might choose not to disclose a potentially risky contact. d) both B and C 6. Joanne is a new mother and she worries about how to bring up her daughter in this increasingly sexualized world so that her daughter doesn't start having sex too early. How can Joanne try to achieve this? a) She can ensure that her daughter has positive emotional connections with her family.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) She can be open and positive about teenage sex and contraceptive use. c) She can make sure that her household is religion-free. d) both A and B 7. At a Thanksgiving dinner you're asked how school is going, and you say you're taking a sexuality course. Later that night, your 14-year-old cousin wants to have a talk. He confesses he's still a virgin and doesn't have a girlfriend, and wants to know if that's normal and if he should just sleep with anyone to lose his virginity. What advice can you give him? a) It's fine to be a virgin at 14. In fact, more than 50 per cent of people are still virgins in Grade 11. b) People have a more positive experience of losing virginity with someone in a close rather than casual relationship, so it's better to wait and do it with someone you care about. c) Men report more pleasure than women the first time, since women may feel pain, so when the time comes, think of your girlfriend's experience as much as your own. d) all of the above 8. Which of the following has been linked to the choice to have sex at an earlier age? a) parental disapproval b) controlling parental behaviour c) prior unwanted sexual contact d) having a younger partner 9. Which of the following has been linked to the choice to have sex at a later age? a) academic achievement b) having an older partner c) prior unwanted sexual contact d) substance use with friends 10. What percentage of female university students in a Canadian study reported having an orgasm during their first intercourse? a) 46 per cent b) 76 per cent c) 6 per cent d) 26 per cent 11. What percentage of male university students in a Canadian study reported having an orgasm during their first intercourse? a) 2 per cent b) 62 per cent c) 92 per cent d) 22 per cent 12. Which of the following has NOT been linked to an earlier age of first intercourse? a) parental disapproval of early sex and contraceptive use b) peer pressure to have sex c) substance use with friends d) prior experience of unwanted sexual contact 13. Your friend Jessica has just had her first intercourse, but she didn't feel pain or bleed, so she's wondering if Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

something's wrong with her anatomy and asks your opinion. a) Nothing's wrong. She could have broken the hymen with a tampon or even by working out hard. b) Nothing's wrong. In fact, only about 30 per cent of women are born with a hymen, so she was probably in the majority born without it. c) Something's not right. In studies, 89 per cent of women report substantial pain and bleeding at first intercourse, so maybe she's lying to you about being a virgin. d) both A and B 14. Which of the following is a possible ethical problem associated with hymen reconstruction surgery? a) It perpetuates discriminatory practices. b) It is often associated with guilty feelings for women who have had it. c) It can cause problems during future childbirth. d) It is done in order to deceive other people.

15. Sven and Nira are very intoxicated and engaging in foreplay. Sven asks Nira if she wants to have sex and Nira slurs "yes." Based on how much consent Nira has given, should Sven proceed? a) Yes, all aspects of free consent have been met. b) No, only one aspect of consent has been met in this scenario. c) No, only two aspects of consent have been met in this scenario. d) No, no consent has been given in this scenario.

16. Saga had sex with Mark even though she didn't really want to. Mark didn't force her; she did it to make him happy. Which of the following took place in this situation? a) sexual compliance b) sexual coercion c) sexual assault d) sexual deviation 17. Approximately what proportion of people report having completed sexual acts they didn't really want to complete at some point in their lives? a) Very few people report being sexually compliant on at least one occasion. b) One quarter of people report being sexually compliant on at least one occasion. c) Half of people report being sexually compliant on at least one occasion. d) The majority of people report being sexually compliant on at least one occasion.

18. Which of the following is a common reason why people participate in sexual acts they don't wish to consent to? a) promoting intimacy b) substance use c) threats by partner d) peer pressure 19. Sexual compliance happens most often in which situation? a) in casual sexual relationships b) when a male threatens a female he knows with violence if sex does not occur c) in longer-term sexual relationships d) when a male stranger attacks a female he does not know

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

20. Alana and Marko just engaged in sexual activity for the first time. What is most likely true about the extent to which Alana and Marko followed the traditional sexual script? a) Alana and Marko followed the traditional sexual script almost exactly. b) It is unlikely that Alana and Marko followed the traditional sexual script at all as it has become very outdated in the twenty-first century. c) The traditional sexual script is varied, so Alana and Marko likely followed some aspects of the script but not others. d) The traditional sexual script is varied, so it is impossible to know whether Alana and Marko adhered to all aspects or no aspects of the script.

21. Tabitha is in her early twenties and was discussing with her close friends the first time she had sex. Though their experiences varied, Tabitha recalled a positive emotional reaction to her first sexual experience. What type of relationship was she most likely in during her first sexual encounter? a) close/committed relationship b) casual sexual relationship c) friends with benefits d) no-strings attached (NSA) 22. What is the most common method for giving sexual consent? a) non-verbal communication b) verbal communication c) sexual signalling d) text messaging 23. Which of the following are reasons people in committed relationships give for sexual compliance? a) making one's partner happy b) promoting intimacy c) avoiding relationship conflict d) all of the above 24. You are a counsellor at a university that recently had a big campaign about consent. Robert, a first-year student, comes to you concerned that he might have abused a classmate. They had been flirting for several weeks, and at a house party last night they were making out. They were tipsy but not drunk. He asked if she wanted to sleep with him, she said "Very much," and they had sex. This morning, however, she texted him "I totally said yes, I know, but I didn't really want it THAT much. Let's stay friends." You advise him that this was a case of ________ and ________. a) sexual compliance; he followed the rules of obtaining consent, so it was not abuse b) sexual compliance; it was abuse because he didn't follow the rules of obtaining consent c) abuse; he should have made it clear that he meant a sexual intercourse by "sleeping" d) abuse; he shouldn't have proposed sex to a girl who was already tipsy 25. The fact that you're taking a course on sexuality is a big conversation starter whenever you go out with friends.

This time someone asks you, "So what's the most vanilla way that people have sex?" You reply, "Well, there's this thing called ________ and it involves ________." a) the traditional sexual script; kissing, then touching, then intercourse, then usually orgasm b) the traditional sexual script; kissing, then oral sex, then intercourse, then usually orgasm c) the common sexual script; kissing, then touching, then intercourse, then usually orgasm d) the common sexual script; kissing, then oral sex, then intercourse, then usually orgasm Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

26. Taylor has recently been fantasizing about sex with multiple people other than his partner. In these fantasies, there are sometimes male and females. Taylor revealed his fantasies to his partner recently. His partner should react __________. a) normally, recognizing that it is not abnormal for people to fantasize about sex with someone other than their primary partner, or sex with both male and female partners b) with worry, and he should ask Taylor to seek counselling because he may be confused about his sexual orientation c) by immediately asking him to indulge all of his fantasies d) by breaking up with him because fantasies will ultimately lead to infidelity 27. Rather than being indicative of activities individuals intend to pursue in real life, fantasies may be one way that people explore sexual desires and adapt sexual scripts. Which of the following characteristics allows for fantasies to do this? a) privacy b) freedom c) imagination d) all of the above 28. Tim and Lesia are not a couple, but they often engage in casual sex. At what level does their sexual script develop? a) spiritual b) individual c) emotional d) national 29. Canadian research has found that engaging in more frequent sexual fantasy is associated with all of the following EXCEPT __________. a) more positive emotions b) higher expectations about one's partner's sexual performance c) greater sexual satisfaction d) a greater number of sexual partners 30. According to the research on sexual fantasy, there are many similarities in men and women's fantasies. What is the main difference? a) More men than women fantasized about anonymous or impersonal sex, and more women than men fantasized about affectionate or foreplay activities. b) More women than men fantasized about anonymous or impersonal sex, and more men than women fantasized about affectionate or foreplay activities. c) Men and women fantasized equally about anonymous or impersonal sex as well as about affectionate or foreplay activities. d) Neither men nor women fantasized about anonymous or impersonal sex as well as about affectionate or foreplay activities.

31. Research has found evidence that men masturbate more than women. This finding is especially true in countries where there is a greater gender inequality. What is the best explanation for the difference in masturbatory patterns? a) Sexual double standards criticize women for sexual activity but not men.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) Women have low sex drives. c) Masturbation is not as pleasurable for women as for men. d) all of the above 32. In countries where the rights of men and women are more similar, the rates of masturbatory activity are more similar. What do some researchers conclude from this finding? a) Masturbation rates in women are related to how much time women are allowed to be alone. b) Masturbation rates in women are related to the amount of domestic responsibility a person has. c) Masturbation rates in women are related to the amount of power they have in their culture. d) Masturbation rates in women are related to the amount of money a woman earns for her household.

33. You are a sex therapist. A woman in her twenties comes to you with a problem of never having had an orgasm although she's been having sex with her husband for two years. You soon find out she has never masturbated because masturbation was considered extremely immoral in her Catholic family. What can you tell her about masturbation? a) Masturbation can help her become more comfortable with her genitals. b) Masturbation can help her learn about her sexual response and preferences. c) Masturbation can interfere with achieving vaginal orgasm, which is the point of sexual intercourse. d) both A and B 34. Cynthia was married to a man before she came out as lesbian. She now likes to joke that every woman who complains that she doesn't get enough foreplay should turn gay because she (Cynthia) is now getting all of it and it's so good. Aside from the fact that "turning gay" is a joke, does she have a point about "foreplay"? a) Studies suggest that same-sex couples spend more time on sensual touching, and it is more satisfying compared to heterosexual couples. b) Studies suggest that although same-sex couples spend more time on sensual touching, it is not as satisfying compared to heterosexual couples. c) Studies suggest that same-sex couples spend less time on sensual touching, but it is more intense and satisfying compared to heterosexual couples. d) Studies suggest that although heterosexual couples spend less time on sensual touching, it is more intense and satisfying compared to same-sex couples.

35. Both men and women report a desire to engage in more __________ during sexual encounters but follow the traditional sexual script instead. a) kissing b) touching c) oral sex d) intercourse 36. What term is used to describe the sexual practice in which partners (clothed or not) rub or thrust their genitals against any part of the other person's body? a) frottage b) cunnilingus c) interfemoral intercourse d) fellatio 37. Despite often being listed as part of the traditional sexual script (TSS), which of the following is appropriately labelled as a sexual response?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) orgasm b) foreplay c) oral sex d) cuddling 38. Which of the following is a problem with making orgasm the goal of intercourse in traditional sexual scripts? a) It may increase performance anxiety and interfere with sexual arousal and orgasm. b) It may be a problem for individuals who do not regularly achieve orgasm during partnered sexual experiences. c) It may lead some to believe that they have a sexual dysfunction if they do not orgasm following intercourse. d) all of the above 39. Which of the following is one common element in the traditional sexual script that is not actually a sexual behaviour? a) orgasm b) arousal c) kissing d) touching 40. You are a sex therapist. A man comes to you with a concern that while he achieves orgasm during vaginal penetration, his wife doesn't. He asks what is wrong with him or his wife. What can you tell him? a) If she achieves orgasm through stimulation of the clitoris, she is just like the vast majority of women.

Vaginal-penetration orgasm is by far not the norm. b) Treating orgasm during coitus as the indicator of sexual functioning may cause his wife's anxiety to perform instead of enjoying the intimate contact. c) Coitus followed by orgasm is just a social script, and there is no objective reason to abide by it. Achieving orgasm by oral or manual stimulation can also count as a satisfying sex life. d) all of the above 41. You're at your best friend's wedding and you're having a little heart-to-heart with her. She and her partner are very happy in bed right now, but she's concerned how to keep the satisfaction high as the years go by. What can you tell her about sexual satisfaction in a long-term relationship? a) Research suggests that they'll be most satisfied if they incorporate both partners' sexual preferences into their love-making in such a way that maximizes pleasure and minimizes displeasure for both. b) Research suggests that they'll be most satisfied if they constantly bring new elements into their love-making to stave off boredom in the bedroom for as long as possible. c) Research suggests that they'll be most satisfied if they constantly switch roles in their love-making in such a way that one time they focus on one partner's pleasure and the other time on the other partner's pleasure. d) Research suggests that they'll be most satisfied if they have the same work schedules, no sexual problems, frequent orgasms, and good communication.

42. Which of the following is true about the correlation between sexual satisfaction and sexual problems? a) Fewer sexual problems leads to greater sexual satisfaction. b) More sexual problems leads to greater sexual satisfaction. c) Sexual problems are not predictive of sexual satisfaction. d) People who are satisfied sexually do not have sexual problems.

43. According to the interpersonal exchange model of sexual satisfaction, when is sexual satisfaction greatest? a) when there are more sexual rewards than costs Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) when there is neither a sexual reward nor a cost c) when there are both sexual rewards and costs d) when there are more sexual costs than rewards 44. Lawrance and Byers define which of the following terms as "an effective response arising from one's subjective evaluation of the positive and negative dimensions associated with one's sexual relationship"? a) sexual functioning b) sexual exchange c) sexual satisfaction d) sexual reward 45. Members of which of the following group reports less use of sex toys and more focus on orgasm? a) heterosexual women b) lesbian women c) gay and bisexual men d) heterosexual men 46. Research has shown men masturbate more and use more explicit sexual materials than women do. Which of the following is a good explanation for this difference? a) There may be a reporting bias because of the sexual double standard. b) More pornographic material is marketed to men. c) Men have easier access to pornographic material. d) It is easier for men to masturbate.

47. When comparing sexual preferences between men and women from the same culture, what do researchers find? a) There is more variability within sexes than between sexes in all cultures. b) There is more variability within sexes than between sexes in cultures where there is more gender equality. c) There is more variability between sexes than within sexes in all cultures. d) There is more variability between sexes than within sexes in cultures where there is less gender equality.

48. According to Byers and MacNeil, men and women in long-term relationships are most sexually satisfied when __________. a) their own sexual costs exceed rewards b) their own sexual rewards exceed costs c) their partner's sexual costs exceed rewards d) their partner's sexual rewards exceed costs 49. Tony and Judy are getting married this summer. They love each other very much and are willing to support one another in every situation. They want to cherish their relationship and not have sex at all before the wedding night. Judy has heard, however, that people must be "sexually compatible" to have a happy relationship, and she's afraid to find out too late that she and Tony don't match. She asks your advice. a) Judy can tell Tony about her concerns and start a conversation about their sexual preferences. If they talk openly, they can negotiate potential differences without having sex before the wedding and continue the communication afterwards. b) She should start sleeping with Tony and seriously consider the wedding if it turns out that he likes having sex more often than she does. c) She knows how often and how long a typical man has sex, so she should consider that before deciding if she Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

wants to marry Tony. d) Judy can tell Tony about her concerns and start a conversation about their sexual preferences. If they find out that their sexual preferences differ, they should seriously consider the marriage as they risk conflict and dissatisfaction.

50. Tyler completes a questionnaire on a dating website detailing his exact sexual preferences, including how often he likes to have sex and the sexual behaviours he prefers. Tyler is matched with Chloe, who is, apparently, a perfect match. What is the likelihood that Tyler and Chloe will have a sexually satisfying relationship? a) unlikely b) somewhat likely c) very likely d) almost certainly 51. In general, it seems that partners sharing the same sexual preferences is only one of the factors contributing to greater sexual satisfaction among couples, meaning that it is unlikely that people develop sexually satisfying relationships simply by finding partners with sexual preferences that are exactly the same as their own. Given this supposition, what is the best way for partners to successfully navigate differences in their sexual preferences, maximizing sexual rewards and minimizing sexual costs? a) self-disclosure and communication b) finding sexual outlets outside the relationship c) hiding one's true desires and beliefs for the sake of the relationship d) all of the above 52. Which of the following is a reason people may introduce sex toys into their sexual repertoire? a) therapeutic reasons b) to enhance or "spice up" their sexual practices c) to enhance sexual pleasure d) all of the above 53. Wendy has been asked to tell a researcher what she predicts her partner will report as his preferences for duration of foreplay and duration of intercourse. What can be predicted the researcher will find? a) Wendy will be good at predicting what her partner wants if they are in a long-term relationship b) Wendy will predict preferences similar to her own preferences, but those will be inaccurate. c) Wendy will predict preferences similar to her own preferences and they will be accurate. d) Wendy will predict preferences based on her own stereotypes, not on what her partner has told her.

54. Over drinks at a pub, your friend Rick confides in you that his wife doesn't enjoy regular intercourse very much and he would like to use some sex toys to give her more pleasure during penetration. They're a rather conservative couple and like to stick to basics. What would you recommend to Rick? a) a vibrator to stimulate the clitoris b) a penis extender to stimulate the cervix c) a penis pump to stimulate the clitoris d) beads to stimulate the anus 55. Why do many non-heterosexual youth delay dating during adolescence? a) They could face repercussions in heterosexist and homophobic societies. b) They are developmentally less suited for early dating. c) Rarely are non-heterosexual youth aware of their sexual/affectional orientation difference at this age.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) Media depictions of same-sex relationships encourage youth to delay early dating experiences.

56. How do SGD individuals typically deal with dating in adolescence? a) The majority date same-sex partners with few problems. b) The majority date same-sex partners and face bullying and discrimination. c) The majority date opposite-sex partners or don't date during adolescence, even though they know they are SGD, for fear of bullying or discrimination. d) The majority are unaware of their same-sex attraction during adolescence and date opposite-sex partners, unaware that they will realize later that they are SGD. 57. Agnieszka has two choices for a new man to start dating. One is Leonel who was "matched" to her personality on an online dating website. The other is a friend, Marco, with whom she is able to communicate easily and resolve conflicts quickly. Who should Agnieszka try dating and why? a) Agnieszka should try dating Leonel because online personality matches have been proven as the reason why relationships that begin online are so successful. b) Agnieszka should try dating Leonel because if she was going to have a successful relationship with Marco it would have happened by now. c) Agnieszka should try dating Leonel because couples who meet online are more motivated to make relationships work and thus the relationship is more likely to be successful. d) Agnieszka should try dating Marco because open communication and good conflict resolution have been found to be at the core of successful relationships.

58. Among heterosexual two-person couples, what is the trend in rates of marriage in Canada? a) declining b) increasing c) stable d) fluctuating 59. Your friend Gillian wants to have a boyfriend, but she's rather shy, and most of the students in her major at university are female, so she doesn't get to meet many men in her daily life. You suggest online dating, but Gillian thinks online dating is good only for one-night stands, and she wants a serious relationship. What do the studies say about it? a) One study found that the majority of relationships that started online were relatively stable two years later. b) Surveys conducted for Match.com found that over a third of the couples married in the three years before the survey had met online. c) Surveys conducted for Tinder found that only 5 per cent of people who met online were in a long-term relationship two years later. d) none of the above 60. You have been dating your partner for two years and think it's time to move in together instead of renting two apartments. Your parents argue that you should consider getting married if you are serious about your relationship. You tell them that in this day and age you have a better chance of staying together without marriage.

Whose position does research support? a) Cohabitating relationships tend to be less stable than marriage, and marriage is more likely to end when preceded by cohabitation. b) Cohabitating relationships tend to be more stable than marriage, and marriage is less likely to end when preceded by cohabitation. c) Cohabitating relationships tend to be less stable than marriage, but marriage is less likely to end when preceded Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

by cohabitation. d) Cohabitating relationships tend to be more stable than marriage, but marriage is more likely to end when preceded by cohabitation.

61. Researchers have found that couples who have been married for a long time have sex less often. What is likely the reason? a) People who are married start out having sex more than unmarried couples but become bored with each other. b) People who have been married longer are older and the decline in sex is age related. c) People who are married always have a lower frequency of sex than unmarried people. d) People who are married longer are not as committed to the relationship as unmarried people.

62. Ten couples got married this past summer. Based on statistics in Canada, approximately how many of these couples will still be married after 20 years? a) eight b) six c) three d) two 63. André and Veronica were married for 12 years and then divorced. Which of the following is true? a) They divorced two years sooner than the average length of marriage before divorce. b) They divorced two years later than the average length of marriage before divorce. c) They divorced four years sooner than the average length of marriage before divorce. d) They divorced four years later than the average length of marriage before divorce.

64. Which of the following is NOT a typical characteristic of a "friends with benefits" relationship? a) monogamous b) ongoing c) non-exclusive d) sexual 65. Polyamorists generally describe their relationships as ____________. a) based more on love than sex b) stable c) egalitarian d) all of the above 66. What term is used to describe an egalitarian relationship which involves being in a romantic and sexual relationship with more than one person at the same time? a) polyamory b) swinging c) semi-dyadic d) friends with benefits 67. What was found in an Internet study of people in "friends with benefits" relationships (FWBR)? a) Both males and females valued the sexual relationship more than the friendship. b) Both males and females valued the friendship more than the sexual relationship. c) Females in FWBR desire sex less frequently than females in committed relationships. d) Females may benefit from comfort and trust in FWBR, but there is no evidence that males do.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

68. In a traditional North American polygamist marriage, which of the following wives would hold the highest status in her marriage to Benjamin? a) 50-year-old Leah who is the first and "legal wife" and who has five grown children with Benjamin b) 45-year-old Sarah who is the second wife and who had no children with Benjamin c) 34-year-old Hannah who is the third wife and who is pregnant with her third child with Benjamin d) 30-year-old Rebekah who had an emergency hysterectomy after delivering her second child with Benjamin 69. Which of the following is NOT typically associated with the lives of women in polygynous communities? a) higher levels of education b) isolation from mainstream society c) younger age of marriage and childbirth d) lack of social power 70. What is the main distinction between "polyamory" and "swinging"? a) There are no rules for swinging. b) Love is not a factor in swinging. c) Sexual contact is allowed in swinging. d) Most swingers are in same-sex relationships.

71. Which of the following types of sexually explicit material was LEAST popular with young heterosexual males who were surveyed in 2006? a) Internet pictures depicting nudity but not sexual activity b) Internet written materials depicting sexual activity c) television portrayals of sexual activity d) DVD/video portrayals of sexual activity 72. Compared to women in non-polygynous marriages, women in polygynous marriages report which of the following? a) psychological and financial distress b) domestic violence c) marital problems d) all of the above 73. What term is used to describe the practice of both partners in an emotionally committed or married couple agreeing to and participating in sex with other individuals, usually at the same time? a) swinging b) polygamy c) polyamory d) friends with benefits 74. Which of the following puts an individual at higher risk of extramarital sex? a) having children b) having parents who divorced c) marital dissatisfaction d) having opposite-sex friends 75. In 2008, Maxime Bernier, the star of Stephen Harper's Quebec caucus, was forced to resign as foreign affairs Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

minister after admitting he had left classified government documents at the home of his then-girlfriend, Julie Couillard, a woman who had previously dated two Hell's Angel's associates. Shortly after they broke up, Couillard gave a tell-all television interview about the relationship, which she followed up with a book. The intense media attention brought about public condemnation. Which theory best describes the media's role in this excerpt? a) agenda-setting theory b) social learning theory c) social exchange theory d) marketing theory 76. Aubrie is 8-years-old and was watching television with her friends. The show depicted girl tweens dressing up and wearing make-up to meet boys from their school at the mall. When Aubrie got home she asked her mom if they could go shopping to buy similar clothes and make-up. When her mom asked why, she ultimately confessed that she had a crush on a boy and wanted to impress him. What theory related to the effects of media best describes this anecdote? a) social learning theory b) social exchange theory c) marketing theory d) agenda-setting theory 77. In recent years, media has begun to portray gay and lesbian characters in a positive light as a part of everyday society. Though the portrayals often feature stereotypes associated with gay and lesbian people, the impact has been generally positive. This is an example of which theory? a) cultivation theory b) agenda-setting theory c) social exchange theory d) marketing theory 78. Which of the following is a potential positive influence of sexuality in the media? a) quick access to reliable information on sexual health b) diverse models of sexuality that may serve as guidance for relationships and interactions c) media characters allow individuals to vicariously practice sexual and relationship norms and ideals d) all of the above 79. Which term is used to describe erotically suggestive media without showing genitals or sexual penetration? a) soft-core b) hard-core c) meta-analytic review d) polymorphism 80. What is probably the most comprehensive, easily accessible, and continuously evolving medium for sexual information, expression, and encounters? a) the Internet b) the Yellow Pages c) Facebook d) online textbooks 81. At a dinner party your friends start a discussion about different configurations of modern families and their Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

effect on children growing up in non-standard homes. They turn to you for an informed opinion. You tell them, "Well, there is some limited research that suggests that a __________ family may benefit children by providing diverse role models and shared resources. On the other hand, there is also research that suggests that children from __________ families tend to have more emotional and behavioural difficulties than kids from a two-parent family." a) polyamorous; polygynous b) polyandrous; polygynous c) polyamorous; polyandrous d) polygamous; polyandrous 82. Your friend went with her husband to the Christmas party at his workplace. She found out that many of his colleagues are very attractive women, some single, and now she can't shake off the thought that he may cheat on her. You bring up a study on risk factors for extramarital sex and tell her that __________ does not increase the chances that a spouse would cheat, but __________ does. a) opportunity to meet potential lovers at work; being male b) opportunity to meet potential lovers at work; sexual dissatisfaction c) being male; opportunity to meet potential lovers at work d) sexual dissatisfaction; opportunity to meet potential lovers at work 83. Your cousin Alex has just had his first child. Even though the infant son can't even sit up yet, Alex is already planning no TV at home and no Internet for the kid until he turns 18. Alex wants to avoid the media's negative influence on his son's views on love, relationships, and sex. You argue that not all media influence is negative, for example __________. a) he can learn from shows and movies about how to say "no" in a sexual situation b) people exposed to more sexual content on TV and Internet tend to have their first intercourse later in life than those who aren't c) media have been the most powerful force in breaking sex-related stereotypes d) all of the above 84. You're meeting with your book club to talk about Never Let Me Go by Kazuo Ishiguro. Someone mentions the scene where Kathy notices that the way older couples touch and talk to each other is a mimicry of what they saw on TV. They copy their "couple behaviour" from the fictional couples from TV dramas. You say, "Oh, that's actually what we all do, according to the __________ theory." a) social learning b) agenda-setting c) cultivation d) social script 85. Approximately what percentage of individuals in relationships report engaging in nonconsensual non-monogamy? a) 4 per cent b) 8 per cent c) 10 per cent d) 15 per cent 86. Which of the following is not part of the description of the Internet as being driven by a "Quin-A engine"? a) accessibility b) affordability Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) anonymity d) accountability 87. Which of the following statements about online sexual content use is true? a) More women read erotic material online alone than men. b) More women share sexual fantasies online than men. c) More men read erotic material online alone than women. d) Men and women maintain sexual relationships online the same amount.

88. Open relationships are most similar to which type of consensual non-monogamous relationship? a) swinging b) polyamory c) polygamy d) friends with benefits 89. Approximately what percentage of North Americans report engaging in consensual non-monogamy at some point in their lifetime? a) 5 per cent b) 15 per cent c) 20 per cent d) 30 per cent 90. In what stage of the relationship does "couple identity" typically develop in online relationships? a) first stage b) second stage c) third stage d) fourth stage SHORT ANSWER QUESTIONS 1. In a Canadian study of heterosexual first-year undergraduate students, __________ per cent respondents deemed penile–vaginal intercourse as "having sex."

2. Individuals who are unsatisfied with their virgin status are referred to as "__________ virgins."

3. Most consent to engage in sex is given __________-__________.

4. In sexual research, "TSS" stands for __________ __________ __________.

5. When performed on a male, oral sex is referred to as __________.

6. When surveyed about using sex toys, the majority of women's partners (male or female) express positive feelings toward their partner's __________ use, and this support is in turn related to greater sexual satisfaction.

7. In Canada, the average length of marriage before a couple divorces is about __________ years.

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8. __________ involves being in a romantic and sexual relationship with more than one person at the same time.

9. __________ __________ proposes that media portrayals create a shared set of values and expectations about reality among media consumers.

10. Parental control and parental disapproval of contraceptive use are linked to a(n) __________ age of first intercourse.

11. Women are more likely than men to experience __________ with first penile-vaginal intercourse.

12. An individual's agreement to engage in sexual behaviour is referred to as __________ __________ .

13. Hannah doesn't feel like having sex with her boyfriend but she knows he really wants to, so she goes through the motions. This is an example of __________ __________.

14. The one part of the sexual script that isn't actually a sexual behaviour is __________.

15. Younger age, few sexual problems, and greater frequency of orgasm are examples of __________ factors that contribute to sexual satisfaction.

16. Leandra and Eric both have low sexual satisfaction because they rarely have time to have sex because of their work schedules. Their sexual satisfaction is being affected by a(n) __________ factor.

17. Lilli is married to Dave but is also dating Philip, with whom she has an emotional and sexual relationship.

Dave knows about Lilli and Philip's relationship and supports it because it makes Lilli happy. These relationships are an example of __________.

18. ________ ________-________ is any emotional or sexual behaviour with a person outside of a monogamous relationship without the agreement of one's partner.

19. Oral stimulation of a woman's genitals by a partner is called ________ 20. A theory that proposes that individuals model characters seen in media, especially those who receive positive rewards is ________ ________ theory.

21. ________-________ media explicitly depicts genitals and/or penetrative sexual activity.

22. The sexual practice in which partners (clothed or not) rub or thrust their genitals against any part of the other person's body is called ________.

23. ________ ________ are sexual thoughts or images that stimulate a person physiologically and/or emotionally.

24. A sexual position in which partners engage in tandem (simultaneous) oral stimulation of each other's genitals is often called the "________-________" position.

25. The practice of both partners in an emotionally committed or married couple agreeing to and participating in sex with other individuals, usually at the same time is called ________.

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ESSAY QUESTIONS 1. Discuss the arguments for and against vaginal "revirgination" surgery.

2. Discuss the major differences between polyamory and polygamy.

3. Despite being a sexual response rather than a sexual behaviour, orgasm is often identified as a major part of people's sexual scripts. What are the potential challenges that might arise from the pressure to have orgasm as the goal of a sexual encounter?

4. Describe three theoretical perspectives on how the media affects sexual behaviour.

5. Describe both possible positive effects and possible negative effects of online sexual activity on an intimate sexual relationship.

6. The popularity of the Internet has been described as being driven by the "Quin-A engine." List the five factors that has lead to this popularity.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. b 3. c 4. a 5. a 6. a 7. d 8. c 9. a 10. c 11. b 12. a 13. a 14. a 15. b 16. a 17. d 18. a 19. c 20. a 21. a 22. a 23. d 24. a 25. a 26. a 27. d 28. b 29. b 30. a

31. a 32. c 33. d 34. a 35. b 36. a 37. a 38. d 39. a 40. d 41. a 42. c 43. a 44. c 45. d 46. a 47. b 48. d 49. a 50. a 51. a 52. d 53. d 54. a 55. a 56. c 57. d 58. a 59. a 60. a

61. b 62. b 63. a 64. a 65. d 66. a 67. b 68. c 69. a 70. b 71. b 72. d 73. a 74. b 75. a 76. a 77. a 78. d 79. a 80. a 81. a 82. a 83. a 84. a 85. b 86. d 87. c 88. a 89. c 90. c

SHORT ANSWER QUESTIONS 1. 90 2. reluctant 3. non verbally 4. traditional sexual script 5. fellatio 6. vibrator 7. 14.5 8. Polyamory 9. Cultivation theory

10. later 11. pain 12. sexual consent 13. sexual compliance 14. orgasm 15. individual 16. lifestyle 17. polyamory 18. Nonconsensual

non-monogamy 19. cunnilingus 20. social learning 21. Hard-core 22. frottage 23. Sexual fantasies 24. sixty-nine 25. swinging

ESSAY QUESTIONS 1. For: it may prevent honour killings, it may prevent other physical harm, it may prevent divorce, it is relatively Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

safe and women who have had it have not reported adverse effects or regrets.

Against: it perpetuates the discrimination of women who have had sex in some cultures, it is not medically necessary, and it may be unethical because it is intended purpose is to deceive a future spouse.

2. Some of the following points may be used but answers will vary.

Polyamory involves being in a romantic and sexual relationship with more than one person at the same time. In some cases, only one partner in a polyamorous relationship will be intimately involved with more than one person. In general, polyamorists describe their relationships as based more on love than on sex, relatively stable (some spanning decades), and relatively egalitarian (e.g., in terms of how time and resources will be shared among multiple partners; Barker & Langdridge, 2010). Some polyamorists are also co-parents. Polyamorous relationships can be very diverse in structure.

Polygamy is a type of polyamory in which one person is married to more than one spouse simultaneously. In North America, polygynists are predominantly heterosexual, and they tend to be conservative in their religious views and lifestyle; they also usually publicly recognize all of their marital relationships, legal or not. Wives in polygynous marriages have an emotionally and sexually exclusive relationship with their husband. Traditionally, a hierarchy of wives emerges, with older or non-childbearing (e.g., menopausal) wives and their children often holding lower status.

Research from across cultures and religious communities, however, suggests that a polygynous marital structure is often harmful to the welfare of a large number of women and children. Lack of social power, lower levels of education, significantly younger age at marriage and childbirth, parenting large numbers of children, and isolation from mainstream society are associated with the lives of women in polygynous communities. More women in polygynous marriages report psychological distress, financial stress, domestic violence, and marital problems than women in non-polygynous marriages. In addition, children from polygynous families tend to experience more behavioural, emotional, and academic difficulties than their peers from non-polygynous families.

3. One problem is that the pressure to achieve the goal of orgasm may increase performance anxiety and interfere with sexual arousal and orgasm, particularly for those who have never experienced orgasm or have orgasmic difficulties. Another problem is that the traditional sexual script suggests orgasm should follow intercourse, and that it signals a finale to love-making. This approach can be problematic for individuals, particularly women, for whom intercourse does not often lead to orgasm; indeed, a vast majority of women report having orgasms more consistently with sexual activities other than intercourse (Zietsch et al., 2011). Further, this approach may lead some women to believe they have a sexual dysfunction simply because they do not orgasm following intercourse.

4. 1. Agenda-setting theory: media affect what we think is important by highlighting what we should pay attention to; in other words, media set the agenda. From this perspective, sexual topics and issues that frequently appear in media, such as the scandalous sexual affairs of politicians or the AIDS epidemic in the 1980s, become more salient to media consumers, thereby influencing consumers' attitudes about these issues.

2. Cultivation theory: we develop a shared set of values and expectations about reality based on depictions of reality in media. According to this perspective, media "cultivate" certain ideas about sex in media consumers by continually depicting sex in similar ways, according to societal values and stereotypes.

3. Social learning theory: individuals will model their attitudes and behaviours after the fictional (and sometimes non-fictional) characters they see in media, especially when the models are rewarded for particular behaviours.

Thus, media consumers are likely to model their sexual behaviours after sexual behaviours that are portrayed positively in media. Further, media depictions of sexual scenarios provide scripts for enacting certain sexual behaviours that people may not be exposed to elsewhere.

5. On the negative side, online text-based interactions may lead to communication problems between partners, especially because it is difficult to communicate emotional tone and humour without facial expressions, vocal Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

tones, and gestures. In addition, over-involvement in solitary OSA may result in one partner neglecting his or her responsibilities toward the other, such as the responsibility to spend time engaging with the partner. A small number of cybersex users (approximately 1 per cent) develop a sexual addiction or compulsion that interferes with their relationships and ability to function in everyday activities. Further, participating in a high level of cybersex has been associated with separation or divorce. Some partners may view cybersex as infidelity; in other cases, online affairs may lead to offline affairs.

On the positive side, a survey of 8,376 heterosexual adults in committed relationships found that mild or moderate amounts of OSA benefitted relationships for both men and women. Specifically, OSA participants reported an increased quality and frequency of sexual activity, and increased intimacy with their partners. Further, men and women reported that engaging in OSA with their partner improved sexual communication between them. Perhaps this shared experience opens the door for couples to talk about their sexual fantasies and likes and dislikes, which otherwise may not have been discussed.

6. The Internet is a popular source for information about sex and sexuality because it seems to be driven by accessibility, affordability, anonymity, acceptability, and approximation

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CHAPTER 15

Variations in Sexual Behaviour MULTIPLE CHOICE QUESTIONS 1. Which of the following criteria would most likely deem masturbation as abnormal? a) if you used statistical criteria where people's behaviour is surveyed in twenty-first-century Canada b) if you used socio-cultural criteria based on norms in twenty-first-century Canada c) if you used harm-based criteria where it is assumed that masturbation causes blindness d) if you used statistical criteria where people's behaviour is surveyed in twentieth-century Canada 2. Marshall has a foot fetish where he enjoys looking at his partner's feet during sexual activity. Which criteria would most likely label Marshall's behaviour as "abnormal"? a) statistical criteria b) socio-cultural criteria c) harm-based criteria d) sexual activity–based criteria 3. Which of the following sexual behaviours would be considered "abnormal" from socio-cultural, statistical, and harm-based viewpoints? a) sadomasochism with an adult partner who is part of a BDSM club that you also belong to b) having sex with a prostitute c) having sex before the age of consent (age 16 in most countries) d) having sex with an adult first cousin 4. Which of the following is an example of a paraphilic disorder? a) André, who enjoys watching balloons inflate and pop b) Kristof, who worries about being sexually aroused by people with amputated limbs c) Drew, who fantasizes about being crawled on by insects d) Elliot, who enjoys dressing as a child and likes being treated like a baby by his partner 5. Aaron is aroused only by the sight of blood. Aaron is having difficulty developing normal sexual relationships because of this fetish and is distressed by it. Which of the following does Aaron have? a) a transvestic disorder b) a non-exclusive paraphilic disorder c) a fetishistic disorder d) an exclusive paraphilic disorder 6. According to the DSM-5, when is a person diagnosed with a paraphilia but not a paraphilic disorder? a) when the individual engages in the paraphilia but is not distressed by the behaviour b) when the individual engages in the paraphilia and is distressed by the behaviour c) when the individual abstains from the paraphilia but is still distressed by past behaviour d) when the individual abstains from the paraphilia and is not distressed by past behaviour 7. In terms of "abnormal" sexual behaviours, which of the following is often considered a global taboo and cuts across most cultural boundaries?

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a) incest b) bondage c) missionary position d) role playing 8. What term is used to describe any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners? a) paraphilia b) kinbaku c) fetish d) masochism 9. What is the threshold in the DSM-5 for a paraphilia to be labelled as a "disorder"? a) causes harm to the person b) causes the person distress or impairment c) causes harm to others d) all of the above 10. Which of the following would be considered a paraphilic disorder? a) Fred has a balloon fetish; he cannot get sexually aroused unless a balloon is present and he cannot function in his life if he has not achieved satisfaction with a balloon. b) Fred has a foot fetish; he really likes feet and sometimes involves them in his sexual fantasies and behaviours. c) Fred has an animal fetish; he does not act on his desires, he merely fantasizes about various animals, and it does not bother him that his fetish is only in fantasy. d) all of the above 11. Which of the following is NOT required for someone to be diagnosed with a paraphilic disorder? a) sadomasochistic behaviour b) having a paraphilia c) negative consequence of paraphilia d) paraphilia present for at least six months 12. Which of the following is characteristic of a sexual sadism disorder? a) recurrent and intense sexual arousal from the physical or psychological suffering of another person, manifested by fantasies, urges, or behaviours b) acting on sadistic sexual urges with a non-consenting partner c) significant impairment or distress from sadistic sexual urges d) all of the above 13. Which of the following is the most significant reason why atypical sexual behaviours have not been studied very widely? a) They often involve illegal activities that people do not wish to admit to. b) They are very rare. c) Researchers have not developed criteria for diagnosing a paraphilia disorder. d) Researchers are embarrassed to discuss paraphilias with people with paraphilic disorders.

14. Most fetishes are directly related to which of the following? a) household objects Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) the human body c) genital stimulation d) taboo objects 15. Farouk is aroused by women's shoes and often asks his partners to wear high heels when they are engaging in sexual activity. Which term best describes this? a) fetish b) fetishistic disorder c) foot fetish d) paraphilic disorder 16. Benji is turned on by lingerie. Which of the following would he be diagnosed with? a) a mild fetish b) fetishistic disorder c) hypersexuality d) none of the above 17. Which of the following men would NOT be diagnosed with a paraphilia? a) Chris, who is sexually aroused by the thought of himself as a female b) Laszlo, who cannot experience orgasm unless his partner is wearing lingerie c) Sasha, who spanked his last partner without her consent while they were engaging in sexual activity d) Piotr, who lost his job because he would skip work to pursue sexual relationships 18. Yanis sometimes dresses as a woman when he is at home. Which of the following is most likely true of Yanis? a) He is married. b) He is college educated. c) He began cross-dressing as a young child. d) all of the above 19. Some studies have suggested that fetishes are a result of which of the following? a) criminal behaviour b) fashion sense c) genetics d) conditioning 20. A fetish is most likely to appear first in which of the following sex/age groups? a) adolescent females b) adolescent males c) adult females d) adult males 21. What is the main difference between transvestism and transvestic disorder? a) Males with transvestic disorder fantasize about having female body parts and vice versa. b) People with transvestic disorder cross-dress on a daily basis instead of just for sexual pleasure. c) People with tranvestic disorder associate cross-dressing with sex whereas transvestism alone is not associated with sexual arousal. d) People with transvestic disorder are distressed by their desire to cross-dress.

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22. Damien recently tried on female clothing for the first time and really liked it. What is a good estimate of his age? a) 8 b) 10 c) 12 d) 16 23. Transvestic fetishism is most common in which group of people? a) male homosexuals b) male heterosexuals c) female lesbians d) female heterosexuals 24. Boris has been cross-dressing since he was a child. He never found his cross-dressing particularly distressful, but has recently sought treatment because his girlfriend has urged him to. Which term best describes Boris's condition? a) transvestic fetishism b) transvestic disorder with fetishism c) transvestic disorder with autogynephilia d) transgenderism 25. In what way does transvestism differ from being transgender? a) People who have tranvestism have gender dysphoria. b) People who are transgender have gender dysphoria. c) People who have transvestism always have autogynephilia, whereas people who are transgender never have autogynephilia. d) People who have transvestism do not begin cross-dressing until they are adults, whereas transgender individuals prefer to cross-dress from a very early age.

26. According to the current research, fetishes appear almost exclusively in males. When does this typically begin? a) early childhood or adolescence b) infancy from 1-3 years of age c) young adulthood d) middle adulthood 27. The most prevalent psychological problems in people who practice BDSM is related to which of the following? a) rejection from the partner b) social stigma c) learned helplessness d) humiliation 28. Which component of BDSM is best described as the use of restraints, from the simple use of handcuffs or ribbons, to elaborate rituals and art forms such as Japanese rope? a) bondage b) discipline c) dominance Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) submission 29. Which component of BDSM may include painful whipping, biting, and the application of hot wax or other painful stimuli, and may also include sensory deprivation and humiliating behaviours such as boot-licking or behaving like a dog, or the use of feces and urine? a) discipline b) bondage c) dominance d) submission 30. Which six terms fit the acronym BDSM? a) bondage, discipline, dominance, submission, sadism, masochism b) bondage, dog-play, deprivation, serendipity, sadism, masochism c) belittling, deviance, dominance, salivation, sadism, matrimony d) biting, belittling, deviance, domination, serendipity, matrimony 31. Which term best describes someone who derives sexual pleasure from inflicting physical pain or psychological suffering on another person, often to gain power or to humiliate the other person? a) sexual sadist b) sexual masochist c) sexual deviant d) sexual anarchist 32. Keiko is aroused by having pain inflicted on her during sexual activity. Which term best characterizes Keiko's paraphilia? a) kink b) bondage c) sadism d) masochism 33. Alexandra and Tyler have a consensual sexual relationship. When they are "playing," Alexandra is frequently bound and Tyler tells her what to do and sometimes humiliates her by making her lick his feet. What kink group do Alexandra and Tyler belong to? a) bondage and discipline b) sadomasochism c) dominance and submission d) masochism 34. Layla and Corinne have a consensual sexual relationship. When they are "playing," Layla will use hot wax on or apply ice cubes to Corinne's skin. What "kink" group do Layla and Corinne belong to? a) bondage and discipline b) sadomasochism c) dominance and submission d) masochism 35. Gregory and Dylan have a consensual sexual relationship. When they are "playing," they will take turns using a riding crop on each other to inflict pain. What "kink" group do Gregory and Dylan belong to? a) bondage and discipline Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) sadomasochism c) dominance and submission d) masochism 36. Destiny and Roger are in a consensual sexual relationship, and would like to try dominance and submission for the first time. Which of the following should they do in order to be safe? a) establish a safe word b) set up boundaries prior to beginning the scenario c) use a "play" script d) all of the above 37. Timothy is often aroused by fantasies of being beaten and humiliated. Which of the following statements is LEAST likely to be true? a) Timothy was punished as a child when he was caught masturbating. b) Timothy uses masochism as a way to escape the pressures of his life by relinquishing control to someone else. c) Timothy would only be diagnosed with masochism disorder if his fantasies caused him distress. d) Timothy is no more likely to experience psychological impairment because of his masochistic fantasies than someone who does not have these kinds of fantasies.

38. Helena masturbates much more frequently than what is deemed average. Which of the following would she be diagnosed with? a) hypersexuality b) hyphephilia c) persistent genital arousal disorder d) Based on the above, she would not be diagnosed with any disorder.

39. Which of the following individuals would most likely be diagnosed with sexual sadism disorder? a) Richard, who is a "top" in a BDSM relationship and enjoys domination and urinating on his partner b) Hoang, who enjoys non-consensual sex with women and has acted upon it, but experiences no impairment as a result c) Caleb, who derives sexual pleasure from harming animals d) Leonid, who enjoys non-consensual sex with women, has acted upon it, and experiences distress as a result 40. A common preference that is present in all masochists is sexual arousal from which of the following? a) personal suffering b) domination c) humiliation d) bondage 41. What did Charles Moser find about the majority of sadomasochists? a) They were punished for masturbating, which led them to associate pain with sexual arousal. b) They do not recall any erotic enjoyment from punishment as children. c) They experienced violent outbursts as children. d) They are aroused by pain both inside and outside their sexual script.

42. Which term best describes a person who derives sexual pleasure by experiencing pain, humiliation, or suffering? a) sexual masochist Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) sexual sadist c) sexual deviant d) sexual anarchist 43. Some theorists feel that many people who have a preference for a sadistic role in sadomasochistic consensual sex may choose that role for which reason? a) because they don't feel powerful in their professional life b) because they don't like other people c) because they feel ashamed of being passive during sexual activity d) because they are seeking to diminish anxiety about sex 44. Which is a common theme in theories about the causes of hypersexuality? a) poor impulse control b) hormonal imbalance c) exposure at a young age to sexually-explicit material d) being prevented from exploring their sexuality during adolescence 45. How is it determined if a person has "hypersexuality"? a) They meet all the criteria for "hypersexuality" in the DSM-5. b) They masturbate or engage in sexual activity at least 115 times a year. c) They masturbate or engage in sexual activity at least 190 times a year. d) Hypersexuality must be assessed on an individual basis.

46. Holden experiences a persistent, painful erection. Which of the following most likely afflicts Holden? a) hypersexuality b) priapism c) persistent genital arousal syndrome d) satyriasis 47. Max has voyeuristic disorder. Which of the following scenarios would he find the most arousing? a) a nude beach b) a "peep show" c) live streaming sex on the Internet d) watching his neighbour change into her nightgown 48. Which of the following men would NOT be diagnosed with voyeuristic disorder? a) Ryan, who frequents strip clubs b) Yaroslav, who watches webcam broadcasts of women undressing in fitting rooms c) Juan, who prefers secretly watching people undress to having partnered sex d) Carlos, who has broken and entered in order to watch a couple having sex 49. Kayla regularly enjoys going to strip clubs and viewing pornography. Which of the following would she be diagnosed with? a) voyeuristic behaviour b) exhibitionistic disorder c) voyeuristic disorder d) none of the above

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50. Christoph enjoys going to nude beaches so that he can observe other people naked, although he does not partake in being nude. Which of the following would he be diagnosed with? a) voyeuristic disorder b) courtship disorder c) exhibitionistic disorder d) Based on the above, he would not be diagnosed with any disorder.

51. Which of the following is NOT a courtship disorder? a) bestiality b) voyeurism c) exhibitionism d) frotteurism 52. Sam frequently spies on his female neighbour through her window when she is naked. Which paraphilia does Sam have? a) voyeuristic b) exhibitionistic c) frotteuristic d) hyphenphilistic 53. Which disorder is often referred to as indecent exposure? a) exhibitionism b) voyeurism c) frotteurism d) hyphephilism 54. Andrew lurks in a park, waiting for a female jogger to go by before jumping out of the bushes and exposing himself to the jogger. What reaction is Andrew most likely looking for from the jogger? a) He is hoping the jogger will want to have sex with him. b) He is hoping the jogger will scream and run away. c) He is hoping the jogger will call the police. d) none of the above 55. Which of the following men would NOT be diagnosed with a courtship disorder? a) Henry, who ties up his partners and spanks them b) AJ, who will often call random hotlines and then masturbate to the voice on the other end c) Barrett, who will rub his genitals against a woman's leg when he is on a crowded subway d) all of the above 56. A person with exhibitionistic disorder derives sexual pleasure from which of the following? a) urinating in public b) watching the reaction of people when they flash them c) scaring people d) observing an unsuspecting person who is naked 57. What is one factor that voyeuristic disorder and exhibitionistic disorder having in common? a) They both involve nudity in public. b) They both involve deriving pleasure from scaring people.

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c) People with these disorders are distressed by their urges. d) They both are more common in women than men.

58. Telephone scatologia is closely related to which of the following disorders? a) voyeuristic disorder b) exhibitionistic disorder c) frotteuristic disorder d) hypersexuality 59. Which paraphilia is also known as toucherism and involves the act of fantasizing about, or actually engaging in, rubbing against or touching a non-consenting person for sexual gratification? a) frotteurism b) scatologia c) exhibitionism d) biastophilia 60. What is the approximate prevalence of pedophilia among males who commit sexual offences against children? a) 40–50 per cent b) 60–70 per cent c) 80–90 per cent d) 90–100 per cent 61. Which of the following is typical of pedophiles? a) They are violent. b) They are close with their victims. c) They commit sexual offences against children. d) They prey on strangers.

62. Which of the following is NOT true of pedophilia? a) Contact offenses are more harmful than online offenses. b) Most pedophiles are not violent. c) Pedophilia has existed throughout history. d) Treatment can lead to lower rates of recidivism.

63. Phillip has had pedophilic fantasies since he was a small child. He has never acted on these fantasies. In fact, he is also attracted to adults and is in a healthy relationship. But he is growing concerned with the frequency of these fantasies, and is afraid of the social repercussions if he tells anyone about them. Where is he most likely to go to get help? a) to a website meant to provide confidential support for individuals with pedophilic interests who have never acted on them b) to a medical professional trained in treating pedophiles c) to a trusted friend d) to his partner 64. Which of the following is TRUE of most pedophiles? a) They work hard to groom and coerce a specific child they are close to. b) They prey on strangers.

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c) They are often violent in their offences. d) They often reoffend if the offence is incestuous.

65. Which term is used to describe the erotic interest in contact with feces and may overlap with sadomasochism? a) coprophilia b) hyphephilia c) stigmatophilia d) klismaphilia 66. Which term is used to describe being aroused by urine? a) hyphephilia b) stigmatophilia c) urophilia d) necrophilia 67. What is the driving force of the child sex trade? a) poverty b) racism c) government corruption d) a prevalence of paraphilic disorders 68. Which of the following paraphilias is associated with having a lower IQ? a) frotteuristic disorder b) exhibitionistic disorder c) pedophilia d) voyeuristic disorder 69. Which theory explaining the origins of paraphilias is most consistent with the feminist perspective? a) Freudian theory b) behavioural theory c) neurological theory d) cognitive distortion theory 70. Why are paraphilias more common in males than females, according to psychoanalytic theory? a) They result from castration anxiety and the Oedipus complex. b) Men are encouraged to objectify women from a young age. c) Males experience unanticipated erections from a young age and may associate them with whatever activity they are involved with at the time. d) none of the above 71. Which theory would suggest that paraphilias are thought to result from castration anxiety and the Oedipus complex, explaining why they are more common in males than in females and, in this explanation, the fetish object is an unconscious replacement for the mother's missing penis and therefore reduces the male's castration anxiety evoked by the missing penis of his female partner? a) psychoanalytic theory b) behavioural theory c) cognitive theory d) sociobiological theory Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

72. When Ryan was a child, his parents caught him masturbating and punished him severely. During the traumatic punishment, Ryan was grounded and all of his toys were taken away. Instead of toys, he played with his underwear during the grounding. In later life, Ryan has developed an intense underwear paraphilia. What theory would connect his punishment to his paraphilia? a) behavioural theory b) psychoanalytical theory c) cognitive theory d) sociobiological theory 73. Which of the following is characteristic of pedophiles? a) lower IQs than others b) more likely to have repeated school grades c) more likely to receive special education d) all of the above 74. Jake has sexually assaulted several boys. When asked why he did so he said that he was teaching them how to perform sexually so that they would be ready to please women when they were older. Jake's explanation for his behaviour is consistent with which model of pedophilia discussed in your text? a) the behavioural model b) the cognitive distortion model c) the cognitive dissonance model d) the learning model 75. Urijah has recently entered a forensic psychiatric facility. During his assessment interview, Urijah intentionally exaggerated his exhibitionist tendencies to get more attention from the hospital staff. What term best describes his behaviour? a) malingering b) psychometrics c) paraphilias d) cognitive distortions 76. Forensic health clinicians may use a number of psychometrics while assessing a patient suffering from a paraphilic disorder to determine the likelihood that they will return to the behaviour. They are looking for rates of what? a) recidivism b) malingering c) volumetrics d) plethysmography 77. Why can't measures of arousal be used to determine whether a women is sexually interested in children? a) because what women report is attractive to them and their arousal patterns don't match b) because equipment used to measure arousal is stimulating and can confound results c) because women are better than men at intentionally suppressing feelings of sexual arousal d) because most women who commit sexual offences do so because they have difficulty becoming aroused except under very unusual circumstances 78. Self-esteem and social skills training for convicted pedophiles can have which benefit?

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a) It reduces sexual attraction to children. b) It reduces sex drive. c) It reduces compulsive behaviours. d) It reduces recidivism.

79. Which of the following is part of cognitive behavioural therapy for convicted sex offenders? a) empathy training b) aversion therapy c) satiation therapy d) anti-androgen medications 80. What movement dates back to the late nineteenth century and was used well into the twentieth century to limit the members of society deemed to be sexually deviant through surgical castration? a) eugenics b) recidivism c) paraphilesis d) CBT 81. Which treatment is commonly used today to treat paraphilic disorders and is based on the view that internal mental processes reciprocally interact with behaviours and emotional responses? a) cognitive behavioural therapy b) solution-focused therapy c) psychotherapy d) aversion therapy 82. What proportion of convicted child sex offenders will reoffend within 20 to 30 years of committing their crime? a) 25 per cent b) 33 per cent c) 50 per cent d) 66 per cent 83. Which treatment for pedophilia would involve masturbating twice in rapid succession? a) satiation therapy b) orgasmic reconditioning c) cognitive-behavioural therapy d) aversion therapy 84. The first type of medication typically prescribed for extreme cases of paraphilia is which of the following? a) an anti-androgen b) an anti-psychotic c) an anti-anxiety drug d) an anti-depressant 85. Gerald has always felt sexually aroused by certain breeds of dogs, and recently he has sought help. His therapist has recommended he masturbate to a fantasy about dogs until he reaches the point of orgasm, at which point he should switch his fantasy to a more socially acceptable one. Which treatment method is being used? a) orgasmic reconditioning Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) satiation therapy c) aversion therapy d) none of the above 86. Carlita is seeking treatment for her hypersexuality. Which of the following treatments would her therapist be most likely to recommend? a) a community-based support program b) aversion therapy c) orgasmic reconditioning d) a medical treatment 87. Which of the following is NOT a risk factor for those who sexually abuse children? a) violent tendencies b) sexual deviance c) antisocial traits d) intimacy deficits 88. Which therapeutic technique requires the client to masturbate to the paraphilic fantasy until the point of orgasm, at which time the fantasy is switched to a more socially acceptable one, the goal being to associate orgasm with a more appropriate stimulus? a) orgasmic reconditioning b) aversion techniques c) satiation d) CBT 89. Toucherism, the act of fantasizing about touching, or actually touching, a non-consenting person for sexual gratification, is a version of which type of paraphilic disorder? a) pedophilic disorder b) voyeuristic disorder c) frotteuristic disorder d) exhibitionistic disorder 90. Sexual sadism disorder and sexual masochism disorder both belong to a group of paraphilic disorders that involve pain and suffering and are typically referred to as ________ disorders. a) sadomasochism b) algolagnic c) courtship d) sadistic 91. In the DSM that is used to identify and diagnose paraphilic disorders, what does Criterion B specify? a) the negative consequences of the paraphilia b) the qualitative nature of the paraphilia c) the behaviours associated to the paraphilia d) all of the above 92. In order to be diagnosed with a paraphilic disorder, how long must the disorder have been present? a) 2 months b) 4 months Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) 6 months d) There is no time listed in the DSM. 93. What are two situational elements that are often important to somebody that has voyeuristic disorder? a) The victim is unsuspecting of being watched and the voyeur has a fear of getting caught. b) The victim knows they are being watched and the voyeur has a fear of getting caught. c) The victim is unsuspecting of being watched and the voyeur does not care if they get caught. d) The victim knows they are being watched and the voyeur does not care if they get caught.

94. An erotic interest in non-human animals, whereby the attraction is to particular species, breeds, and biological sex is called ________. a) bestiality b) zoophilia c) aniphilia d) coprophilia SHORT ANSWER QUESTIONS 1. Scott has an intense sexual attraction to feet (foot fetish). He derives sexual pleasure from looking at pictures of feet, particularly pictures of large feet. This type of sexual attraction is referred to as __________.

2. A person can be said to have a(n) __________ __________ when a person has a sexual interest in something unrelated to the genitals that causes them distress.

3. Any person with a paraphilic disorder acting out their fantasy with a __________-__________ partner is breaking the law in North America.

4. The __________ are the part of the body that is most commonly a source of a sexual fetish.

5. An autoerotic form of pedophilia is termed __________.

6. Andy has intense sexual interest in children. He has never touched a child for purposes of sexual gratification, but he is constantly fighting off distressing urges to do so. The name of Andy's disorder is __________.

7. Gerry is aroused when he receives an enema and he finds this distressing. The name of Gerry's disorder is __________.

8. __________ theory of paraphilia places an emphasis on masculinity and femininity.

9. A measure that quantifies changes in penis size is known as a __________ measure.

10. The __________ movement led to surgical castration being a common treatment for pedophilia well into the twentieth century.

11. Dr. Singh defines a sexual behaviour as abnormal if it occurs very infrequently in a population. This is an example of a __________ definition of abnormality.

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12. The key factor that distinguishes a paraphilia from a paraphilic disorder is whether __________ is involved.

13. When diagnosing a particular paraphilic disorder, Criterion A specifies the __________ __________ of the paraphilia.

14. When diagnosing a particular paraphilic disorder, Criterion B specifies the __________ __________ of the paraphilia.

15. Voyeuristic disorder and exhibitionistic disorder are both examples of __________ __________.

16. Toucherism is most closely related to the __________ disorder.

17. Tim is aroused by cross-dressing, but feels this pattern affects his ability to maintain romantic relationships.

Tim may be diagnosed with __________ __________.

18. A person who intentionally tries to contract HIV/AIDS is called a(n) __________ __________.

19. A pedophile explains that when he abused his victims, he truly believed he was teaching them valuable lessons about sexual behaviour. This is an example of a __________ __________.

20. Penile plethysmography (PPG) is most likely to be used when assessing __________ interests in pedophiles.

21. With ________ therapy, fantasies of the paraphilic behaviour are linked with an unpleasant stimulus, such as an unpleasant smell or an electric shock.

22. ________ Law is an American law that mandates that communities have access to information about the presence of convicted sex offenders in their neighbourhoods.

23. ________ includes learning self-regulation and attention to the present moment as well as maintaining a curious, open, non-judgmental, and accepting attitude.

24. Intentionally faking or exaggerating symptoms for personal gain is called ________, which is sometimes a problem in the assessment of paraphilic disorders.

25. Uncontrollable genital arousal in men that presents as a persistent, often painful erection is called ________.

26. Sexual activity between persons of a close enough genetic relationship that they are not legally permitted to marry is called ________.

27. Travel for the purposes of engaging in uninhibited sex is called ________ ________.

28. ________ is an excessive, insatiable sex drive that leads a person to continually pursue sexual encounters despite negative consequences.

ESSAY QUESTIONS 1. What are three methods of determining what is "normal" sexual behaviour?

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2. Hypersexuality is not listed as a diagnosis in the DSM. Explain the controversy with a diagnosis of hypersexuality. What is required in other models for an individual to meet diagnostic criteria?

3. Discuss the difference between a paraphilia and paraphilic disorder. How can one differentiate between the two?

4. What are the three courtship disorders and why are they put in this category?

5. Describe three "arguments" made by pedophiles to justify pedophilic behaviour and explain what is problematic about each argument.

6. Compare the prevalence rates of paraphilias in males and females. What are two explanations for prevalence rates that are observed as a function of sex?

7. Describe cognitive behaviour therapies for treating paraphilias.

8. What aspects about making sex offender information available to the public may be problematic?

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. c 2. a 3. d 4. b 5. d 6. a 7. a 8. a 9. d 10. a 11. a 12. d 13. a 14. b 15. a 16. a 17. a 18. d 19. d 20. b 21. d 22. a 23. b 24. a 25. b 26. a 27. b 28. a 29. a 30. a 31. a 32. d

33. a 34. a 35. b 36. d 37. a 38. d 39. d 40. a 41. b 42. a 43. d 44. a 45. d 46. b 47. d 48. a 49. d 50. d 51. a 52. a 53. a 54. a 55. a 56. b 57. c 58. b 59. a 60. a 61. b 62. a 63. a 64. a

65. a 66. c 67. a 68. c 69. b 70. a 71. a 72. a 73. d 74. b 75. a 76. a 77. a 78. d 79. a 80. a 81. a 82. b 83. a 84. d 85. a 86. a 87. a 88. a 89. c 90. b 91. a 92. c 93. a 94. b

SHORT ANSWER QUESTIONS 1. paraphilia 2. paraphilic disorder 3. non-consenting 4. feet 5. infantilism 6. pedophilia 7. klismaphilia 8. Psychoanalytic 9. phallometric 10. eugenics

11. statistical 12. harm 13. qualitative nature 14. negative consequences 15. courtship disorders 16. frotteuristic 17. transvestic disorder 18. bug chaser 19. cognitive distortion 20. paraphilic

21. aversion 22. Megan's 23. Mindfulness 24. malingering 25. priapism 26. incest 27. sex tourism 28. Hypersexuality

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ESSAY QUESTIONS 1. 1. Statistical; do a survey 2. Cultural; look what is typical in a culture, limit conclusions to that culture and time period 3. Consider normalcy judgment based on "doing no harm." Behaviour is normal if it does no harm, not normal if it does. One must have consent to do no harm and because consent varies from culture to culture this view is also going to vary by culture. Also, sometimes we think things are harmful because of cultural views (e.g., masturbation) so this view has a second source of cultural contribution but it is generally deemed to be reasonable now that we need proof that something is harmful before saying it is harmful.

2. In order to identify hypersexuality, even if we are unable to diagnose it using the DSM, we must consider the question, "What is an excessive frequency of sexual behaviour?" We may cite studies indicating that male undergraduate students masturbate an average of 12 times per month, and female undergraduates, 4.7 times per month (Pinkerton, Bogart, Cecil, & Abramson, 2002), and that the average number of times individuals aged 20 to 29 have sex per year is 117 (Durex, 2005). Preference for frequency of sexual activity, including masturbation, is simply that—a personal preference; as a result, the meaning of "excessive frequency" will be different for every person. In addition, few individuals can be expected to exhibit statistically average tendencies, as statistical averages merely represent a calculated central value of a wide range of data points. Thus, hypersexual disorder does not simply entail engaging in sexual behaviour more frequently than what is deemed to be average; individuals who meet the proposed criteria for hypersexual disorder have significant impairment in their relationships, work, and education because they spend so much time thinking about or pursing sexual activities.

3. Paraphilia: any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners.

Paraphilic disorder: a paraphilia that causes distress or impairment to the individual, or that may harm others when acted upon.

Atypical sexual behaviours are referred to as paraphilias, a word derived from the Greek para ("deviation") and philia ("love" or "attraction"). Typically, researchers, mental health practitioners, and others involved in the study of atypical sexual behaviours define paraphilias according to the guidelines set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent edition of the DSM (DSM-5) characterizes paraphilias as intense and persistent sexual interests other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners. The DSM-5 defines a paraphilic disorder as a paraphilia that is currently causing distress or impairment to the individual, or a paraphilia that causes personal harm, or risk of harm, to others when acted upon (APA, 2013).

The paraphilias exist on a continuum that ranges from "normal" to abnormal. Indeed, many people are aroused by or engage in some degree of the paraphilias described below from time to time, and occasional paraphilic interests are not considered abnormal or deviant. Paraphilic interests can be exclusive, meaning that the paraphilic object is the only thing that turns the person on sexually, or they can be non-exclusive, meaning that the person is aroused by more culturally typical sexual interactions as well as the paraphilic object. This distinction between exclusive and non-exclusive paraphilias may be an important one to make for providing appropriate treatments.

4. A courtship disorder is a disturbance in one or more phases of the common Western notion of partnered sexual activity, which include (1) looking for and finding a partner; (2) approaching that partner with conversation; (3) non-genital physical touching; and (4) sexual intercourse (Freund & Blanchard, 1986). It is hypothesized that individuals with courtship disorders experience one or more of these phases in a distorted manner. The three disorders are: (1) voyeuristic disorder; (2) exhibitionistic disorder (and telephone scatologia); and (3) frotteuristic disorder. Placing each of these disorders under the umbrella term of courtship disorders makes sense because they Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

are highly comorbid (Freund & Blanchard, 1986); indeed, men with one of these disorders show elevated penile responses to stimuli depicting images associated with the other disorders (reported in Cantor et al., 2009). In addition, these paraphilic disorders are similar to one another in that they all often involve non-consenting victims. It is hypothesized that these disorders may develop because the individuals lack the proper social skills to approach partnered activity in a consenting manner.

5. 1. Contemporary societal values are too restrictive, and that general attitudes toward sexual matters change over time, as they have in the cases of masturbation and same-sex sexual behaviours; Problem: this argument largely ignores the issue of consent.

2. Other paraphilias (e.g., "homosexuality") have been removed from the DSM and that sex with children has existed throughout history. Problem: While it is true that sex with pubescent children has existed throughout history, one is hard pressed to find any example of widely condoned sex with a prepubescent child.

3. Arguments from men who have gone to countries such as Cambodia or Thailand and provided housing or school tuition for children in exchange for sex; these men often argue that the children's lives are better because of their "generosity." Problem: How can you say sex without consent is acceptable? How do you know that the children are not being harmed?

6. Paraphilias are more common in males than in females.

1. More males than females experience paraphilias because of the evolutionary sex differences based on males being able to inseminate multiple female partners for biological fitness. From this point of view, it would be beneficial for males to become aroused to a variety of stimuli that do not contain emotional content, such as fetish objects.

2. Another explanation is based on the observation that it may be the combination of sexually explicit stimuli and widespread prohibitions about sexual behaviour that drives some paraphilias; most of the sexual stimuli in Western culture are aimed at a male audience.

7. A) Cognitive-behavioural therapies B) Behaviour therapy C) Social skills training D) Modification of distorted thinking E) Relapse prevention. Most sex offender treatment follows the CBT model (Kaplan & Kreuger, 2012), usually paired with relapse-prevention (RP). Much of the work is typically done in group settings. Treatment intensity (frequency and duration of meetings) depends on recidivism risk. A variety of treatment approaches are in use today, but it is generally agreed upon that group treatment using CBT/relapse prevention with a social-skills component is the gold standard. As with much psychotherapy, therapist characteristics that maximize treatment outcome include empathy, warmth, directiveness, and rewardingness (Beech & Hamilton-Giachritsis, 2005). This model focuses on challenging an offender's cognitive distortions about sexual offending; encouraging the offender to empathize with others; getting the offender to take responsibility for offending, including a disclosure of the offence to the group; identifying personal risks for offending, including paraphilic sexual preferences; and developing personalized safety plans to address those risks (Marshall, Marshall, Serran, & Fernandez, 2006).

8. One criticism is that public access to tools such as sex offender apps may give people a false sense of security because they believe that they know where all the sex offenders are located and may not consider the many sex offenders who have never been convicted or who have yet to commit their first offence. Another criticism is that public access to sex offender registries may lead to social isolation of individuals listed in these registries, and loneliness is a major risk factor for recidivism. Thus, public awareness of a sex offender's identity may actually increase his or her risk of reoffending. Another thing to consider is who is on the registry. Convictions are not standardized; for example, a conviction of sexual assault can mean anything from something the public might think of as harassment (e.g., slapping someone on the buttocks) to violent rape. In addition, there are certain cases in which individuals might be convicted of a criminal sexual offence for actions that are of little harm to the general public.

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CHAPTER 16

Sexual Dysfunctions MULTIPLE CHOICE QUESTIONS 1. Erin has difficulty talking about sex with her partner and during a discussion where her partner was urging her to talk about sex more Erin said, "My parents never talked about sex and they get along. Why do you need me to be so open about private things?" Which category of sexual problem best explains Erin's response? a) socio-cultural b) intrapsychic c) organic d) interpersonal 2. Jasmine and Calvin have been dating for six months and have recently been arguing about how often Calvin plays video games. Jasmine thinks that Calvin should play less but Calvin doesn't see the problem and refuses to change his habits. Jasmine and Calvin have been having sex less frequently. Which category of sexual problem best explains the decline in Jasmine and Calvin's sex life? a) socio-cultural b) intrapsychic c) organic d) interpersonal 3. Your best friend has been having problems with her husband who sometimes wouldn't orgasm at all during penetration. She's been organizing special nights with candles and lingerie, when she would tell him, "Now you'll orgasm for sure with all this sexy atmosphere." He eventually told her she made him suffer from "performance anxiety." She thinks he made that up. It's not a thing! What do you say to that? a) It is a thing—he feels a lot of pressure to orgasm quickly when you have put so much effort in creating the mood and you have these strict expectations. b) He's making it up. He's looking for excuses because he's probably masturbating and watching porn too much to be turned on by a regular woman. c) It is a thing in general, but it shouldn't be in his case since you're giving him all this extra stimulation with the candles and sexy lingerie. d) It is a term in sex therapy, but it has nothing to do with your situation. It refers to performing gender roles in society, not to having sex with someone.

4. Your close friend is getting married in a church wedding. She and her fiancé are taking preparatory lessons with the priest, required in their religion. The priest has advised them that when they have children, they should avoid raising the subject of sex with them so as not to awaken any sinful desires. What would a sex therapist say in response to this statement? a) Taboo around sexuality in childhood may make it difficult to communicate freely about their sexuality in adulthood. b) Taboo around sexuality in childhood is the most common risk factor in sexual abuse in early adolescence. c) Taboo around sexuality in childhood helps individuals appreciate the gravity of sexual decisions later in life and respect their sexual partners. d) none of the above

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5. At a bachelorette party, the bride-to-be asks all guests for advice on a good relationship. One guest says, "You better learn how to fight with your husband right." The bride-to-be is surprised that someone would wish her fights with her beloved husband. Is the guest onto something, though? a) Learning good conflict-resolution skills helps express normal anger that surfaces in every relationship. b) Not being able to express anger safely and effectively in an intimate relationship may lead to being unable to express or feel passion as well. c) Not being able to resolve fights effectively may lead to power struggles that can be played out in bed. d) all of the above 6. What can be said about the influence of specific religious teaching on the prevalence of sexual dysfunction in Canada? a) Most Canadians are influenced by the Christian value system and their sexual dysfunctions can be linked back to Christian values related to feeling shameful about sex and only having sex for reproduction. b) In Canada, most people are raised Christian and no link has been found between Christian upbringing and sexual dysfunction. c) In Canada, where the population varies a great deal in religion and religiosity, it is not possible to compute the influence of specific religious teachings on sexual dysfunction rates. d) The sexual practices of Canadians have never been found to be influenced by religious teachings.

7. "Never go to bed angry," is good advice for someone who wants to avoid which source of sexual dysfunction? a) organic b) intrapsychic c) socio-cultural d) interpersonal 8. In Canada, what do most parents teach their children about sex? a) nothing b) topics related to pregnancy but not topics related to pleasure c) topics related to following social rules, like not being naked or touching yourself in public, and nothing related to pregnancy or pleasure d) how to follow a gender role but nothing about reproduction or pleasure 9. After Fifty Shades of Grey by E.L. James became a bestseller, people have been talking a lot about BDSM. When you open your Facebook one day, you see a growing discussion on your wall started by a strict Christian friend who quotes The Diagnostic and Statistical Manual of Mental Disorders to prove that BDSM is a pathology.

You decide to reply, saying, "Actually, the latest, Fifth Edition from 2013 defines sadism and masochism as pathology only when they are accompanied by ________." a) distress and dysfunction b) sodomy c) physical marks such as bruises d) pain 10. Which of the following is a myth about sex that can lead to sexual dysfunction? a) "Sexual intercourse does not have to involve penile penetration of a vagina." b) "Talking during sex improves pleasure." c) "If sexual activity doesn't end in orgasm, it's okay." d) "Sex should be natural and spontaneous."

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11. Your friend from Europe heard the news that Canada has introduced a new sexual education curriculum that includes lessons about consent. He finds it very progressive that students get such a rounded education. You reply, "Yeah, well, that's kind of new in only one province now. In general, in Canada, we don't learn for example about ________ in school." a) sexual feelings, desire, or pleasure b) contraception other than condoms and the pill c) reproductive biology d) sexually transmitted infections 12. When Canadian youth see sex portrayed in the media, including on the Internet, what do most young people conclude? a) that what they see in the media is reflective of how "normal" people experience sex and sexuality b) that media are not as good a source on information as sex education in the schools c) that what they see in the media is not reflective of reality d) that what they see in the media is heavily biased towards promoting traditional Christian values and ideals about sex 13. Your friend Jenny calls you in tears. She's sure her boyfriend, who works for a renovation company, is cheating on her because she wanted to have sex when he came home from work but he didn't. He claimed to be completely wiped after eight hours of sanding floors in the summer heat and he just wanted to collapse in bed. He did look sweaty, dirty, and tired and he said he loved her very much, but Jenny is sure that a man never says no to sex. What can you tell her? a) It's a myth that men always want sex and are always ready. Sometimes they're simply too tired to think about it. b) He most likely is cheating on her. Men are genetically designed to be sex-ready and willing regardless of circumstances. c) It's a myth that men always want sex, but it's true that they're always ready. So he could have gotten an erection just to please her. d) none of the above 14. At a family dinner you say you're studying human sexuality. Your cousins are immediately interested and, against your aunt's nervous protests, start asking questions about what's true and what isn't in common knowledge about sex. You tell them, "Actually it is not a myth that ________." a) the clitoris is the only human organ whose sole function is pleasure b) women's sexuality is more complicated than men's c) sex goes downhill after marriage d) a man is always ready to have sex 15. Taylor and Tom met at a diabetes fundraiser and have been dating for a year. They're both diabetic. Tom's doctor has warned him that he might develop erectile dysfunction, but so far he hasn't had problems with erection.

Taylor, however, has been uncomfortable during sex recently, saying penetration hurt her, though she still is very much attracted to Tom and would like to have sex a lot. Her doctor never mentioned potential sex problems, so she is confused. What could be the problem? a) Diabetes can affect both men and women's genitals in the same negative way, but doctors tend to pay attention only to its effects on erection and ignore lubrication in females. b) While diabetes affects erection in men, it does not have an effect on lubrication or sensation in women, so Taylor's problem must be caused by a different condition. c) Diabetic men produce an antibody that has been proven to cause vaginal dryness in women who exchange body fluids with them. Diabetic women don't produce it and are not immune to it.

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d) none of the above 16. There is very little evidence that ________ can cause problems in sexual desire. a) low testosterone b) anemia c) cardiovascular disease d) hypothyroidism 17. Which of the following can seem to increase sexual desire while actually decreasing sexual performance in men? a) anti-depressants b) vitamin supplements c) viagra d) alcohol 18. Monica is on birth control and is experiencing low sexual desire. Which form of birth control is Monica likely using? a) Depo-Provera b) an intrauterine device c) condoms d) a diaphragm 19. Melanie is experiencing vaginal dryness because of a prescription medication she is taking. The dryness is causing her to avoid sexual activity. What is the term for the cause of Melanie's dysfunction? a) psychogenic b) iatrogenic c) pharmogenic d) aphrogenic 20. Which of the following is true about aphrodisiacs? a) Researchers have yet to find an aphrodisiac that actually induces sexual desire more than a placebo. b) Viagra is the most effective aphrodisiac currently known. c) Alcohol is the most effective aphrodisiac currently known. d) Effective aphrodisiacs have been used throughout history and vary from culture to culture.

21. At a work Christmas party, John (23) got drunk and hit on his boss's daughter, Alexis. They slept together, but John regretted it the next morning, realizing that he didn't find her attractive after all. Alexis told her father that they were dating, and now John is looking for a new job to get out of this relationship. He has to stay with her until he lands a new job, but he's having trouble getting an erection when they're in bed together. His friend advises him to just pop Viagra and soldier on. Will that help? a) Viagra enables blood flow to the penis but only when a man is subjectively aroused, so it won't work if Alexis doesn't turn John on. b) Viagra enables blood flow to the penis that causes an instant physiological erection independent of the mood, so John can use it to feign arousal. c) Viagra enables blood flow to the penis that causes an instant physiological erection, but after about 20 minutes subjective arousal is necessary to sustain it, so John would have to be quick with Alexis. d) It is irrelevant because no doctor would prescribe Viagra to a healthy male in his twenties, and it's impossible to obtain the drug in any other way than through a prescription.

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22. What was the intended purpose of the prescription drug called Diane (which can be prescribed to women with severe cystic acne) when it was first created? a) birth control b) chemical castration c) to increase sexual desire d) to treat symptoms of menopause 23. Which of the following is true concerning drugs like Viagra? a) They automatically cause erections by increasing blood flow to the penis. b) The vast majority of men prescribed these drugs fill and refill their prescriptions. c) They are most effective if combined with sex therapy. d) They are popular because they are safe to take if a person has cardiovascular problems (a leading cause of erectile dysfunction).

24. What is a PDE-5 inhibitor? a) an erectogenic drug b) an anti-depressant that inhibits serotonin reuptake c) a type of antiretroviral drug d) the morning-after pill 25. Malcolm usually comes before his girlfriend does, and then he usually makes her come with his hand. He believes he could give her orgasm by penetration if he only lasted longer, but he obviously is suffering from premature ejaculation. What would be the best first step for him to take to address this problem? a) He should use two condoms at the same time to limit sensation in his penis. b) He should imagine during penetration a scene from any of the Saw movies to get his mind off the arousal. c) He should ask his family doctor for a selective serotonin reuptake inhibitor drug to delay his reactions to arousal. d) none of the above 26. What is the most commonly reported male sexual dysfunction? a) erectile dysfunction b) rapid ejaculation c) delayed ejaculation d) dyspareunia 27. Recent critiques of the notion that the "point" of sexual intercourse is for the male to perform until the female reaches orgasm have led to a rejection of which of the following terms? a) premature ejaculation b) delayed ejaculation c) ejaculatory incompetence d) retarded ejaculation 28. Which of the following can be a prescribed medical treatment for men who feel they ejaculate too quickly? a) topical lidocaine b) topical estrogen c) SSRI anti-depressants Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) Botox injections in the base of the scrotum 29. Mark experiences delayed ejaculation. Which of the following scenarios may explain Mark's problem? a) Mark has problems maintaining an erection because of a blood pressure medication he is taking. b) Mark has recently stopped taking SSRIs. c) Mark is worried about "getting caught" having sex with his girlfriend in his parents' house. d) Mark has been using erectogenic drugs.

30. Based on the DSM-5, a man can be diagnosed with premature (early) ejaculation if he meets which set of criteria? a) He ejaculates within 30 seconds of penetration 75 per cent of the time for three months. b) He ejaculates within 60 seconds of penetration 75 per cent of the time for six months. c) He ejaculates within 30 seconds of penetration 75 per cent of the time for six months. d) He ejaculates within 60 seconds of penetration 90 per cent of the time for three months.

31. Which of the following best describes the evidence related to the cause of rapid ejaculation? a) Rapid ejaculation usually occurs because of anxiety. b) Rapid ejaculation usually occurs because of penile hypersensitivity. c) There is a rapid ejaculation gene. d) There is no consistent evidence for a cause of rapid ejaculation.

32. What often provides instant relief to men who report rapid ejaculation due to performance anxiety? a) wearing multiple condoms b) taking SSRI anti-depressants c) psychoeducational counselling d) using a numbing agent on the penis 33. What two factors may have been conflated in men reporting delayed ejaculation? a) arousal and anxiety b) performance and arousal c) performance and anxiety d) arousal and pleasure 34. Which of the following is true of most men who have delayed ejaculation? a) There is an underlying organic cause for their problem. b) They never experience orgasm. c) They are able to experience orgasm while masturbating but not in partnered sex. d) They do not want their "dysfunction" treated because they enjoy being able to brag about how long they can stay hard.

35. Julia, your new sex therapy client, is distressed that her husband doesn't find her attractive, because he achieves orgasm rather quickly when he masturbates, but hardly ever when he penetrates her. She says that usually during sex she spreads her legs, tells him to go on, and lies there waiting for him to finish, because she's exhausted after a long day. Shouldn't it be enough for him that she's offering her vagina when he's hard? What can you tell her? a) Often an erection means that the man is somewhat aroused, but not enough to achieve orgasm. Spending some time and attention on increasing arousal before penetration may help. b) Often an erection means that the man is aroused and ready to penetrate until orgasm. If he is not ejaculating, Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

there must be a physiological cause; e.g., a new drug that he has been taking. c) Often an erection means that the man is aroused and ready to penetrate until orgasm. If he is not ejaculating, there must be a psychological cause; e.g., he's thinking about work or another sexual partner. d) both B and C 36. What does Binik's approach to treating dyspareunia emphasize? a) treating the pain but ignoring the association with sex b) focusing on the sexual relationship and ignoring the pain because it will eventually dissipate c) conditioning women with dyspareunia to have a more positive opinion of sexual intercourse by pairing intercourse with other sensual pleasures including fragrances and soothing music d) having women complete "Binik's inventory," which assesses whether dyspareunia is the result of vulvar, vaginal, or psychological problems 37. Anne is not aroused during sex so she is not producing lubrication, making sexual penetration difficult. What should the first step be in Anne's attempt to correct this problem? a) trying a plant-based non-petroleum lubricant b) trying a water-based lubricant c) examining why she is not aroused by her partner d) stopping all medications linked to lubrication (e.g., anti-depressants and oral contraceptives) 38. When using condoms, it is important to use which type of lubricant? a) oil-based lubricant b) water-based lubricant c) plant-based lubricant d) almond oil lubricant 39. Why did Lonnie Barbach recommend changing the disorder named "anorgasmia" to "preorgasmia"? a) because the main problem is not that they can't have an orgasm, but that they have yet to have an orgasm b) because the main problem women report is that they have orgasms too soon, not that they don't have orgasms c) because the main group of females who report not having orgasms are not yet sexually mature d) because the physiological response of women who report not having orgasms is very similar to the physiological response of "normal women" about to have an orgasm 40. Your friend Jeff, a college student, started dating Allison, and they had their first sexual intercourse together.

During penetration, Jeff noticed that Allison started rubbing her clitoris. He tells you that he feels cheated because Allison basically masturbated when he was inside her, and this is not how a woman should orgasm when with a man. What can you say to that? a) Most women need clitoral stimulation for orgasm, so she might not have had an orgasm at all without it. It's natural. b) Most women achieve orgasm through vaginal stimulation, but they sometimes use clitoral stimulation when their partner does not arouse them enough with penetration, so Jeff should think about that. c) Many women who can't achieve orgasm through vaginal penetration can do it through anal penetration, so Jeff and Alison should try that. d) Most women need clitoral stimulation for orgasm when their sexual responses are not developed fully. Alison should work on moving on to the next stage—vaginal orgasm.

41. A few college friends are having a girls-only night in a residence room. Two bottles of Moscato embolden them to start sharing stories of the best orgasm ever, to a lot of excited giggles. Only one girl, Ashley, isn't joining Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

in the fun, sitting quietly with an embarrassed expression. When the others question her, she admits she's never masturbated or had an orgasm in her life. A barrage of advice ensues. Which suggestion would be the most reasonable for Ashley to start with? a) You should totally check out this book, For Yourself: the Fulfillment of Female Sexuality by Lonnie Garfield Barbach. It will really help you get to know your body. b) You should get a boyfriend and lose your virginity as soon as possible. A guy will know how what make you tick. He'll know how and where to touch you. c) What you need is a good vibrator! I'll go shopping with you! Just put it in, turn it on, and wait—you'll orgasm before you know it. d) Oh, no! You might be frigid! My sister had that. Go see a doctor—you can get one of those new pink Viagra pills, right?

42. What is the recommended treatment for most women with anorgasmia? a) finding a new sexual partner b) the use of lubricants c) hormone therapy d) bibliotherapy 43. What is thought to be the primary cause of anorgasmia in women? a) circulatory problems b) side effects from medications c) lack of knowledge about her own body d) low estrogen 44. Milena is looking forward to having sex with her partner, but as soon as his body comes in contact with hers, she panics. Which sexual disorder that was removed from the DSM-5 is Milena experiencing? a) sexual aversion disorder b) dyspareunia c) hypoactive sexual desire disorder d) anorgasmia 45. You're catching up over coffee with your good friend, Linda, who confesses in a whisper that she's been recently feeling pain during intercourse with her long-time boyfriend, Juan. She hasn't told anyone yet. She's hasn't noticed bleeding or anything out of the ordinary, and it doesn't hurt at other times, only when she has sex.

Juan likes to thrust quite hard, and she's not always into it. What would you advise her? a) Try to find a good doctor who will listen to you and take time to reproduce the pain during examination. It can be anything from an infection to not being aroused. b) Try lube. It looks like a typical case of too much friction. It'll feel really good when you get the right lubrication. c) Go to a drugstore and get an over-the-counter vaginal cream. It's a yeast infection. A week of treatment and you'll be back to normal. d) none of the above 46. Andrea is receiving treatment for a sexual dysfunction that involves the insertion of a vaginal dilator in combination with relaxation training. What disorder is Andrea likely being treated for? a) dyspareunia b) anorgasmic disorder c) vaginismus Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) preorgasmic disorder 47. You're a sex therapist. Your new client came to you because her family doctor told her she had vaginismus and prescribed dilators, but she isn't so sure about the treatment. You know that vaginismus stems from a woman's fear or reluctance to engage in intercourse. What areas of her experience would you explore to understand the reasons for her fear? a) Is she afraid of unwanted pregnancy? b) Has she been sexually abused or assaulted? c) What does she know and think about sex and her own body? d) all of the above 48. A new and popular treatment for vaginismus involves which of the following? a) Botox injections into the pelvic floor muscles b) hypnotherapy to decrease a woman's anxiety about sexual penetration c) a surgical ring-shaped implant that prevents the vagina from closing completely d) introduction of anal penetration as an alternative to vaginal penetration 49. You're looking through the mail in your sex therapy office. Among the letters is a glossy invite to a seminar on Dr. Peter Pacik's new vaginismus treatment using Botox. As you read through the description of the treatment, you start questioning it. How? a) Is it in the woman's best interest to ignore her underlying fear of penetration and force open her vagina when she's unconscious? b) How is the Botox going to affect the nerves in the clitoris and vulva, which are responsible in most part for sexual stimulation? c) Considering how sensitive the area around the vaginal opening is, can the numerous injection sites become painful and infected after the procedure? d) none of the above 50. What sexual problem causes the most couples to seek sex therapy? a) rapid ejaculation b) erectile dysfunction c) anorgasmic disorder d) sexual desire discrepancy 51. Tracy and Charles, a young married couple, come to you, a sex therapist, with this problem: Charles wants to have sex "too often," and Tracy just "can't keep up." Charles blames Tracy for being "frigid," and she blames him for being a "sex addict." What's the solution? a) There is no simple solution. You have to find out what's going on in their relationship to start seeing possible causes of their disagreement. b) It's normal for men to have a higher sex drive than women do. Charles can masturbate on those days when Tracy doesn't want to have sex. c) Men and women's sex drives are similar, but women are socialized to express it less. Tracy can experiment with masturbation more to increase her sex drive. d) Low sex drive in women is usually hormone based. Tracy can start taking testosterone pills to boost her sexual desire.

52. Why do many women with no sexual desire "just do it" with their partner? a) Couples who "just do it" eventually show an increase in sexual satisfaction.

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b) The woman wants to show a commitment to her partner even though she doesn't want to have sex. c) Low sexual desire usually goes away on its own. d) Having sex with low sexual desire is better than not having sex at all.

53. Masters and Johnson developed their approach to therapy based on what observation regarding couples seeking therapy? a) Couples seeking therapy were usually very angry at each other. b) Couples seeking therapy were usually both suffering from low desire. c) Couples seeking therapy usually avoided all touching so as to avoid dealing with the sexual problem they were having. d) Couples seeking therapy usually had a problem linked to physiology.

54. Masters and Johnson's approach to sex puts an emphasis on which of the following? a) sex as a bodily/physical function b) sex as a psychological phenomenon c) sex as a subject of philosophical debate d) sex as an expression of intimacy 55. The goal of therapy outlined by Masters and Johnson is to do which of the following? a) to improve communication in order to improve sexual functioning b) to reveal unconscious desires and wishes that can impede sexual functioning c) to teach couples how to stimulate each other as a means of improving sexual satisfaction d) to eliminate obstacles to sexual functioning 56. In the midst of work, childrearing, and financial problems, Kate and Jason have completely stopped having sex. Now that their situation is more stable, they want to rediscover their intimacy, but they feel anxious about it.

A therapist who uses the Masters and Johnson method tells them to start from the very beginning and gives them their first assignment: ________. a) touch each other while avoiding breasts and the genitals b) touch each other, genitals and breasts included, but with no focus on one spot c) stimulate each other's genitals without leading to orgasm d) stimulate each other's genitals without engaging in intercourse 57. Which of the following is NOT part of the early stages of Masters and Johnson's approach to sex therapy? a) touching with no genital contact b) touching with genital contact c) non-demand genital pleasuring d) intercourse to orgasm 58. Masters and Johnson's approach to sex therapy has been critiqued for which of the following reasons? a) for focusing on unconscious desires that weren't directly measurable or observable b) for focusing on the couple as a pair instead of on each individual with their own individual problems c) for having sexual penetration as the goal of the therapy d) for defining sexual functioning as a matter of subjective experience and not biology 59. You're a sex therapist, and you have your first appointment with Leila regarding her problems achieving orgasm with her long-term boyfriend. You practice therapy based on the Masters and Johnson's paradigm, so at the end of the session, you tell her, "For our next meeting ________, because ________."

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) come with your boyfriend; this kind of issue is best tackled as a couple b) bring your sex toys; we need to examine how you have been trying to achieve orgasm so far c) write down how often you had sex between now and the next visit; we need to analyze your sexual response d) interview your partner with the questionnaire I'll give you; we need to know his side of the story as well 60. Which of the following is an example of an intrapsychic factor that can contribute to sexual problems? a) performance anxiety b) poor communication c) diabetes d) religious teachings 61. Performance anxiety is an example of a(n) __________ factor that can contribute to sexual problems. a) intrapsychic b) interpersonal c) cultural d) organic 62. Which of the following is an example of an interpersonal factor that can contribute to sexual problems? a) performance anxiety b) hostility c) diabetes d) religious teachings 63. Poor communication in a relationship is an example of a(n) __________ factor that can contribute to sexual problems. a) intrapsychic b) interpersonal c) cultural d) organic 64. Which of the following is an example of a psychosocial factor that can contribute to sexual problems? a) performance anxiety b) hostility c) misinformation d) poor communication 65. Misinformation is an example of a(n) __________ factor that can contribute to sexual problems. a) intrapsychic b) interpersonal c) cultural d) organic 66. By the mid-1980s, what percentage of sexual problems were thought to be psychogenic in nature? a) 20 per cent b) 40 per cent c) 60 per cent d) 80 per cent

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

67. By the mid-1980s, what percentage of sexual problems were thought to be caused by organic or iatrogenic factors? a) 20 per cent b) 40 per cent c) 60 per cent d) 80 per cent 68. What consequence of diabetes can lead to sexual problems in men? a) peripheral neuropathy b) loss of interest in sex c) low testosterone d) high blood sugar 69. Norm takes Effexor to help with his anxiety. Ever since he started taking the medication, his interest in sex has disappeared. Norm's lack of interest in sex may be best categorized as a(n) __________ disorder. a) organic b) iatrogenic c) psychosocial d) intrapsychic 70. All of the following are examples of possible iatrogenic sources of sexual problems EXCEPT __________. a) depression b) surgery c) medication d) medical treatment 71. All of the following are diagnoses related to orgasm EXCEPT __________. a) premature (early) ejaculation b) delayed ejaculation c) hypoactive sexual desire disorder d) female orgasmic disorder 72. Which of the following disorders is related to sexual arousal? a) erectile disorder b) female orgasmic disorder c) delayed ejaculation d) hypoactive sexual desire disorder 73. Which of the following disorders is related to sexual desire? a) sexual interest/arousal disorder b) female orgasmic disorder c) erectile disorder d) delayed ejaculation 74. Which of the following sexual problems arises only in the context of a relationship? a) female orgasmic disorder b) erectile disorder c) sexual desire discrepancy Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) penetration disorder 75. For how long must a man ejaculate within 60 seconds of penetration 75 per cent of the time in order to meet the criteria for premature (early) ejaculation? a) 2 weeks b) 2 months c) 6 weeks d) 6 months 76. Which of the following disorders is most likely to be caused by a lack of sexual knowledge? a) premature (early) ejaculation b) female orgasmic disorder c) erectile disorder d) dyspareunia 77. Allison talked to a therapist about a sexual problem she is having. The therapist recommended bibliotherapy.

What disorder does Allison MOST likely suffer from? a) female orgasmic disorder b) dyspareunia c) genito-pelvic pain/penetration disorder d) sexual desire discrepancy 78. Historically, female genital pain during intercourse has been referred to as __________. a) vaginismus b) dyspareunia c) peripheral neuropathy d) hysteria 79. Historically, female genital muscle tightening that prevents penetration has been referred to as __________. a) vaginismus b) dyspareunia c) peripheral neuropathy d) hysteria 80. All of the following may be part of sex therapy based on guidelines set by Masters and Johnson EXCEPT __________. a) genital touching b) sexual intercourse c) face touching d) stroking breasts 81. What is the third phase of sexual therapy as outlined by Masters and Johnson? a) sensate focus exercises b) non-demand genital pleasuring c) touching the body from head to toe d) sexual intercourse 82. What is the first phase of sexual therapy as outlined by Masters and Johnson?

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a) sensate focus exercises b) non-demand genital pleasuring c) touching all parts of the body from head to toe d) sexual intercourse 83. What is the second phase of sexual therapy as outlined by Masters and Johnson? a) sensate focus exercises b) non-demand genital pleasuring c) touching all parts of the body from head to toe d) sexual intercourse 84. How does the amount of time currently spent training medical students on sexual matters compare to how much time was spent prior to the 1990s? a) Less time is spent on sexual matters. b) There has been no change in the amount of time spent on medical matters. c) Slightly more time is spent on sexual matters. d) Significantly more time is spent on sexual matters.

85. Gina and Dave are receiving sex therapy from a therapist who bases their program on the work of Masters and Johnson. About how much time each day will the couple spend on sensate focus exercises at the beginning of treatment? a) 10 minutes b) 20 minutes c) 30 minutes d) one hour 86. Neil and his partner are receiving sex therapy based on the work of Masters and Johnson. Their main concern is Neil's performance anxiety. The therapist thinks she can reduce Neil's anxiety by reducing his __________. a) orgasms b) spectatoring c) arousal d) erections 87. Effective treatment of dyspareunia must focus on __________. a) finding the underlying cause of the pain b) having the woman come to accept her pain as normal c) finding the underlying cause of the muscle spasms d) having the woman come to accept the muscle spasms as normal 88. Which of the following disorders is most closely associated with a fear response? a) erectile disorder b) vaginismus c) female orgasmic disorder d) desire discrepancy disorder 89. Diabetes is a relatively common __________ cause of sexual problems. a) organic b) intrapsychic Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) cultural d) interpersonal 90. Which of the following is the most under-reported male sexual difficulty? a) delayed ejaculation b) premature ejaculation c) rapid ejaculation d) erectile dysfunction SHORT ANSWER QUESTIONS 1. The most common interpersonal problem that results in sexual dysfunction is poor __________ in a relationship.

2. __________ is a disease that can impact sexual functioning by affecting both hormones and sensation.

3. Since the advent of Viagra in the late 1990s, many people argue that erectile disorder is 90 per cent __________ and 10 per cent __________.

4. When a sexual problem is the result of surgery, prescription medication, or medical treatment, its cause is described as __________.

5. The most under-reported sexual problem in men is __________ __________.

6. The technical term for pain during sexual activity is __________.

7. The term for a physical response in the vagina resulting from a fear of penetration is __________.

8. Due to its complexity, __________ __________ desire disorder is arguably the most difficult sexual dysfunction to treat effectively.

9. Chris is concerned about the timing of ejaculation and is constantly thinking about his performance during sex.

Chris' behaviour is known as __________.

10. The name for the therapeutic activities Masters and Johnson recommend for couples experiencing sexual dysfunction is __________ __________ exercises.

11. Worries about early ejaculation are a form of __________ anxiety.

12. Misinformation is an example of a(n) __________/cultural factor that can lead to sexual problems.

13. Jen was diagnosed with hypoactive sexual desire disorder 10 years ago and Jane was diagnosed with sexual aversion disorder 15 years ago. Today both women would be diagnosed as having __________ __________/__________ __________.

14. The most common issue that causes couples to seek sex therapy is __________ __________ __________.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

15. A simple approach to treating female orgasmic disorder is __________, which includes information on female anatomy.

16. If a man exhibits genuine anorgasmia, it will have a(n) __________ cause.

17. Many women experience female orgasmic disorder because of a lack of __________.

18. Vaginismus is most closely associated with __________-related emotions.

19. Graduated plastic cylinders may be used in the treatment of __________.

20. In __________-__________ __________ __________, the couple focuses on stimulating each other's genitals without engaging in intercourse.

ESSAY QUESTIONS 1. Describe the controversy concerning including sadism and masochism as a diagnosis in the DSM. 2. What are three "normal" physical factors that can contribute to low sexual desire six months after giving birth?

3. What are five myths about sexuality that, if believed, can lead to sexual dysfunctions?

4. Describe Masters and Johnson's sensate focus exercises. Explain the goal of the therapy as well as the criteria for determining if the therapy has been successful.

5. Describe both sides of the debate regarding whether pharmaceutical companies should be allowed to market "Viagra for women."

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. d 3. a 4. a 5. d 6. c 7. d 8. b 9. a 10. d 11. a 12. a 13. a 14. a 15. a 16. a 17. d 18. a 19. b 20. a 21. a 22. b 23. c 24. a 25. d 26. b 27. a 28. c 29. d 30. b

31. d 32. c 33. b 34. c 35. a 36. a 37. c 38. b 39. a 40. a 41. a 42. d 43. c 44. a 45. a 46. c 47. d 48. a 49. a 50. d 51. a 52. b 53. c 54. a 55. d 56. a 57. d 58. c 59. a 60. a

61. a 62. b 63. b 64. c 65. c 66. d 67. a 68. a 69. b 70. a 71. c 72. a 73. a 74. c 75. d 76. b 77. a 78. b 79. a 80. b 81. b 82. a 83. c 84. a 85. b 86. b 87. a 88. b 89. a 90. a

SHORT ANSWER QUESTIONS 1. communication 2. Diabetes 3. organic; psychogenic 4. iatrogenic 5. delayed ejaculation 6. dyspareunia 7. vaginismus 8. hypoactive sexual

9. spectatoring 10. sensate focus 11. performance 12. psychosocial 13. sexual interest arousal disorder 14. sexual desire discrepancy 15. bibliotherapy

16. organic 17. knowledge 18. fear 19. vaginismus 20. non-demand genital pleasuring

ESSAY QUESTIONS 1. The APA requires empirical evidence of a disorder to include it on the DSM; however, out of millions of doctor's visits sadomasochism was not mentioned even once. Thus there isn't empirical support that sexual sadism Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

or sexual masochism is a "disorder" in and of itself, and it was recommended that these issues be included in the section on variations in sexual behaviour, not as pathological. This is controversial because members of the BDSM community report that they sometimes suffer distress due to the stigma associated with "kink" preference and wish for psychological issues related to BDSM to be included somewhere on the DSM-5 as a result. The result is that the DSM-5 recognizes sexual sadism and sexual masochism as pathological only if a person is suffering distress because of the preference for these sexual behaviours.

2. 1. Prolonged bleeding during childbirth can cause low hemoglobin level.

2. Breastfeeding produces prolactin which can cause vaginal dryness.

3. New parents may be too exhausted for sex, as most newborns don't sleep through the night.

4. The mother may have been prescribed the hormonal contraceptive Depo-Provera, which can reduce sexual desire.

3. Students may mention any five of the following: 1. "Real" sex equals intercourse.

2. Sexual satisfaction equals orgasm.

3. Bigger is better (when it comes to breasts and penises).

4. A man always wants and is always ready to have sex.

5. Women's sexuality is more complicated than men's.

6. Sex should be natural and spontaneous.

7. Talking ruins the mood.

8. You shouldn't start anything you can't finish.

9. Sex goes downhill after marriage; it gets even worse after you have children.

4. In the initial stage, the sex therapist asks the couple to spend time each day touching each other, for approximately 20 minutes each, with no breast, genital, or anal contact permitted. This phase allows couples to reconnect physically without having the expectation that sex will follow. Thus, performance anxiety is circumvented and the individuals are able to attend to the sheer sensations of touching and being touched without having to wonder if their genitals will function adequately.

In the second phase, couples are instructed to touch one another from head to toe, including the genitalia, without focusing on any particular area and with no particular aim, other than enjoying the pleasure of touch.

The third phase consists of a variety of different exercises specific to a given difficulty, but in most cases the couple is instructed to engage in on-demand genital pleasuring. The objective at this point is to allow the couple to experience heightened sexual pleasure as well as to target the sexual symptom for elimination without triggering the anxiety and spectatoring engendered by the expectation of intercourse. The goal of the therapy is to reduce anxiety related to performance.

Therapy is considered successful when penetration is successful.

5. Pro: Some argue that the medication will help women and that women have the right to access drugs that may help them with a sexual problem.

Con: The drugs have not been shown to be effective and allowing them may cause widespread misunderstanding about desire in women. Objections include the assumption that low desire is problematic, the assumption that low desire is biochemical in origin, whether a disease model of low desire is appropriate, whether low desire can even be treated, and whether low desire should be treated, etc. Women could take a medication that does harm to solve a problem that either doesn't really exist or is not actually treatable.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 17

Sexual Assault and Harassment MULTIPLE CHOICE QUESTIONS 1. Tim keeps posting obscene remarks on Anita's Facebook page. He has repeatedly asked her out and she has said no each time. Once at a club he danced so close to her that she decided to leave. What is the most appropriate term for Tim's behaviour? a) sexual assault b) sexual harassment c) stalking d) teasing 2. Terry goes to clubs where he knows Uma will be. Once or twice they've chatted at the bar. Terry is hoping one of these days he can start a relationship with her. What type of behaviour is Terry exhibiting? a) harmless pursuit b) stalking c) harassment d) sexual harassment 3. What is one way in which the terms "sexual assault" and "rape" differ? a) "Sexual assault" includes all unwanted sexual acts excluding sexual intercourse, whereas "rape" refers only to unwanted sexual intercourse. b) "Sexual assault" includes all unwanted sexual acts including sexual intercourse, whereas "rape" refers only to unwanted sexual intercourse. c) "Sexual assault" can be committed by anyone on anyone but only women can be victims of "rape." d) "Sexual assault" can occur even when both parties consent to the activity however "rape" is defined as sexual intercourse in the absence of consent.

4. How does the DSM-5 classify people who commit rape? a) There are no diagnoses in the DSM-5 that have rape as a criterion. b) Most people who commit rape meet the DSM-5 criteria for "frotteurism disorder" or "sexual sadism disorder." c) Most people who commit rape meet the DSM-5 criteria for sexual sadism disorder. d) Most people who commit rape do not meet the criteria for any diagnosis on the DSM-5.

5. What diagnoses do most therapists choose when they must give a DSM-5 diagnosis to a person who has committed rape? a) sexual sadism disorder b) frotteurism c) unspecified paraphilic disorder d) antisocial personality disorder 6. Which term refers to the range of non-consensual sexual experiences, including unwanted touching; oral, anal, and vaginal intercourse; and sexual violence? a) sexual assault b) rape Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) sexual harassment d) stalking 7. Which term refers to any unwanted sex-related behaviours that are considered by the recipient to be offensive, threatening, or demeaning? a) sexual harassment b) sexual assault c) rape d) stalking 8. Which term refers to harassing behaviour such as repeatedly following, intimidating, or tracking another person against their will? a) stalking b) sexual assault c) rape d) sexual harassment 9. Prior to 1983, which of the following was NOT consistent with rape laws in Canada? a) Anyone could be a victim of rape. b) Rape was limited to forced heterosexual intercourse. c) Rape could only occur outside of marriage. d) A person's prior sexual activities could be used as evidence of consent.

10. Under the current criminal code of Canada, which of the following is NOT a category of sexual assault? a) intermediary sexual assault b) sexual assault c) sexual assault with a weapon, threats to a third party, or causing bodily harm d) aggravated sexual assault 11. A number of studies examining the International Classification of Diseases' psychiatric diagnoses of individuals who have been incarcerated for sexual crimes have found high rates of __________. a) pedophilia b) sexual preference disorders c) substance-use disorders d) courtship disorders 12. Prior to 1983, which of the following acts would NOT have met the legal definition of rape? a) a husband having non-consensual sexual intercourse with his wife b) a man having non-consensual anal intercourse with another man c) a man having non-consensual sexual intercourse with a woman d) a man having non-consensual sexual intercourse with a child 13. Current Canadian law classifies rape under which specific category of offense? a) assault b) sexual offenses c) rape d) sexual assault

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

14. According to the Canadian Criminal Code, which of the following is the most serious offense? a) rape b) sexual assault c) sexual assault with a weapon d) aggravated sexual assault 15. On Saturday night, Alana said it was okay for Paolo to have sex with her, but on Monday, Alana claimed she did not give consent to the sex she had with Paolo on Saturday. According to Canadian law, Alana may not have given consent under which of these circumstances? a) Alana was 12 years old and Paolo was 14 years old. b) Alana was drunk on Saturday night. c) Alana was 15 years old and Paolo was 17 years old. d) Alana was 16 years old and Paolo was 19 years old 16. What is the formal legal age of consent for penile–vaginal intercourse in Canada? a) 14 b) 15 c) 16 d) 17 17. In which of these situations would the "close-in-age" exception apply to the laws regarding legal age of consent for sexual activity? a) when Lacey, who is 13, has consensual vaginal intercourse with Peter who is 12 b) when Hannah, who is 13, has consensual vaginal intercourse with José, who is a 15-year-old supervisor at the summer camp she attends c) when Jada, who is 15, has consensual vaginal intercourse with Micah, who is 21 d) when Tricia, who is 18, has consensual vaginal intercourse with Kirk, who is 20 18. What is the legal age of consent for anal intercourse in Canada? a) 15 b) 16 c) 17 d) 18 19. In order to obtain estimates based on the percentage of surveyed individuals who report having participated in or experienced a certain condition in a given period of time, researchers surveyed individuals who report having been sexually assaulted or having sexually assaulted someone at least once. What are they attempting to estimate? a) prevalence b) incidence c) self-report reliability d) validity of measure 20. In a random sample of 2000 children aged 10 to 16 years, Boney-McCoy and Finkelhor (1995) found that 7.6 per cent had been sexually victimized during the previous year. What estimate has been documented in this research? a) incidence b) prevalence c) self-report reliability Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) validity of measure 21. A nationally representative survey found that sexual assault victimization rates were approximately how many times higher for females than for males. a) three b) five c) seven d) ten 22. Why do incidence estimates, which are based on official records, likely underestimate the number of sexual assaults and the percentage of the population who experience unwanted sexual contact? a) Many sex crimes go unreported to authorities. b) Most measures of sexual assault are not reliable. c) Sexual assault is generally overestimated in population studies. d) The actual number of perpetrators taken into custody is an accurate reflection of the number of sexual assaults taking place.

23. What percentage of Canadian female university students reported that a male attempted to use emotional manipulation to get them to engage in sexual activity at some point in their past? a) 30 per cent b) 45 per cent c) 60 per cent d) 70 per cent 24. Incidence rates for sexual assault are likely inaccurate for which of the following reasons? a) People underreport sexual assaults. b) Incidents that are reported as sexual assaults but not proven to be cases of sexual assault are included in the estimate. c) Sexual assault is not differentiated from physical assault in reports of assault filed with the Canadian government. d) Sexual assault is over reported because it is a tactic for justifying obtaining the morning-after pill in cases where sexual activity was in fact consensual.

25. Which is true about how sex traffickers view Canada? a) Canada is an unappealing destination because of high minimum sentences for sex trafficking. b) Canada is an appealing destination because of low minimum sentences for sex trafficking. c) Canada is an unappealing destination because of the low maximum sentences for sex trafficking. d) Canada is an appealing destination because there are no laws against sex trafficking for people over the age of 14.

26. According to rape trauma syndrome, which of the following would be a common action of someone in the acute phase? a) excusing the perpetrator b) changing jobs c) moving to a different city d) moving past the experience emotionally 27. Which of the following women is likely in the reorganization phase following a sexual assault?

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a) Stefanie, who is experiencing confusion and shock b) Blair, who is blaming herself for the attack c) Danica, who has decided to move to another city d) Aisling, who is experiencing extreme anxiety 28. Approximately what percentage of sexual assault victims have persistent emotional difficulties more than five years after the assault? a) 10 per cent b) 25 per cent c) 33 per cent d) 66 per cent 29. Although research has demonstrated that the majority of victims recover from the trauma of sexual assault within five years, nearly one third of victims have substantial difficulty that persists years beyond the acute aftermath of the incident. A significant number develop an anxiety disorder that involves persistent and chronic psychological symptoms, such as flashbacks, nightmares, avoidance of stimuli associated with the trauma, hyperarousal, and anxiety. What is this condition known as? a) post-traumatic stress disorder b) anxiety disorder c) rape trauma syndrome d) depression 30. Katrina was the victim of a rape incident during her first year of university. She graduated over three years ago. She still has nightmares about the incident and often lies awake at night. Which of the following does Katrina suffer from? a) post-traumatic stress disorder b) rape trauma syndrome, acute phase c) rape trauma syndrome, reorganization phase d) none of the above 31. Several of your classmates and you get into a discussion about the long-term effects of sexual assault. One of your classmates asks you about the possibility of any positive outcomes, or post-traumatic growth, that could come out of a victim's response to rape. For example, a victim may choose to spend more time with loved ones after the assault. What could you say to counter this argument? a) These positive changes may not be significant compared to the harm caused by the assault. b) Perceived positive changes could just be a defensive illusion. c) The victim may see-saw back and forth between distress and positive growth. d) any of the above 32. Your best friend has confided in you that she just found out her sister was the victim of sexual abuse from her boyfriend of a year. Your friend feels guilty that she didn't recognize the signs beforehand so that she could help her sister get out of the relationship sooner, and she blames herself. What advice can you give your friend? a) It's important that your friend's sister can get emotional support from your friend, so they should be open about the guilt your friend is feeling. b) It's important that your friend's sister can heal without the extra distress of her family members feeling sorry for her or guilty that they didn't act sooner, so she shouldn't talk to her sister about how she is feeling. c) Your friend should talk to a professional. d) Your friend is right to feel guilty, but there's nothing she can do about it now.

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33. The most common treatment for survivors of sexual assault seeking professional help is cognitive-behavioural therapy (CBT). Which of the following is a component of CBT? a) stress inoculation training (SIT) b) prolonged exposure (PE) c) cognitive processing therapy (CPT) d) all of the above 34. Which exposure-based treatment for sexual assault involves psychotherapy to alleviate trauma-related symptoms and associated distressing memories through exposure to stimuli of traumatic events while simultaneously focusing on dual attention stimulus (e.g., hand-tapping)? a) eye movement desensitization and processing b) repeat exposure c) cognitive processing d) muscle relaxation 35. Which of the following is NOT a likely method of treatment for sexual assault victims? a) physical therapy b) stress inoculation training c) cognitive processing therapy d) prolonged exposure 36. Which of the following is often characterized by insomnia, depression, flashbacks, and nightmares? a) post-traumatic growth b) post-traumatic stress disorder c) paraphilic disorder d) cognitive-behavioural therapy 37. Which common psychotherapeutic intervention for sexual assault victims involves identifying a hierarchy of individually feared stimuli associated with assault (e.g., the dark, strangers)? a) prolonged exposure b) stress inoculation training c) cognitive processing therapy d) flooding 38. Which common psychotherapeutic intervention for sexual assault victims involves having the victim imagine themselves experiencing the assault again while they repeatedly retell the story of what happened? a) prolonged exposure b) stress inoculation training c) cognitive processing therapy d) flooding 39. Which common psychotherapeutic intervention for sexual assault victims involves having the victim use a journal to record feelings and then discuss those writings during therapy sessions? a) prolonged exposure b) stress inoculation training c) cognitive processing therapy d) flooding Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

40. Which of the following is both a socio-cultural and a situational factor that can lead to the occurrence of a sexual assault? a) religion b) location c) alcohol d) gender 41. Which of the following is an interpersonal contextual factor that can lead to the occurrence of a sexual assault? a) religion b) gender c) personality d) alcohol 42. You've just found out that one of your friends has been sexually assaulted when walking home alone at night on campus from one of the local bars. In tears, she tells you she blames herself for wearing such a short skirt and a crop top. What can you tell your friend? a) Women are sexually assaulted while wearing all types of clothing, and wearing a short skirt was not the reason she was assaulted. b) She should never wear a short skirt again. c) While some sexual assaults may take place because of the way the victim is dressed, she can't know for sure if her short skirt was the reason she was singled out. d) none of the above 43. You are a female undergraduate student living on campus. You've just signed up to take a course you are really looking forward to, but it's available only in the evenings, which means you won't finish until after 10 pm.

Your mom keeps bringing up how concerned she is about you walking home alone at night. What can you tell her to make her feel better? a) Most sexual assaults do not occur outdoors in public, and most are not committed by strangers. b) A large percentage of sexual assaults and attempted sexual assaults are committed by classmates, so you won't get close to anyone else in your class. c) You will make sure to dress unattractively in baggy clothing, so you won't get assaulted. d) none of the above 44. Which of the following is NOT a rape myth? a) Women seldom make false reports of sexual assault. b) Women cause men to sexually assault them by the way they look or dress. c) It is not sexual assault if both people are drunk. d) Offenders can be identified based on their demographic characteristics (race, class, etc.).

45. Which of the following is NOT a rape myth? a) You cannot tell a rapist by the way they look. b) Sexual assault usually occurs outside and at night. c) Sexual assault is usually perpetrated by a stranger. d) Sexual assault is simply an impulsive act of sexual gratification.

46. Which of the following IS a rape myth? a) If a survivor of sexual assault did not fight back, they were not really assaulted.

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b) A person cannot be sexually assaulted by their spouse. c) Women often make false reports of sexual assault. d) all of the above 47. Which form of sexual assault is most likely to remain legal in some countries? a) spousal rape b) trafficking c) stranger rape d) sexual assault with a weapon 48. Situational characteristics can play a role in sexual assault. Which of the following is NOT a place where sexual assaults are more likely to occur? a) a dark alley b) house parties c) places where drugs and alcohol are present d) places where victims are known to the perpetrator 49. Which dynamic risk factor may develop from beliefs that women are devious, an inability to understand women's facial affective cues, or a lack of empathy? a) intimacy deficits b) offence-supportive social influences c) limited sexual self-regulation d) psychopathy 50. What condition promotes sexual assault in which offenders associate with people who are supportive of their behaviour in various ways? For example, these people may demonstrate antisocial attitudes, reinforce negative beliefs about women, or commit sexual offences with the offender. a) offence-supportive social influences b) competitive disadvantage c) young male syndrome d) psychopathy 51. Which of the following people exhibits individual risk factors for sexual offending? a) Chris, a male from a middle-income family whose father often says women are devious creatures b) Henry, a male from a low-income background who was abused as a child and has a general lack of empathy for others c) Tyreed, a male from a low-income background who lives with an older brother that has been accused of sexual assault more than once d) all of the above 52. Based on a synthesis of the forensic psychological literature on individual differences, which of the following is NOT a main route for sexual offending? a) over-protective parent syndrome b) young male syndrome c) competitive disadvantage d) psychopathy 53. Galen sexually assaulted Jessica while they were at a party and Jessica reported the assault to police. Galen is Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

18 years old and his parents, who are both doctors, were shocked when they learned of Galen's arrest. Galen had a normal childhood, according to his parents, and got along well with his peers, including many close female friends. Which route to sexual offending best describes Galen's situation? a) young male syndrome b) competitive disadvantage c) psychopathy d) victim precipitation theory 54. Which route to sexual offending results in the offender feeling the least amount of guilt or responsibility for their action? a) young male syndrome b) competitive disadvantage c) psychopathy d) the influence of drugs or alcohol 55. Richard was born with mild cognitive impairment and lived in foster homes most of his life. At puberty, Richard developed a sexual interest in younger boys and was caught possessing child pornography when he was 12 years old. Richard is now 20 years old and recently committed a sexual assault against a 10-year-old boy he met in a park. Which of the following best explains Richard's route to offend? a) young male syndrome b) competitive disadvantage c) psychopathy d) sexual sadism 56. Eli was convicted of attempted sexual assault when he was in high school. He worked with a therapist and now holds a steady job and is married. Which of the following was the likely cause of his sexually assaultive behaviour, according to Lalumière? a) young male syndrome b) competitive disadvantage c) psychopathy d) none of the above 57. Jon committed a sexual assault. His parents died when he was a child and he grew up in a number of foster homes, some of which were abusive. Which of the following was the likely cause of his sexually assaultive behaviour, according to Lalumière? a) young male syndrome b) competitive disadvantage c) psychopathy d) none of the above 58. Carter was convicted of sexual assault. He has a wife and children, and he grew up in a stable, middle-income family. Which of the following was the likely cause of his sexually assaultive behaviour, according to Lalumière? a) young male syndrome b) competitive disadvantage c) psychopathy d) none of the above 59. Gaius was convicted of attempted sexual assault with a minor. He grew up in a single-parent home. Which of Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

the following was the likely cause of his sexually assaultive behaviour, according to Lalumière? a) young male syndrome b) competitive disadvantage c) psychopathy d) none of the above 60. Which of the following behaviours has NOT been shown to help stop a sexual assault? a) screaming b) using physical force c) biting d) crying 61. You and some of the classmates from your human sexuality class decide to get dinner one day after class. One of your classmates starts a heated discussion in favour of victim precipitation theory. Which of the following points could you add to the conversation? a) It's not a strong theory, especially as it is faulted for shifting blame from the perpetrator to the victim! b) Most demographic variables are not significantly associated with sexual assault. c) Actually, there are some correlates of revictimization, such as insecurity about relationships with men. d) all of the above 62. You are a young woman who works late and has to walk home alone late at night in a secluded part of town.

You often think about what you would do if someone attacked and tried to sexually assault you. Which of the following would be your best defense? a) screaming, yelling, biting, scratching, or hitting the perpetrator b) crying and pleading with the attacker c) trying to flee or struggle d) both A and C 63. Your college roommate comes into your room in tears. She tells you that her ex-boyfriend has just sexually assaulted her. What should you do first? a) Ask her if she needs any medical care, and if so, help her to obtain it. b) Encourage her to report the assault to the police immediately. c) Tell her that it is not her fault that she was assaulted and she is in no way to blame. d) Tell her you are there for her and will help her with whatever she needs.

64. How soon following a sexual assault does medication need to be taken in order to effectively prevent HIV/AIDS? a) within 12 hours b) within 24 hours c) within 48 hours d) within 72 hours 65. What is the maximum sentence for someone convicted of aggravated sexual assault in Canada? a) 10 years b) 14 years c) 25 years d) life in prison

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66. What was the median sentence given to someone convicted of sexual assault and other sexual offences in Canada in 2014-2015? a) 255 days b) 14 months c) 3 years d) 5 years 67. According to Statistics Canada, which of the following is true about the median amount of jail time given for someone who is convicted of sexual assault compared to the amount of jail time given for a typical robbery? a) It is about the same as the median amount of jail time given for robbery. b) It is about eight days longer than the median amount of jail time for robbery. c) It is about 3 months shorter than the median sentence for robbery. d) It is about two years shorter than the median sentence for robbery.

68. Which of the following is true about people who are convicted of sexual assault? a) They are at the same risk for recidivism as other offenders. b) They are at higher risk for recidivism than other offenders c) They are at lower risk for recidivism than other offenders. d) They have the highest recidivism rate of all offender types.

69. Men who experience sexual assault victimization are more likely to report __________. a) poor physical health b) infrequent emotional or social support c) low life satisfaction d) all of the above 70. Which of the following is true of sexual victimization of men? a) A male victim of sexual assault is more often assaulted by a stranger. b) A male victim of sexual assault will have experienced different effects than a female victim of sexual assault. c) A male victim of sexual assault is more likely to be in a homosexual relationship than a female victim of sexual assault. d) None of the above are true.

71. Which of the following is associated with childhood sexual abuse? a) depression and anxiety b) post-traumatic stress disorder c) interpersonal problems in adulthood d) all of the above 72. Sashi was recently promoted at work. To celebrate her promotion, her boss took her out for dinner. While at the dinner, he stated that she could return the favour of her promotion and put his hand on her leg. What type of sexual harassment is this? a) quid pro quo b) hostile work environment c) psychological d) derogatory manipulation 73. Kaden thought he was being funny by repeatedly making advances towards a co-worker named Brittany. He Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

would ask her out most days and pretend he was completely in love with her. What he did not realize was that all this attention made Brittany very uncomfortable. Though he may think his actions are innocuous, what type of sexual harassment is he actually engaging in? a) hostile work environment b) quid pro quo c) psychological abuse d) derogatory manipulation 74. Which of the following individuals is most at risk of being sexually harassed in the workplace? a) Fateema, an immigrant working as a waitress and being paid under-the-table b) Riza, a Muslim male working in a company with individuals that are predominantly Christian or Jewish c) Golshan, a young female in a wheelchair working in a low-paying office job d) All of the individuals above are at increased risk of being sexually harassed in the workplace.

75. You've been at your job for about a year, and have asked to switch to another department within the company that you think would be a better fit for you. Then one of the managers from that department offers to buy you a coffee so that you can discuss the move. You accept, but it soon becomes clear that the manager wants a sexual favour in exchange for moving you to the new department. What should you do? a) Talk directly to the manager about why his proposition is inappropriate and how it makes you feel. b) Seek out the human resources department and let them handle investigating the complaint. c) Agree to the manager's proposition; you really want to move your career forward. d) Refuse the manager's proposition, but don't report the incident in hopes that it will not affect your chances.

76. You are a female university student studying engineering, and you happen to be the only female in your tutorial for an engineering class. The teaching assistant has made some inappropriate sexual comments during one of your tutorials. What should you do? a) Report the incident to the appropriate authorities at your university. b) Nothing; the teaching assistant grades all your papers and you wouldn't want to risk getting a lower mark. c) Talk to the teaching assistant; they may not realize that what they said was inappropriate. d) Use social media to out the teaching assistant to other students that may potentially take a class with the same teaching assistant in the future.

77. Which theory is based largely on feminist perspectives and suggests that gender inequality and sexism in society leads to sexual harassment? a) socio-cultural theory b) organizational theory c) sex-role spillover theory d) natural/biological theory 78. In late 2011, there were reports that Cain had sexually harassed several female employees during his tenure as CEO at the National Restaurant Association. In at least two of the cases, the women had previously settled civil suits with the association in exchange for their agreement to not discuss the allegations further. One of the women who publicly came forward reported that Cain had sexually assaulted her when she approached him for assistance in getting her job back at the association or finding a new job; when she questioned him about what he was doing, he replied, "You want a job, right?" Which theory best illustrates the conditions that promoted sexual harassment in this excerpt? a) organizational theory b) four-factor theory Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) natural/biological theory d) sex-role spillover theory 79. Which theory best describes the following description of sexual harassment? Marina was recently promoted to her first managerial position at the company she has been working at for five years. She now manages at team of six. For the first few months, everything went well, but lately one of her reports has started making lewd comments to her during their biweekly meetings. a) sex-role spillover theory b) natural/biological theory c) sociocultural theory d) organizational theory 80. Which theory best describes the following description of sexual harassment? Gail was recently laid off from her job at a small company that's been having some financial difficulties. When she emails the CEO to ask for a reference, he replies with an offer to help her find a job if she will go out to dinner with him. a) sex-role spillover theory b) natural/biological theory c) sociocultural theory d) organizational theory 81. Which theory of sexual harassment would predict that Teresa, a vice president at a technology company, may be more likely to be harassed than Julia, her lower-ranking administrative assistant? a) sociocultural theory b) organizational theory c) sex-role spillover theory d) natural/biological theory 82. In cases of sexual assault, a harasser may have the belief that a woman should not be in a position of managing others despite the organizational perspective that workers should be able to advance and be in leadership positions without regard to gender. As a result of this gap between the individual belief and the organizational perspective, conflict is likely to arise in which the harasser's sex-role stereotypes are different from actual gender roles. Which theory best explains this scenario in which sexual harassment may occur? a) sex-role spillover theory b) four-factor theory c) sociocultural theory d) natural/biological theory 83. Stalking can have severe psychological, economical, and social impacts on victims. What differentiates stalking from most other types of sexual assault and is important to consider for those working with this population? a) Stalking is chronic and may have a range of lasting impacts on the victim. b) Stalking is less invasive than other types of assaults and its impact on victims can easily be treated. c) Most people are unaware they are being stalked. d) Stalking is very rare.

84. Which of the following may be used to curb stalking behaviour in Canada? a) peace bond b) restraining order Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) protection order d) all of the above 85. In Canada, what percent of people who are criminally harassed are harassed by someone they know? a) 22 per cent b) 48 per cent c) 62 per cent d) 70 per cent 86. What percentage of students are estimated to have experienced sexual harassment at school? a) 5 to 10 per cent b) 15 to 20 per cent c) 25 to 30 per cent d) 35 to 40 per cent 87. What is the Canadian average for self-reported stalking incidents in 2014? a) 1 per cent b) 6 per cent c) 14 per cent d) 20 per cent 88. To understand and describe possible motivations for stalking, researchers have often attempted to develop classification systems. These classification systems are typically based on which of the following? a) characteristics of the victim b) characteristics of the perpetrator c) the nature of the stalking behaviours d) all of the above 89. A ________ is a civil court order available in some provinces that provides various emergency and long-term orders to protect victims of family violence. a) protection order b) restraining order c) peace bond d) peace order 90. ________ refers to a route in which some individuals, usually young men, are willing to engage in risky, violent, and competitive behaviour in order to demonstrate their dominance and willingness to incur risks to attain goals. a) victim precipitation theory b) Psycopathy c) Competitive disadvantage d) Young male syndrome SHORT ANSWER QUESTIONS 1. Frank often pats Camila's bottom when she is using the photocopier at work. Frank thinks it's a sign of affection but Camila doesn't like it. Frank's actions could best be described as __________ __________.

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2. Committing rape is a criterion that is necessary but not sufficient for the DSM-5 diagnosis of __________ __________ disorder.

3. If Gabbi and Trent have consensual sexual intercourse and Gabbi is 12 and Trent is 13, this is considered legal and consensual because of the __________-__________-__________ exception.

4. The age of consent for __________ __________ is 18 years in Canada, with no "close-in-age" exceptions.

5. A(n) __________ estimate is based on documented cases of a certain condition, such as sexual assault, during a given period of time.

6. A(n) __________ estimate can be generated using a survey.

7. According to rape trauma syndrome, the __________ phase of the response pattern lasts about one to two months.

8. Many victims of sexual assault develop __________-__________ __________ __________, which can consist of sleep problems, depression, flashbacks, and anxiety.

9. __________ __________ are widely held beliefs that serve to legitimize sexual assault.

10. If one is being harassed by a non-relative, a __________ __________ may be the best legal action to take.

11. An acquaintance of Hailey's forced Hailey to perform oral sex on him. Hailey is a victim of __________ __________.

12. Laws pertaining to the age of consent are biased against people who have __________ sex.

13. "For a sexual purpose, touching, directly or indirectly, with a part of the body or with an object, any part of the body of a person under the age of 16 years" is the definition of __________ __________ .

14. In Canada, __________ women and girls are particularly vulnerable to sex trafficking.

15. Burgess and Holmstrom (1974) proposed __________ __________ __________, which is a two-phase pattern of response to sexual assault.

16. In the __________ __________ of the rape trauma syndrome victims attempt to restore order in their lives and re-establish a sense of control.

17. A theorized route to delinquent and/or criminal acts in which individuals engage in risky, violent, and competitive behaviour, especially during adolescence and early adulthood, to demonstrate their dominance and willingness to incur risks to attain goals is called ________ ________ ________.

18. Annie was sexually assaulted two years ago. The experience resulted in her realizing the importance of her family and friends. This is an example of __________-__________ __________.

19. Sexual assaults are more likely to occur inside than outside. This is an example of a __________ characteristic Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

that leads to sexual assault.

20. The notion that certain personal characteristics can make an individual more vulnerable to sexual assault is known as __________ __________ theory.

ESSAY QUESTIONS 1. Compare the legal definitions of "rape" and "sexual assault" in Canada prior to 1983 and in Canada today, and explain why the definition was changed.

2. What are the main characteristics of the Criminal Code regarding sexual assault since 1983?

3. Describe rape trauma syndrome (RTS).

4. Provide three rape myths from the text and explain why they are not true.

5. Discuss evidence that contradicts the following two rape myths: a) "Women cause men to sexually assault by the way they look or dress." b) "Sexual assault usually occurs outside and at night."

6. If someone is sexually assaulted, what are three things that you could say/do immediately to help them?

7. Outline Lalumière and colleagues' three main routes to sexual offending.

8. What effects can sexual harassment have on the environment of an organization? What can be done to address this?

9. The text provides a number of theories that seek to explain why sexual harassment occurs. Discuss one of these theories and provide an example.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. b 2. a 3. b 4. d 5. c 6. a 7. a 8. a 9. a 10. a 11. c 12. a 13. d 14. d 15. b 16. c 17. a 18. d 19. a 20. a 21. c 22. a 23. d 24. a 25. b 26. a 27. c 28. c 29. a 30. a

31. d 32. a 33. d 34. a 35. a 36. b 37. b 38. a 39. c 40. c 41. c 42. a 43. a 44. a 45. a 46. d 47. a 48. a 49. a 50. a 51. d 52. a 53. a 54. c 55. b 56. a 57. b 58. c 59. b 60. d

61. d 62. d 63. a 64. d 65. d 66. a 67. c 68. c 69. d 70. a 71. d 72. a 73. a 74. d 75. a 76. a 77. a 78. a 79. a 80. d 81. c 82. a 83. a 84. d 85. d 86. c 87. b 88. d 89. a 90. d

SHORT ANSWER QUESTIONS 1. sexual harassment 2. sexual sadism 3. close in age 4. anal intercourse 5. incidence 6. prevalence 7. acute

8. post traumatic stress disorder 9. Rape myths 10. peace bond 11. sexual assault 12. anal 13. sexual interference 14. Indigenous

15. rape trauma syndrome 16. reorganization phase 17. young male syndrome 18. post-traumatic growth 19. situational 20. victim precipitation

ESSAY QUESTIONS 1. Prior to 1983, the law defined rape exclusively as forced heterosexual intercourse enacted by a man on a woman (i.e., sexual penetration of a woman's vagina by a man's penis), outside of marriage. The rape law was criticized for being limited to sexual penetration, defining only males as perpetrators and females as victims, and Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

excluding husbands from being charged with rape. In addition, a victim's prior sexual activities could be considered as evidence of her consent, which called into question her credibility as a victim. Under this law, many cases of rape did not proceed to trial or were dismissed in the courts simply because the woman had engaged in prior consensual sex with the alleged perpetrator or had engaged in sexual intercourse with a number of other partners prior to her involvement with the alleged perpetrator.

In 1983, the Criminal Code of Canada was amended, with an expanded definition of sexual assault under the general heading of "Assault," to make it easier for victims to report sexual assaults to police. The Parliament of Canada removed rape and indecent assault as specific offences and replaced them with three levels of seriousness of sexual assault: (1) sexual assault; (2) sexual assault with a weapon, threats to a third party, or causing bodily harm; and (3) aggravated sexual assault (Criminal Code, sections 271–3). The level of seriousness of the assault was determined by the amount of force used and the degree of injury sustained by the victim. In essence, these amendments made it possible for a spouse of either sex to be charged with sexual assault. Furthermore, the primary aims of the changes were to de-emphasize the sexual nature of the offence and to improve the conditions for the victims of sexual assault, so they no longer needed to defend their reputation in court.

2. Although many people today still use the term rape to refer to forced sexual intercourse, the Canadian Criminal Code exclusively uses the term sexual assault to refer to a range of non-consensual sexual experiences, including unwanted touching; oral, anal, and vaginal intercourse; and sexual violence. Consent is not obtained simply because of marital or cohabitational status or because of previous consensual relations. In addition, neither a silent or ambiguous response to sexual initiation nor tacit approval given while under the influence of alcohol or drugs (Figure 17.2) or while unconscious is a satisfactory indicator of sexual consent. Finally, the partner, with few exceptions, must be 16 years of age or older to legally consent to sexual intercourse.

3. Rape trauma syndrome (RTS), which describes a two-phase response pattern consisting of an acute, or disruptive, phase and a reorganization phase. During the acute phase, which begins immediately following a sexual assault, it is common for victims to experience a range of emotional reactions such as anxiety, intense fear, anger, depression, disbelief, and vulnerability. In particular, a woman may blame herself for what happened, possibly reflecting broader sociocultural attitudes that assign blame to women for their own victimization and, by default, excuse the perpetrator. The emotional reactions in this phase often escalate and persist for one to two months but then slowly begin to decrease, although the sexual assault is never forgotten. In the reorganization phase, which can last from months to years, victims attempt to restore order in their lives and re-establish a sense of control. Many victims report that making some lifestyle changes, such as changing where they live or what they do for work, helps them to regain control and can even lead to positive growth.

4. Myth 1: Women cause men to sexually assault by the way they look or dress. This myth is simply not true.

Studies have shown that women are sexually assaulted while wearing different types of clothes, and women of all ages and physical body types have been sexually assaulted. One study that interviewed individuals who were arrested for sexual assaults found that the thing they most often look for is a victim who seems to be vulnerable, not one who is particularly attractive or dressed in a certain way (Stevens, 1994).

Myth 2: It is not sexual assault if either person is drunk or under the influence of drugs at the time of the assault. If a person's judgment is impaired by alcohol or drugs, or if the use of drugs or alcohol has left a person unconscious, he or she cannot legally give consent. As a result, having sex with someone who is impaired or unconscious is defined as sexual assault. Conversely, being drunk or under the influence of drugs is not an acceptable defence for committing sexual assault.

Myth 3: Rapists come from a certain demographic of people: non-white, lower class, "criminal types." Individuals who commit sexual assault come from every racial, ethnic, socioeconomic, age, and social group. Similarly, victims come from every type of demographic group. It is also important to consider that sexual assaults are substantially underreported and often take place in domestic situations, where the perpetrator may not be Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

otherwise involved with the criminal justice system.

Myth 4: Women often make false reports of sexual assault. Women rarely make false reports of having been sexually assaulted. In fact, sexual assault is a highly underreported crime. Some estimates from victimization surveys indicate that only 5 to 10 per cent of sexual assaults are reported to police. In addition, the estimated rate of false accusation of sexual assault has been shown to be similar to the rate for other crimes, at 2 to 10 per cent (Lisak, Gardinier, Nicksa, & Cote, 2010).

Myth 5: You can tell a rapist by the way he looks. Individuals who commit sexual assault are not easily identifiable based on appearance. Some may appear friendly, normal, and non-threatening. Many are young, married, and have children.

Myth 6: Sexual assault usually occurs outside and at night. This myth is only partly true. While 43 per cent of sexual assaults were found to occur between 6 p.m. and midnight and 24 per cent were found to occur between midnight and 6 a.m., these assaults were not typically occurring out in public (Greenfeld, 1997). Indeed, most assaults (60 per cent) occur in a private home, with the largest percentage (38 per cent) occurring in the victim’s own home.

Myth 7: Sexual assault usually occurs between strangers. Despite the fear that dangerous men are lurking in bushes or dark alleys waiting for their potential victims, most sexual assaults are committed by someone known to the victim. This is especially true among university students (see Figure 17.6).

Myth 8: Sexual assault is an impulsive act of sexual gratification. Sexual assault is primarily an act of violence and is used as a way to obtain power over another person. Although a person may want to have sex, he or she has the ability to not act on such desires or motivations. A person’s suggestion to the contrary should be seen as more of a threat than an indication of desire or physical necessity (e.g., a man’s statement that he will be in great physical pain without having sex is as an invalid, coercive tactic).

Myth 9: If a victim didn’t physically fight back, she or he wasn’t really sexually assaulted. Different people respond to traumatic, life-threatening events in different ways. Some people may fight their assailant with all of their strength, whereas others may respond in a non-aggressive, seemingly passive manner. Whatever a person does to survive an assault should not reflect on the nature of the crime committed against him or her.

Myth 10: A person cannot be sexually assaulted by her or his intimate partner. Within an intimate relationship, each partner must give consent each time sexual relations occur, and each may choose to say “no” for any reason.

If one partner forces the other to have sex against her or his will, the act constitutes sexual assault. In addition, if a person changes her or his mind about having sex after first consenting, that person’s partner should stop.

Continuing with the sexual activity despite a partner’s protests, or using verbal or physical coercion to obtain sex, is non-consensual and is legally considered to be sexual assault.

Most countries offer their citizens the legal right to say “no” to sex with anyone, including a spouse or a partner.

Indeed, as noted previously in this chapter, sexual assault within a marriage has been illegal in Canada since 1983.

Yet marital rape does occur even where it is illegal, and an estimated 7 to 25 per cent of wives are raped at least once during their marriage (Russell, 1990).

5. Myth A dispelled: Men arrested for committing sexual assault report that they look for victims based on how easy it will be to commit the crime, not based on appearance.

Myth B dispelled: About 25 per cent of sexual assaults occur during the day and at least 60 per cent occur in private homes.

6. 1. Remind them that sexual assault is definitively against the law and police should be called.

2. Remind them they are not at fault; although a victim is not responsible for the sexual assault, he or she may be able to take control over what happens after the event.

3. If any medical care is needed, this should be obtained immediately; medical practitioners can also obtain evidence from the body and clothing that may be very important for a successful criminal prosecution of the assailant.

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Do not force a victim you know to take action; just provide emotional support.

7. 1. Young male syndrome: Young male syndrome refers to a route in which some individuals, usually young men, are willing to engage in risky, violent, and competitive behaviour in order to demonstrate their dominance and willingness to incur risks to attain goals. The incidence of their behaviour including sexual assault and other crimes, peaks in late adolescence and early adulthood and then desists when important life events (e.g., employment, marriage) occur in adulthood.

2. Competitive disadvantage: Competitive disadvantage describes a route in which some children begin life with neurodevelopmental insults (i.e., brain damage due to acute or chronic trauma) and are raised in disadvantaged environments (e.g., single-parent, poor, chaotic, and/or abusive households).

3. Psychopathy: Psychopaths show no signs of early neurodevelopmental perturbations.

8. The University of Calgary conducted a meta-analysis on the consequences of workplace sexual harassment. In this study, they found that not only were victims susceptible to decreased productivity, but their co-workers also showed decreased productivity as well as increased conflict among each other. This was seen as contributing to increased absenteeism, loss of staff through resignations or firings, and overall decreased job satisfaction.

Similarly, sexual harassment in schools can lead to students, not only previous victims, leaving school to avoid future harassment. Organizations can work to avoid such consequences by adopting clear anti-harassment policies and by acting quickly to resolve any complaints through a fair and thorough process. This will prevent future incidents of sexual harassment as well as stop a snowball effect of negative organizational consequences.

As a co-worker or as a student colleague, you should work to avoid exacerbating a problem–offer support to anyone who reports having experienced sexual harassment, but avoid participating in idle gossip or spreading rumours related to the incident.

9. Answers may vary. Sociocultural theories, based largely on feminist perspectives, suggest that gender inequality and sexism in society leads to sexual harassment. That is, sexual harassment occurs in various forms because of society's stereotypical view that males are dominant and superior to women. In turn, sexual harassment then contributes to maintaining gender stratifications by highlighting sex-role expectations. These gender stratifications occur at individual (e.g., among employees) and organizational levels. According to this theory, men and women are socialized to expect specific ways of interaction, with men as aggressive and dominant and women as passive and accepting.

According to organizational theory, sexual harassment occurs because of a wide range of organizational issues such as power and status inequalities. Similar to the sociocultural theory, the organizational theory suggests that power differentials within an organization affect the likelihood that sexual harassment will take place. however, the difference is that the focus of power differentials is not gender specific. Sexual harassment, which can be perpetrated by males or females, is often seen as an attempt to gain power within an organization. In addition to power differentials, organizational theory encompasses other contributing factors of sexual harassment, including permissiveness of the organizational climate, gendered occupations, and organizational ethics and norms.

A relatively recent and widely reported case that illustrates some of the key tenets of the organizational theory of sexual harassment is that of successful business executive and one-time Republican front-runner for US president Herman Cain. In late 2011, there were reports that Cain had sexually harassed several female employees during his tenure as CEO at the National Restaurant Association. In at least two of the cases, the women had previously settled civil suits with the association in exchange for their agreement to not discuss the allegations further. One of the women who publicly came forward reported that Cain had sexually assaulted her when she approached him for assistance in getting her job back at the association or finding a new job; when she questioned him about what he was doing, he replied, "You want a job, right?" Based on the allegations, this presents an apparent example of quid pro quo sexual harassment, in which an individual in a position of great authority attempted to use his power over this woman to gain sexual favours.

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Although the organizational theory helps to explain contextual factors of sexual harassment, it does not focus on the influence of individual differences in attitudes and beliefs. In contrast, the sex-role spillover theory attempts to integrate contextual characteristics and individual gender-based beliefs. The foundation of this theory is that men and women have pre-existing beliefs and gender-based expectations for how to behave in various settings (e.g., workplace, school), regardless of whether these beliefs and expectations are applicable to a particular setting. For example, a harasser may have the belief that a woman should not be in a position of managing others despite the organizational perspective that workers should be able to advance and be in leadership positions without regard to gender. As a result of this gap between the individual belief and the organizational perspective, conflict is likely to arise in which the harasser’s sex- role stereotypes are different from actual gender roles. Further, this would explain why some women in positions not traditionally held by women (e.g., high-ranking female military officers, female CEOs of large corporations) experience sexual harassment.

The natural/biological theory posits that sexual harassment signifies an expression of sexual attraction. According to this theory, because men have a stronger innate drive to be sexually aggressive and find a mate than do women, men who sexually harass women are simply using their power to try to maximize their chances of gaining sexual access and procreating. Thus, sexually aggressive behaviour may occur at work or in other inappropriate situations to increase these chances. Although this theory has a significant strength in acknowledging the impact of innate human instincts, there are several weaknesses. For example, sexual harassment in particular and sexual coercion in general are treated in very simplistic ways, with a lack of consideration of other individual and interpersonal factors. Also, proving the validity of this theory is difficult given that studies cannot be easily designed to test it.

The four-factor theory incorporates key components of the previously mentioned theories. According to this theory, there need to be four conditions present for sexual harassment to occur: (1) the person needs to be motivated to harass by any number of factors (e.g., power, sexual attraction), (2) the person must overcome cognitive inhibitions to not harass, (3) the person must overcome societal and cultural inhibitions to not harass (e.g., an organization’s anti-harassment policies), and (4) the person must overcome any resistance by the victim.

Relative to the single-factor theories, the four- factor theory has been better supported by empirical research findings. Therefore, it seems likely that a combination of individual, sociocultural, and organizational factors lead to sexual harassment.

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CHAPTER 18

Selling and Buying Sex MULTIPLE CHOICE QUESTIONS 1. Which of the following is technically not illegal in Canada? a) human trafficking b) operating or visiting an establishment where sex trade work takes place c) selling sexual services d) offering or seeking out sex in exchange for money 2. Approximately what percentage of American men admitted to paying for sex in a survey conducted in 2000? a) 1.8 per cent b) 4.2 per cent c) 6.2 per cent d) 10.8 per cent 3. Which of the following provides some Asian countries with nearly 14 per cent of their gross national product? a) Condom manufacturing b) Sex work c) Surrogate parenting d) Sex reassignment surgeries 4. Which term is used to describe the commercial enterprises that deal with buying and selling sex-related services? a) sex industry b) escort agency c) pornification d) all of the above 5. Which term is used to describe a company that sends out sex trade workers to off-site locations such as homes, hotels, and motels? a) escort agency b) sex industry c) pornification d) all of the above 6. Which term is used to describe the process of making or becoming more visibly or explicitly sexual? a) pornification b) sex industry c) escort agency d) all of the above 7. What form of sex trade work has been deemed the "new slave trade"? a) human trafficking b) pornification Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) sex tourism d) escort agencies 8. A term for people who work in the sex trade that is neither demoralizing nor glamorizing is __________. a) sex workers b) prostitutes c) call boys d) call girls 9. You're at a pub with some friends. The conversation veers from Canada's new prostitution laws to what counts as prostitution in the first place. You suggest that sex work is a much broader concept than a person accosting someone for sex on the street. You friend says, "Yeah, but technically __________ is not sex work." a) sleeping with your boss to get a promotion b) giving someone a blowjob so that they take you shopping c) sleeping with someone who took you out to a $200 dinner because you feel like you owe them d) All of the above situations are examples of sex work.

10. Melissa exchanges sex for money through an escort agency. The most appropriate term for her is __________. a) a prostitute b) a sexist worker c) a sex worker d) a whore 11. Which term refers to making sex work and activities related to it illegal? a) criminalization b) legalization c) abolition d) decriminalization 12. Which term refers to dealing with sex work by making it legal but subject to regulations? a) legalization b) criminalization c) abolition d) decriminalization 13. Which term refers to a legal option for dealing with sex work by allowing it and punishing those who exploit or coerce sex trade workers? a) abolition b) criminalization c) legalization d) decriminalization 14. Which term refers to a legal option for dealing with sex work by repealing all laws governing it? a) decriminalization b) criminalization c) abolition d) legalization

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15. According to a 2008 report, approximately what percentage of Canadians believes that the sex trade is immoral? a) 10 per cent b) 32 per cent c) 68 per cent d) 90 per cent 16. During what time period was the number of sex workers (SWs) decreased compared to earlier time periods? a) during World War I b) during the Victorian era c) during World War II d) during the first part of the nineteenth century 17. You are discussing sex work laws in class. Your classmate says, "Sex work is basically sexual abuse with remuneration. The law should go after the pimps, not sex workers, who are victims." You say, "So you're advocating to __________ sex work." "Yes, exactly!" a) abolish b) criminalize c) decriminalize d) legalize 18. You are discussing sex trade work law in class, specifically the difference between legalization and decriminalization. Your classmate says, "There are many countries around the world where SW is theoretically legal, but it's subject to so many restrictions that sex workers are still largely forced to the underground. But in __________, for example, SW has been decriminalized, not legalized, which makes it not a subject of criminal law at all, only of civil law." a) New Zealand b) Switzerland c) Netherlands d) all of the above 19. You're in class discussing Canada's new prostitution law and alternatives to it. Your classmate brings up the decriminalization of sex work in New Zealand and Australia, citing a study which shows that once SW is decriminalized, __________. a) customers may become more likely to request more unusual sexual services b) the number of sex workers increases c) customers may become more likely to negotiate the price of sexual services d) the income of sex workers increases 20. When sex work was decriminalized in Australia, what sexual activities seemed to increase, as noted by researchers? a) anal intercourse b) fringe sex (e.g., bondage) c) oral sex without condoms d) vaginal sex 21. Approximately what percentage of sex work takes place indoors (i.e., is not connected to "street walking"). a) 20 per cent Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) 40 per cent c) 60 per cent d) 80 per cent 22. Paul is a responsible adult who has sexual needs that are not being met in the traditional fashion of dating and meeting people. He believes that he should be able to purchase sex from another person and that this should be a legal choice between consenting adults. Which legal view of sex work does Paul have? a) decriminalization b) criminalization c) abolition d) legalization 23. Which form of sex work generally has the lowest status, earns the least, and faces the greatest risk of violence and ostracism? a) street-based sex workers b) sex workers in escort agencies c) exotic dancers d) brothel owners 24. What form of sex work has the highest status, earns the most, and works under the most secure conditions? a) sex workers in escort agencies b) exotic dancers c) street-based sex workers d) brothel owners 25. According to Shaver's 2011 assessment, most sex workers are not which of the following? a) educated b) young c) female d) addicted 26. Over drinks with the guys, your friend Jack brags that he's hired an escort and that she was amazing: she had a university degree, was very classy, rich, and self-confident. Jack believes she loves her job and he recommends escorts as high-quality alternative to relationships. Your friends wonder if escorts are indeed such a lucky bunch living the high life. You say, "Many studies will show you that the majority of female sex workers __________." a) have not completed high school b) have been physically or sexually abused in childhood, or both c) started that line of work because they needed money d) all of the above 27. Which category of sex workers is most likely to report enjoying sex? a) female SWs who give clients hand jobs b) transgender SWs who engage in receptive anal intercourse c) female SWs who provide oral sex d) female SWs who work with their clients expeditiously 28. Which type of sex worker is most likely to enjoy their work? a) a woman working in a licensed brothel in Australia Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) a woman working as a porn actor in Canada c) a bar-based sex trade worker d) a man working as a porn actor in Canada 29. Which of the following groups may be at greater risk for entering the sex trade for "survival"? a) homeless youth b) children in Central America, South America, and Asia c) non-heterosexually identified youth d) all of the above 30. Your friend Jack is of the opinion that prostitutes like their jobs and they picked them because they enjoy sex more than most women. He says, "I'm telling you, I read about this woman in Australia, who applied for a job in a legal brothel run by women after she was fired from her waitressing job, and she loved it!" You reply, "Funny, I read a study about female sex workers in those same legal brothels in Victoria. The results said that some of them enjoyed that work more than other jobs available to them, which __________." a) raises the question of what those other jobs available were, and if they had means to get more education and a more stable job than waitressing b) proves your point c) raises the question of how many women in unfulfilling dead-end jobs in other countries that don't have legal brothels would be much happier as sex workers d) none of the above 31. You are the most likely to do "survival" sex work as a teenager if you __________. a) come out to your family as gay and get rejected b) are a female from a middle-class family who likes good clothes c) are into risky sexual behaviour such as wet t-shirt contests or stripteases d) are into risky sexual behaviour such as BDSM 32. Why may SGD youth be at greatest risk for joining the sex trade? a) SGD teens cannot find gratifying sex by partnering with people from their schools. b) SGD teens are more likely to become homeless as a result of their family rejecting their sexual preference. c) People pay more for sex with SGD individuals than for heterosexual teens. d) SGD teens tend to be more open to different lifestyles than heterosexual teens.

33. In Canada, which group has the highest risk of acquiring HIV/AIDS as a sex worker? a) female SWs b) male SWs c) transwomen SWs d) transmen SWs 34. Approximately what percentage of female sex workers report being raped at least once during their career? a) 30 per cent b) 50 per cent c) 70 per cent d) 100 per cent 35. You meet your old friend Stacy at a party in your hometown. You used to be quite close until you moved away to go to university. She didn't go to college after high school. She's single and working a retail job for minimum Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

wage with no prospects of promotion. She feels like her life is going nowhere, with no chance of getting married or having a well-paying job. She confesses, "I'm actually thinking of escorting, you know? At least I'll have money, I'll look great, and men will want me." You say, "I guess it's an option, if you're OK with the fact that ________." a) 70 per cent of sex workers from a few different countries report having been raped since starting in this business b) the median income for sex workers is $30,000 per year c) the death rate among female sex workers is two times higher than among the general population d) all of the above 36. Which of the following is least likely to lead to emotional distress in a sex worker? a) the sex itself b) being harassed by police c) society's negative view of sex workers d) being harassed by clients 37. What is the main difference between the life of a male sex worker and the life of a female sex worker? a) the amount of money they earn b) the amount of violence they experience while working c) the sexual acts they perform d) how long they can remain working 38. In Canada, sex work is not legalized, and therefore not protected by labour codes. What is the result for sex workers because of this condition? a) Sex workers are not entitled to parental leave. b) Sex workers do not receive compensation for workplace injuries. c) Sex workers do not pay into or receive government pensions. d) all of the above 39. Which of the following problems is less prevalent for male sex workers than for females? a) violence b) economic conditions c) STI risk d) all of the above 40. What factors motivate men in the sex trade to advertise on the Internet? a) monetary benefits b) positive effects on the self c) sexual pleasure d) all of the above 41. You meet your old friend Farouk at a party in your hometown. You used to be quite close until you moved away to go to university. He didn't go to college after high school. He's gay, single, and working a retail job for minimum wage with no prospects of promotion. He feels like his life is going nowhere in this small town, and he's seriously considering moving to Toronto and working as an escort. You say, "I guess it's an option, considering that ________." a) male sex workers very rarely experience violence against them b) male sex work is now all on the Internet: you don't have to do the street or clubs c) it easier for males than females to find a different job after you're done with sex trade Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) all of the above 42. What benefits do male sex workers who advertise online experience compared to street-based workers? a) They can be selective about their clients. b) They charge higher fees. c) They have greater control over their work schedules. d) all of the above 43. Which term refers to a male sex worker who looks for customers on the street? a) street hustler b) bar hustler c) call boy d) kept boy 44. Which term refers to a male sex worker who looks for customers in a bar? a) bar hustler b) street hustler c) call boy d) kept boy 45. Which term refers to a male sex worker who either works for an escort agency or is self-employed as an escort? a) call boy b) street hustler c) kept boy d) bar hustler 46. Sylvio is a 23-year-old sex worker who is financially dependent on an older man, Peter, who receives sexual services from Sylvio in exchange. In the hierarchy of male sex workers, what is Sylvio? a) a bar hustler b) a kept boy c) a street hustler d) a call boy 47. Which of the following male trade workers have the lowest status and receive the lowest pay? a) street hustlers b) call boys c) kept boys d) bar hustlers 48. Which of the following sex workers would likely be paid the most? a) a male escort who advertises as being feminine b) an escort who advertises as being a male-to-female transgender c) a male who advertises as being masculine d) a female-to-male transgender escort 49. You catch up with your friend Jose, who has been working as an escort for a year. He tells you, "It's been quite all right, honestly. I meet guys online, all the money is handled by credit cards, pretty much like AirBnB, so it's Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

nice and civilized. Though, my ambition is still to move up to a ________, so I sleep with one guy all the time, have a steady paycheque, and don't have to keep looking for clients." a) street hustler b) bar hustler c) call boy d) kept boy 50. According to Weisburg's study, what is the most common reason that men become sex workers? a) money b) sex c) adventure d) delinquent lifestyle 51. What do most men report is their primary reason for visiting a strip club? a) to touch naked women b) to drink alcohol c) to have a sexual encounter d) to party with friends 52. An exotic dancer can earn the most money for having physical contact with a customer in which situation? a) when the club allows physical contact for a set price b) when the club has strict rules against physical contact c) when the club has private rooms for physical contact d) when physical contact must take place as a lap dance in a public area 53. Which term is used to describe dancing that involves the removal of most or all of one's clothing with the intent of creating erotic arousal in the viewer? a) exotic dancing b) pornification c) ballet d) sexually explicit material 54. Jennifer got a part of a stripper in a school theatre production. Even though it's a small part with only a few dance appearances, she wants to analyze a real-life dancer's role to better identify with it. What should she know about an exotic dancer's work? a) It's about creating an impression of being sexually and emotionally available. b) It's about mastering original pole-dancing techniques. c) It's about creating an impression of being rich and sexy. d) It's about being able to negotiate sex trade work off the club premises.

55. In addition to showing off physical attributes, what else influences exotic dancers financially? a) originality of their performance b) making connections with the audience c) making customers feel sexually desirable or special d) all of above 56. What do new exotic dancers report as a usually positive aspect of the work? a) money Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) flexible hours c) general enjoyment d) all of the above 57. After playing an exotic dancer in a school theatre production, to a huge applause, Jennifer feels beautiful and sexually empowered because she was attractive and desired on stage. She's considering a job in a strip club for the thrill and extra income for tuition. She puts her idea out on Reddit, and gets a response from a stripper with 10 years' experience: "It is thrilling at the beginning, but be aware that the longer you stay in it, the more you'll struggle with __________." a) a double life, or society's disapproval if you're open about your job b) aggressive, abusive patrons c) too much drinking, plus sleep deprivation d) all of the above 58. Which of the following techniques are methods exotic dancers use to manage the stress related to their work? a) setting personal rules b) distancing themselves by believing they are not like the others c) creating a "dancer persona" d) all of the above 59. Which of the following is NOT a negative cost of exotic dancing? a) the ease of keeping work completely separate from private lives b) effects of substance use and abuse c) strain on the body d) aggressiveness of abusive patrons 60. What is the best term for textual, visual, and audial material that specifically promotes or creates sexual arousal and shows enjoyment of sexuality in an equal and balanced manner toward people of either sex? a) Erotica b) Pornography c) Sexually explicit material d) Smut 61. What is the best term for textual, visual, and audial material that specifically promotes or creates sexual arousal and presents sexuality in an unequal, unbalanced, violent, or degrading manner toward people of either sex? a) erotica b) pornography c) sexually explicit material d) smut 62. Research has shown which of the following preference patterns towards viewing sexually explicit material? a) Both women and men are equally responsive to the sex of the actor but men prefer scenes where the actor can be objectified. b) Men are more responsive to the sex of the actor but women prefer scenes where the actors can be objectified. c) Women are more responsive to the sex of the actors and prefer scenes where actors can be objectified. d) Men are more responsive to the sex of the actors and prefer scenes where actors can be objectified

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63. Globally, which of the following is the third most profitable industry? a) sex tourism and human trafficking b) the trade of weapons c) the industry related to sexually explicit material d) the trade of illicit drugs 64. To spice up their relationship, Jenny and Tom are watching an erotic video together. In the video, the female and male actors meet by chance on a beach, are instantly mutually attracted, kiss passionately, give each other oral sex, and then the male penetrates the female vaginally. If Jenny and Tommy were a typical woman and man, what would they focus on in the video? a) Jenny would imagine how it would feel if she met a sexy, willing stranger on a beach. Tom would look at the female's body and focus on the action around genitals. b) Jenny would look at the male's body and focus on the penis. Tom would look at the female's body and focus on the vagina. c) Jenny would be aroused by the female but would try not to look at her. Tom would imagine how it would feel to meet a sexy, willing stranger on a beach. d) none of the above 65. The effect of viewing sexually explicit material (SEM) on a person's behaviour seems to be related to which of the following? a) whether the SEM portrays realistic or unrealistic events b) whether the viewer is male or female c) the interpretation of the viewer d) whether the material is consistent or inconsistent with the viewer's morality 66. According to Seto, Maric, and Barbaree, what do the results from studies examining the relationship between sexually explicit material and sexual assault indicate? a) Viewing sexually explicit material leads to an increase in the likelihood that someone will commit a sexual assault. b) Sexually explicit material involving children (child porn) is used by most people who commit sexual offenses against children. c) Sexually explicit material increases sexual aggression in men predisposed to sexual assault but not in other men. d) Sexually explicit material has no statistically significant positive or negative effects on people of any age.

67. Your friend Leigh needs your advice. She discovered in her boyfriend's browser history that he was watching porn. Although her boyfriend has been delicate and respectful in their sexual encounters so far, Leigh is now worried that he might show his true colours, becoming aggressive and demanding that they do what he watches in those videos. With your knowledge of the studies of sexually explicit material and adults, what can you tell her? a) Men who are not predisposed to sexual violence are unlikely to show any effects of pornography other than sexual permissiveness. b) Men who watch erotica don't show negative behaviours, but men who watch pornography gradually turn from respectful to sexually aggressive. c) Statistical studies demonstrate that consumption of sexually explicit materials causes sexual and moral harm to women. d) Consumption of sexually explicit material indicates inadequacies in the individual's sexual activity that he or she is trying to compensate for.

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68. A 2004 research study by Senn and Desmarais showed that women's moods were most positively affected by which of the following? a) viewing erotica with a friend or partner b) viewing non-violent pornography c) viewing violent pornography d) viewing erotica by themselves 69. Which of the following is a positive outcome associated with sexually explicit materials (SEM)? a) Viewing pornography tends to cause males to view women as equals. b) In the gay community, pornography helps promote safer sex practices. c) In countries where SEM is more readily available, there are lower sex crime rates. d) Viewing pornography increases the mood of severely depressed women.

70. According to research, at what age is it developmentally appropriate for adolescents to view sexually explicit material? a) 12 b) 14 c) 16 d) 18 71. Consuming pornography at a young age __________ the likelihood of perpetrating sexual assault. a) increases b) decreases c) doesn't affect d) has no proven effect on 72. Which of the following is true regarding sexually explicit material and sexual assault of children? a) Men who have a history of sexual assault against children who view SEM of children are more likely to reoffend. b) Men who have a history of sexual assault against children are less likely to have viewed sexually explicit material involving children than a random control group who have never committed an offence against children. c) Men who express an attraction towards sexual experiences with children are more likely to engage in sex with a child if they have seen sexually explicit material involving children than if they have not. d) Men who have a history of sexual assault against children view sexually explicit material related to children as frequently as men with no history of sexual assault against children.

73. When staying at your relatives' house for the Thanksgiving long weekend, you accidentally see your 14-year-old cousin Troy watch a video in which three men aggressively penetrate a woman. Given your knowledge of the research on the effects of SEM on youth, how could you best react? a) In a way that wouldn't embarrass Troy, try suggesting erotica instead. Tell him it's proven that watching violent pornography at a young age often results in sexually aggressive behaviour. b) Do nothing. Fourteen is the developmentally appropriate age for viewing SEM, and the only proven effect of pornography on youth is becoming more permissive. c) In a way that wouldn't embarrass Troy, talk to him about safe sex. Exposure to violent pornography at a young age often makes boys more permissive but not aggressive in sexual behaviours. d) Do nothing this time, but observe Troy over the weekend to see if he does it again. Only a fraction of youth aged 10 to 14 watch SEM intentionally, so he most likely just stumbled upon it by accident.

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74. Who is most likely to have seen sexually explicit material (SEM) on the Internet for the first time? a) David, who is 10 b) Elise, who is 11 c) Tristan, who is 12 d) Marcus, who is 13 75. What group reported having less real life sex as a result of watching sexually explicit material on the internet? a) heterosexual men b) gay men c) lesbian women d) heterosexual women 76. According to experts, the only case where a sex addiction is truly occurring is in which of these situations? a) where there is a need to increase the amount of SEM viewed in order to feel satisfied b) where the individual feels a sense of anxiety before viewing SEM and a sense of release and relief after viewing SEM c) where the person is deteriorating psychologically as a result of viewing SEM d) where the person has urges to view SEM 77. Which category of women did Polk and Cowan find is viewed most negatively by the public? a) sex workers b) women in general c) porn stars d) movie stars 78. On a night out with friends, the conversation drifts into watching online sexually explicit material. One male friend says watching porn is good for the relationship and encourages his female friends to watch it more to see the benefits for themselves. One of the females asks you for an informed opinion. You reply, "Well, the studies show that women who have watched porn often report ________." a) increased sexual self-confidence b) being more critical of their partner's bodies c) more interest in actual sex d) none of the above 79. After you moved out of your parents' house, there is no more family surprising you in your room or overhearing you from their bedroom next door. With this new freedom, you've been watching sexually explicit videos every evening after school and on the weekends. When you catch yourself thinking about those videos during a lecture and looking forward to going home and watching more, you start wondering if you're addicted.

What should you ask yourself to assess the problem? a) Do I feel a sense of relief while watching SEM? b) Does the fact that I'm watching it make me feel stressed out and unhappy? c) Do I feel like I'm losing control? d) all of the above 80. You're having dinner with your roommates in your shared kitchen, when another roommate comes to the table, sits down heavily and says, "I just had the biggest shocker of my life: my sister's been in two porn videos!

And she's planning to do more..." "You have a porn star sister!" says one friend, earning a look of exasperation.

Trying to defuse the situation, you say "Hey, look on the bright side! There is a study that shows that porn stars are Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

viewed more positively than _______." a) SWs b) virgins c) retail clerks d) gold diggers 81. Your friend's brother, Liam, who's exclusively gay, did a few sexually explicit amateur videos and got an offer of a contract for five longer films. The money isn't bad, and Liam is excited to enter the world he's been watching from the other side of the camera lens. Your friend is aghast at Liam's new idea and organizes an intervention with your roommates to dissuade him from signing the contract. Which of your roommates' arguments below is factual? a) You'll get an STI! STIs are common among porn actors. b) You'll have to have sex with women! Even if you sign for gay porn, you'll be contractually obliged to act in any configuration the director wants. c) You'll get so bored! Porn behind the scenes is shooting the same scene over and over again, sometimes with a guy you don't even like as a person. d) both A and C 82. When interviewed, how did more porn actors describe their job? a) disgusting b) fun c) boring d) satisfying 83. Positive effects are most likely to result from an individual viewing __________. a) erotica b) video pornography c) a stripper d) a pornographic magazine 84. Most street hustlers identify as __________. a) gay b) bisexual c) transsexual d) heterosexual 85. When compared to women university students that did not dance, which of the following findings did women exotic dancers NOT exhibit? a) Women exotic dancers scored higher on measures of sexual permissiveness. b) Women exotic dancers scored lower on measures of birth control use. c) Women exotic dancers scored lower on measures of sexual communication. d) Women exotic dancers scored lower on measures of self-esteem.

86. In a nationally representative American survey of 2,021 adults, the most common social experience relating to sexuality over the lifespan for both men and women was which activity? a) attending a strip club b) hiring a SW c) engaging in public nudity Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) going to a brothel 87. The current Canadian law around sex work is largely based on which of the following legal options? a) criminalization b) abolition c) legalization d) decriminalization 88. ________ is textual, visual, and audial material that promotes or creates sexual arousal and presents sexuality in an unequal, unbalanced, violent, or degrading manner toward certain people based on gender/sex. a) Pornography b) Erotica c) Sex work d) Stripping 89. Couples who watch SEM together may find it easier to ________. a) recognize that they have different sexual interests and break up b) discuss sexual acts, and to break up their "routine" sex lives c) create arguments in favour of sex work d) find new positions they like 90. In what way did SEM affect young boys and young girls differently? a) Young boys and girls viewed SEM in the exact same way. b) Young boys were more scared by SEM then did girls were. c) Adolescent boys perceived SEM as more realistic than teen girls did. d) Adolescent girls perceived SEM as more realistic than teen boys did.

SHORT ANSWER QUESTIONS 1. Those who see the buying and selling of sex as a personal choice between consenting adults are in favour of __________ of sex work.

2. Youth of all sexual preferences who are __________ are at the greatest risk of entering the sex trade.

3. In terms of ethnicity, __________ women are disproportionately found in sex work and also report higher rates of childhood abuse.

4. In terms of gender, __________ sex workers are least likely to experience violence against them.

5. Most exotic dancers distance themselves from work by creating a different __________ that they use on stage.

6. Both erotica and pornography are types of __________ __________ __________.

7. Viewing sexually explicit material is developmentally appropriate starting at about age __________.

8. Heavier users of __________ have politically liberal views, making them more receptive to feminist thinking.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

9. According to Levine, a diagnosis of sex addiction is limited to those who experience __________ __________ as a result of their behaviour.

10. A __________ __________ is supported by his sugar daddy.

11. Maggie is concerned about street-based prostitution and underage trade workers in her community. She is most likely to advocate for the __________ of sex work.

12. The __________ of sex work would make sex work legal with no regulations.

13. A(n) __________ sex worker may feel unsafe compared to other SWs because of harassment from police and members of the public.

14. Among male sex workers, __________ __________ have the lowest social status.

15. Sophie works in the sex trade and finds her work enjoyable and sometimes has spiritual experiences when she is working. Sophie is most like a(n) __________ __________.

16. Sexual material that shows equal enjoyment of sexuality among men and women is referred to as __________.

17. Sexual material that is degrading to women or men would be classified as __________.

18. A Dutch study found that for men, increased consumption of sexually explicit material on the internet was associated with their greater dissatisfaction with the appearance of their __________.

19. Being a "porn star" isn't actually that great because most porn actors find the work __________.

20. A company that sends sex workers to clients at off-site locations such as homes, hotels, and motels is call a(n) ________ ________.

ESSAY QUESTIONS 1. Differentiate between the legalization of sex trade work and decriminalization. What impact might this have on sex trade workers?

2. Describe the four potential legal options for dealing with sex trade workers in Canada. Outline the arguments in favour of each option.

3. Explain four reasons why male sex trade workers are less often victims of violence than females sex trade workers.

4. How do the views of exotic dancers who are new to exotic dancing differ from the views of more experienced exotic dancers?

5. Differentiate between erotica and pornography. What concern might there be with the proliferation of Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

pornography?

6. Describe the situations in which sexually explicit material seems to have a positive outcome for adults versus those in which it seems to have a negative outcome for adults.

7. Should sexually explicit themes be allowed on television? How does this compare to violence on television?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. c 2. b 3. b 4. a 5. a 6. a 7. a 8. a 9. d 10. c 11. a 12. a 13. a 14. a 15. c 16. c 17. a 18. a 19. a 20. b 21. d 22. a 23. a 24. a 25. a 26. d 27. b 28. a 29. a 30. a

31. a 32. b 33. c 34. c 35. a 36. a 37. b 38. d 39. a 40. d 41. a 42. d 43. a 44. a 45. a 46. b 47. a 48. c 49. d 50. a 51. c 52. b 53. a 54. a 55. d 56. d 57. d 58. d 59. a 60. a

61. b 62. d 63. c 64. a 65. c 66. c 67. a 68. a 69. c 70. b 71. a 72. b 73. a 74. d 75. d 76. c 77. a 78. d 79. d 80. a 81. d 82. c 83. a 84. d 85. d 86. a 87. b 88. a 89. b 90. c

SHORT ANSWER QUESTIONS 1. decriminalization 2. homeless 3. Indigenous 4. male 5. persona 6. sexually explicit material 7. 14

8. erotica 9. psychological deterioration 10. kept boy 11. criminalization 12. abolition 13. transgender 14. street hustlers

15. exotic dancer 16. erotica 17. pornography 18. stomachs 19. boring 20. escort agency

ESSAY QUESTIONS 1. The legalization of STW is a legal option for dealing with sex trade work by making it legal but subject to regulations. The decriminalization of STW is a legal option for dealing with sex trade work by repealing all laws governing it. Legalizing STW might lead to laws that protect STWs and legitimize the practice. STWs may also Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

then be eligible for benefits such as health care, workers' rights, and pensions. Decriminalizing sex work merely removes laws and provides no guidance on other aspects.

2. 1. Criminalization: will help eliminate street based prostitution and underage STWs 2. Legalization (regulation): believe that rules about licensing, medical exams, zoning and registering brothels would be a benefit to both STWs and society 3. Abolition: punishes those who exploit, coerce, or harm STWs 4. Decriminalization: preferred by those who see the buying and selling of sex as a personal choice between consenting adults. The intent is to affirm STWs and provide them a legitimate place in society.

3. First, customers are more likely to perceive male STWs as better able to defend themselves compared to female STWs. Second, customers who seek out male STWs—most of whom are gay or bisexual men, but also women and men who do not define as gay or bisexual—may be less likely to engage in violent behaviour. In particular, most gay men are less physically aggressive than are most heterosexual men; perhaps this is the case because when men become comfortable sexualizing other men, as most gay men have, it becomes incompatible for them to aggress against other men.

Third, women have a lower status in society compared to men.

Fourth, because male STWs are generally not stigmatized or marginalized to the degree that female STWs are, and because they are particularly not stigmatized within the gay community, they may be less likely to be targeted for victimization.

4. Dancers new to their work talk about the positive aspects, such as the money, flexible hours, and general enjoyment. Some dancers describe their time on stage as spiritual, and Barton and Hardesty (2010) interpret this as a time when dancers are in "flow," a term used to describe something akin to a peak experience.

After a few years, however, many dancers begin to focus on the costs of their work, such as the effects of substance use and abuse, strain on the body, and the aggressiveness of some abusive patrons (Barton, 2007).

Some dancers also report that their work interferes with their private lives. Indeed, many young dancers who hide their occupation from family and friends report feeling the strain of leading a "double life."

5. Definitions of sexually explicit material (SEM) vary, depending on an individual's or group's views on sex and sexuality. Some feminists distinguish between erotic SEM and SEM that is violent and/or degrading to women (Garos, Beggan, Kluck, & Easton, 2004). The word erotica refers to sexual material that shows equal enjoyment of sexuality in both men and women, and the word pornography refers to sexual material that presents sexuality in a manner that is unequal, unbalanced, violent, or degrading toward men or women. Most sexually explicit videos today would fall more into the category of erotica rather than pornography. Pornography may increase the risk of developing sexually deviant tendencies, committing sexual offences, developing problems in one's intimate relationships, and accepting rape myths.

6. Negative outcomes associated with SEM: 1. Exposure to pornography is associated with an increased risk of developing sexually deviant tendencies, committing sexual offences, developing problems in one's intimate relationships, and accepting rape myths.

2. Some viewers experience distorted perceptions of sexuality, devaluation of marriage and monogamy, and increased aggression.

3. Promotes hyper-masculine views of gay men and promotes unsafe, unrealistic sex practices as "real."

4. Violent pornography may be linked to negative outcomes for people predisposed to aggression.

Positive outcomes Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

1. Women show elevated moods after viewing erotica.

2. People who view erotica have a more positive view of women in general.

3. Access to SEM is linked to a reduction in sex crime rates.

7. Some people advocate that there should be less violence on television and that rules about erotica on television may be too strict. Studies indicate that exposure to erotica on TV has no effect except to create a more open opinion towards sex in an individual, which could be considered healthy. Studies have shown that violence on television is positively correlated with violent action. It seems that research indicates a more positive societal outcome from erotica on television than from violence.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

CHAPTER 19

Sexual Health Education in Canada MULTIPLE CHOICE QUESTIONS 1. What are the main goal(s) of sexual health education in Canada? a) promoting positive outcomes and preventing negative sexual health outcomes b) describing sex research from research from the fields of education, health promotion, medicine, nursing, psychology, and social work c) preventing teen pregnancy and preventing STIs in all Canadians d) providing Canadians with information about the physical aspects of sex including birth control, STI prevention, pregnancy, and menopause 2. What do most government policies on sexual health tend to emphasize? a) reducing negative health outcomes b) enriching sexual experiences c) promoting positive indicators of sexual health d) reducing barriers to access 3. Which of the following is an example of an emotional motivation that may need to be addressed in order for the person to make a healthy decision about their sexual behaviour? a) I don't feel comfortable talking about condom use with my partner. b) I don't like the way condoms feel when I use them. c) None of my friends use condoms, so I don't want to use them. d) Condoms are expensive.

4. Which of the following is an example of a social motivation that will help promote healthy sexual choices? a) I feel comfortable talking about birth control with my partner. b) I feel more like an adult when I use oral contraceptives. c) All of my friends use condoms for oral sex and intercourse. d) I engage in sexual activities for social acceptance.

5. Which of the following is a behavioural skill that may be taught in a sex education class? a) learning how to talk to a partner about condom use b) learning how pregnancy happens c) learning the names of sexually transmitted infections d) learning about the reasons to use condoms 6. The information that oral contraception will not prevent sexually transmitted diseases of the mouth or genitals may help someone with which of the following motivations choose a more positive behaviour? a) I don't want to use condoms because I take oral contraception, which prevents pregnancy, and my partner and I have both tested negative for STIs and are monogamous. b) I don't like to use a condom when engaging in oral sex. c) All of my friends use oral contraception to prevent pregnancy. d) I don't know how to talk to my partner about using condoms.

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

7. Which of the following is a component of the information-motivation-behavioural skills (IMB) model for effective program development and evaluation? a) Determine the sexual health needs of the target population through research. b) Design a program to meet the needs of the target population. c) Evaluate the program. d) all of the above 8. The information-motivation-behavioural skills (IMB) model specifies that sexual health behaviours are initiated and maintained by three factors. Which of the following is NOT one of these factors? a) information about the teacher or health care provider delivering sexual health messaging b) behavioural skills enabling someone to engage in sexual health behaviour c) motivation to apply knowledge in order to maintain sexual health d) information or knowledge about the behaviour 9. Recent research in the US among teens aged 15 to 19 indicated that abstinence-only sexual health education will have similar outcomes to which of the following? a) no sexual health education b) comprehensive sexual health education c) inclusive sexual health education d) pregnancy-only sexual health education 10. Which of the following is a characteristic of an effective sexual health education program? a) Educators/leaders are carefully selected, participate in training, and believe in the curriculum they are teaching. b) Support from a school and/or other relevant stakeholders is required. c) The program's behavioural goals, teaching methods, and materials are geared to its audience, taking into account factors such as age, culture, and sexual experience of the participant. d) all of the above 11. What is one possible problem with an "abstinence only" approach to sexual health education? a) The programs discriminate against SGD individuals by emphasizing sex as only appropriate in the context of a heterosexual marriage. b) The programs do not explore positive sexual outcomes. c) The programs have been shown to be effective at preventing teen pregnancy but not at preventing STIs. d) The programs ignore negative sexual outcomes.

12. When researchers looked at the incidence of STIs in teenagers who were educated in an abstinence-only SHE program, how did the results compare to those from teenagers who had comprehensive SHE or no SHE? a) Teens in the abstinence-only group had lower pregnancy and STI rates than the no SHE group but higher STI and pregnancy rates than the comprehensive SHE group. b) Teens in the abstinence-only group had lower STI and pregnancy rates than both the comprehensive sex education group and the no sex education group. c) Teens in the abstinence-only group had the same rate of STIs and pregnancy as teens in the no SHE group. d) Teens in the abstinence-only group had higher STI and pregnancy rates than both the comprehensive SHE group and the no SHE group.

13. The breadth and depth of school-based SHE programs is determined at what level? a) school level b) municipal level Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) provincial level d) federal level 14. A high school sex educator has students role-play buying condoms at the pharmacy. Which characteristic of effective SHE does this activity best represent? a) activities related to sexual communication b) activities related to the social environment c) activities related to the active application of knowledge d) having a clear message 15. Students in Ms. Aiken's Grade 7 sex education class are given a sexual health resources scavenger hunt as an activity. Students work in pairs to locate a free birth control clinic, a nurse hotline, a crisis helpline, and the names of three stores in the community where they could purchase condoms. What characteristic of effective education does this activity best represent? a) activities related to sexual communication b) activities related to the social environment c) activities related to the active application of knowledge d) basic information 16. The following example best describes which characteristic of effective SHE programming? "If the program message is that teens should use condoms every time they have sex, it should not only explore the pros and cons of engaging in unprotected sexual activity but unambiguously emphasize that unprotected sex is a negative and risky choice." a) clear message b) basic information c) theoretical foundation d) activities related to active application of knowledge 17. Which of the following activities would be an effective part of a SHE program? a) having students locate an STI clinic in their local community b) having students role-play a scenario where they talk about using a condom c) having students discuss "embarrassing" actions related to sexual health, like buying condoms d) all of the above 18. You are designing a sexual health education program, and the message you want to emphasize is preventing unintended pregnancy and STIs. Which of the following would be the LEAST effective way to convey this message? a) describing all the possible methods of contraception b) discussing the reasons for wanting to protect oneself during sexual activity c) focussing on just a few key methods of contraception, such as condoms d) All of the above would be equally effective.

19. The following example best describes which characteristic of effective SHE programming? "Students could engage in small group discussions or exercises outside of class, such as locating sexual health services in their community." a) activities related to active application of knowledge b) basic information c) theoretical foundation Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) appropriate program length 20. The following example best describes which characteristic of effective sexual health programming?

"Activities could address the social barrier of feeling embarrassed about buying condoms, the social pressure from a partner to engage in sexual activity, and the social norm that 'unprotected sex is not such a big deal.'" a) activities related to social environment b) activities related to sexual communication c) knowledgeable and motivated educators d) basic information 21. Which of the following of the 10 characteristics of effective sexual health education programs is being described in the following scenario? As part of her sexual education course, Cindy is asking her students to rehearse a short script where they can practice saying "no" to engaging in sexual activity with their partner. a) activities related to sexual communication b) activities related to social environment c) activities related to active application of knowledge d) clear message 22. Which of the following of the 10 characteristics of effective sexual health education programs is being described in the following scenario? Darshit is teaching a sexual education course this semester. Part of his goal for the class is to increase condom use amongst his students. a) specific behaviour target b) clear message c) basic information d) theoretical foundations 23. Which of the following of the 10 characteristics of effective sexual health education programs is being described in the following scenario? Frida teaches sexual education in a school where many of the students come from low-income families, and she is taking this into consideration as she plans out the course. a) appropriate content and teaching methods b) knowledgeable and motivated educators c) clear message d) appropriate program length 24. You are a sex researcher hoping to evaluate the state of sexual health education across Canada. Which of the following factors should you consider to make sure your study will be an effective and useful study for examining sexuality in Canadian youth? a) Ensure that you have a nationally representative sample of Canadian youth. b) Disregard all earlier versions of surveys done in Canada. c) Create a study that will follow participants for enough years following the sexual education program that you can gather useful data. d) none of the above 25. What was the name of one of the comprehensive school-based sexual health education programs conducted in Ontario that is reviewed in this textbook? a) Boy Meets Girl b) Girl Meets Boy c) Boy Time Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

d) Girl Time 26. A survey of students in Grades 7, 9, and 11 was conducted in 2002. What is one example of a piece of information researchers determined may need to be covered more thoroughly in sex education classes as a result of this survey? a) You can become pregnant the first time you have sexual intercourse. b) There is a vaccine for HIV/AIDS. c) They are able to take oral contraceptives. d) People with STIs might not have symptoms.

27. The Canadian Youth, Sexual Health, and HIV/AIDS Study (CYSHHAS) looked at knowledge about transmission, diagnosis, and treatment of STIs in grade 7,9, and 11 students in schools across Canada (Boyce et. al., 2003). In regards to STIs, the students who took the survey in 2002 compared to students who took the same survey in 1989 appeared to be __________. a) less knowledgeable b) somewhat more knowledgeable c) equally knowledgeable d) extremely knowledgeable 28. Some studies indicate that sexual health intervention programs such as Girl Time had little effect on changing attitudes and behaviours related to sexual health. They suggest that this results from scores on certain motivation outcome measures that were already high before the intervention (for example, participants already had strong intent to use contraception during sexual activity). What effect is this known as? a) ceiling effect b) placebo effect c) randomized control effect d) maximizing effect 29. According to a 2003 survey, which group was least likely to respond that it is alright to masturbate? a) females in Grade 9 b) females in Grade 11 c) males in Grade 9 d) males in Grade 11 30. Which of the following differences did researchers find when they compared data from teens in 1989 to data from teens in 2002? a) a decrease in the number of sexual partners b) an increase in teen pregnancy rates c) a decrease in STI rates d) a decrease in the age of first intercourse 31. According to a survey conducted in 2002, which of the following teens was LEAST likely to have used a condom the last time they had intercourse? a) Abby, who is 15 b) Janelle, who is 16 c) Heba, who is 17 d) Dasha, who is 18

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

32. Tabitha and Eshan are both in tenth grade and have been dating for a while. They recently had sexual intercourse, but did not use a condom. Which of the following reasons would they most likely give as to why they did not use a condom? a) "We weren't expecting to have sex." b) "Wearing a condom just doesn't feel as good as not wearing one." c) "None of our friends use condoms." d) "We're too embarrassed to buy condoms."

33. Helena, a Grade 11 student, has been dating her boyfriend for a year now, and they've decided they want to have sex together. From which of the following sources is Helena most likely to get information from about the risk of pregnancy? a) school b) her parents c) her friends d) the Internet 34. Based on a comparison of data from 1989 and 2002, which area of sexual health education was in need of improving in 2002? a) information about pregnancy b) information about sexually transmitted infections c) information about monogamy d) information about alternatives to sexual intercourse for younger teens 35. Khalil is in Grade 11 and admits to not using a condom the last time he had intercourse. What is the most likely reason Khalil gave for not having used a condom? a) not expecting to engage in sexual activity b) not knowing how to put on a condom c) knowing his partner's sexual history d) not being old enough to engage in sexual activity 36. Amy is in Grade 11 in Saskatchewan. If given the choice between sources of information about pregnancy, which would Amy most likely rank as her most preferred source? a) parents b) friends c) school d) personal experience 37. When researchers did a meta-analysis to see what impact talking about sexual behaviour had on actual sexual behaviour in teens, what did researchers find? a) Teens who had comprehensive SHE were more likely to have intercourse before age 18 than teens who did not have any SHE. b) Teens in abstinence-only programs had intercourse significantly later than teens who were in comprehensive SHE programs or teens who received no sex education. c) Teens who had SHE that included a discussion of intercourse were less likely to have penetrative intercourse than teens who did not receive SHE. d) Teens who did not receive SHE were least likely to have sexual intercourse before the age of 18.

38. Gregory and Khalil, both Grade 9 students, have been dating for several months and have decided they are Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

ready to take their relationship to the next level. From which of the following sources are they most likely to get information from about the risk of STIs? a) school b) their parents c) their friends d) the Internet 39. In the Canadian Youth, Sexual Health, and HIV/AIDS Study (CYSHHAS), why did teens report that parents were not rated as a preferred source of information about sex? a) Teens were uncomfortable talking with parents about sex. b) Parents are generally not knowledgeable about sex. c) Teens preferred to talk to religious leaders instead. d) all of the above 40. With regard to influencing sexual behaviours among teens, which group is most responsible for perceived norms for sexual activity that are closely tied to one's social environment? a) peers b) parents c) teachers d) religious leaders 41. Which of the following contributes to the success of peer-to-peer SHE programs? a) Youth seek approval from their peers. b) Many youth feel more comfortable receiving information from peers. c) Youth often consider information from a peer who has recently dealt with a sexual issue as more credible than similar information delivered by adults. d) all of the above 42. Which of the following is true about teens discussing sexual issues with their parents? a) Both males and females are comfortable talking to the opposite-sex parents about sex. b) Three-quarters of females in Grade 11 are comfortable talking to their mothers about sex. c) Females are more comfortable talking about sex with their mothers. d) Half of males in Grade 11 are comfortable talking to their fathers about sex.

43. Which of the following best describes what is true about the influence of peers on a teen's choices about sexual activity? a) Teens are more likely to have sex if they know for a fact their peers are having sex, but are not influenced by simply suspecting their peers are having sex. b) Teens are influenced by whether or not they believe their peers are having sex regardless of whether their peers are actually having sex. c) Female teens are more likely to have sex if they know their peers are having sex, males are not affected by peer behaviour. d) Male teens are more likely to have sex if they know their peers are having sex, females are not affected by peer behaviour.

44. Which of the following questions is a youth most likely to hear during a sexual encounter in mainstream North American media? a) "How many sexual partners have you had?"

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) "Have you been tested for STIs?" c) "What method of contraception should we use?" d) none of the above 45. Canadian youth receive influential information about sexuality from popular media sources like the Internet, TV, movies, magazines, books, and songs. What impact do shows like Riverdale, which frequently depict poorly supervised high school students staying out late socializing, drinking, and engaging in various sexual behaviours without any negotiations of safe sex, have on youth? a) It gives them faulty beliefs about what is "normal" sexual behaviour. b) These shows do not impact young people's belief systems. c) It reinforces content typically depicted in school-based sex education programs. d) It provides guidance on the best means to communicate with sexual partners.

46. A longitudinal study of 13- to 17-year-olds in eastern Canada found that 84 per cent of males and 46 per cent of females had viewed Internet pornography. Other research argues that Internet pornography may be more influential on the development of youth sexuality than any other type of media. Given this rate of online pornography usage, why are no available statistics on the impact of pornography on youth sexual behaviour and expectations recorded? a) ethical constraints b) poor sampling c) few appropriate statistical models d) all of the above 47. Why do researchers know so little about the influence of Internet pornography on teens? a) Parental controls prevent researchers from studying a representative sample of teens who have viewed pornography. b) Teens aren't interested in Internet pornography because the actors are typically much older than they are. c) There are many ethical and legal problems related to conducting experiments that involve showing pornography to people under 18. d) It is very difficult to distinguish the influence of mainstream media (e.g., television) from the influence of pornography.

48. Why is it important to discuss media literacy with teens? a) Teens are bombarded with media messages about their sexuality and it can have a negative impact. b) The Internet has a large amount of false information. c) The Internet is a valuable source for experimentation and self-definition for the SGD youth community. d) all of the above 49. Carson is in Grade 11 and is finding he is attracted to both men and women, although he's not sure if he would prefer to date only one or the other. Which of the following is Carson most likely to get information from to explore his sexuality? a) the Internet b) television shows c) school d) his friends 50. Which of the following have researchers inferred about the influence of pornography on teens based on the influence of pornography on adults?

Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

a) Viewing pornography is related to both males and females having a more negative view of their own bodies. b) Viewing pornography results in males having a more positive view of females, but females having a more negative view of themselves. c) Viewing pornography results in both males and females having a more positive view of their own sexual performance. d) Viewing pornography has no influence on males but negatively affects females' views of themselves.

51. Current media portrayals of sexual situations involving teenagers are most likely to exclude which of the following groups? a) lesbian women b) gay men c) bisexual, asexual, and intersex individuals d) all non-heterosexual groups 52. Who represents the primary opposition to comprehensive and inclusive SHE in Canada? a) religious groups b) parents c) teens d) women 53. When Canadian schools exclude sexual orientation from their SHE classes, what are they doing? a) They are exercising their right to free speech. b) They are following what research suggests is "best." c) They are violating the sexual rights of all who take their classes. d) They are ignoring public opinion.

54. Young Canadians who have access to visual media and the Internet will likely be exposed to sexual content.

Whether purposefully or, more often, passively, the media is educating young people about sex, and it is not always in a positive, informative, and unbiased way. What is the best strategy for teens and those who care for them to lessen the negative impact of sex-related messages from the media? a) Increase media literacy among youth. b) Attempt to restrict all access to online materials that might be sexually suggestive. c) Inform young people of the negative consequences of all media. d) Restrict what content is broadcast in public space.

55. When making decisions regarding the sexual health education curriculum, what do politicians frequently value most? a) public opinion b) research findings c) evidence-based practice d) comprehensive assessments 56. Bastian is a homosexual attending a Catholic school in Ontario. Which of the following scenarios is he most likely to face? a) Sexual health will be discussed in a manner that is consistent with religious values regarding sexuality b) His peers will all be homophobic. c) The sexual education program will be similar to a public school, following the provincial curriculum. d) He will be bullied.

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57. Which of the following high school students is most likely to have engaged in sexual intercourse? a) Aabish, a ninth grader who identifies as Muslim b) Kinga, a twelfth grader who immigrated from Poland c) Freddie, a tenth grader who identifies as homosexual d) Carlotta, an eleventh grader from a wealthy background 58. Which of the following high school students is LEAST likely to have engaged in sexual intercourse? a) Aabish, a ninth grader who identifies as Muslim b) Kinga, a twelfth grader who immigrated from Poland c) Freddie, a tenth grader who identifies as homosexual d) Carlotta, an eleventh grader from a wealthy background 59. The exclusion of topics in public SHE related to non-heterosexual sexual orientations and gender identities can be considered __________. a) a violation of sexual rights for access to relevant and comprehensive SHE b) a violation of moral rights, as access should be based on the dominant moral codes of a culture c) a violation of cultural norms that dictate the accepted practices within a certain time period d) a violation of legal rights, because federal legislation requires fully comprehensive SHE to be taught in all Canadian schools 60. In which province are denominational school rights, that is, the constitutional right to separate public school boards, NOT currently applicable? a) Saskatchewan b) Ontario c) Alberta d) Quebec 61. Which of the following variables was found to significantly affect teen sexual behaviour by the researchers who conducted the Toronto Teen Survey? a) gender b) race c) religion/ethnicity d) neighbourhood 62. Which of the following trends is seen in teens who identified as SGD and completed the Toronto Teen Survey compared to heterosexual teens? a) They were two times more likely to have had sexual intercourse as heterosexual teens. b) They were three times more likely to have had sexual intercourse as heterosexual teens. c) They were half as likely to have had sexual intercourse as heterosexual teens. d) They were one-third less likely to have had sexual intercourse as heterosexual teens.

63. Researchers believe that teens who identify as SGD may have different patterns of sexual activity than their heterosexual counterparts for which of the following reasons? a) They are more likely to have sexual intercourse with the opposite sex to "test" whether they are really SGD. b) They are alienated by heterosexist SHE and thus messages from SHE in school do not influence their behaviour. c) Sexuality is more central to the personal identity of a SGD teen and so sexual activity is more likely.

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d) Teens who are SGD are less likely to have sexual intercourse because they are not attracted to the opposite sex and are not ready to "come out" during their teen years.

64. A survey of 3700 teens found that, daily or weekly, 10 per cent of SGD teens heard homophobic remarks from whom? a) peers b) media c) teachers d) their parents 65. Individuals who identified as LGBTQ+ in the Toronto Teen Survey were more than twice as likely as youth identifying as heterosexual to have engaged in intercourse. What is the best explanation for this finding? a) Sexual health education often excludes sexual and gender minorities, leaving them without the information they need to explore their own sexuality in a healthy way. b) Sexual and gender minorities are pre-dispositioned to be more promiscuous than their counterparts. c) Sexual health education overemphasizes the experiences of sexual and gender minorities, thus exposing them to more diverse sexual behaviours. d) Inclusive sexual health education has led to an increase in sexual behaviours among sexual and gender minorities.

66. Given the prevalence of homophobic, transphobic, and heterosexist societies, gender and sexual minority youth are found to experience higher rates of which of the following? a) risk of suicide b) homelessness/street involvement c) physical violence d) all of the above 67. Immigrant youth sometimes face intergenerational challenges when they are exposed to Canadian-based sexual health education. What is this most likely attributed to? a) acculturation b) lack of knowledge c) cultural sensitivity d) diversity training 68. Which group of young Canadians is least likely to have received SHE? a) East and Southeast Asian youth b) black youth c) white youth d) South Asian youth 69. Which of the following groups may experience barriers to accessing SHE in Canada? a) new immigrants b) Indigenous people c) street youth d) all of the above 70. Which of the following is an essential element in deciding the course of SHE for Indigenous people? a) self-determination Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) multi-language presentation c) adopting culturally sensitive conservatism d) continuing Indigenous customs 71. Members of which group are up to 30 times more likely to have chlamydia than other teens? a) Indigenous youth b) black youth c) street youth d) Catholic youth 72. The best way for Canada to support and inform populations that lack access to important and personally relevant SHE is to establish comprehensive sexual health programs based on what? a) cultural awareness b) inclusivity c) acceptance of diverse attitudes toward sexuality d) all of the above 73. Why is it important to make SHE available to older adults? a) They are less likely to have had access to the types of sex education programs and initiatives currently available when they were growing up. b) There tends to be fewer sexual health resources specifically aimed at older adults. c) Some of the negative sexual outcomes that are of greatest concern for today's population, such as HIV/AIDS, did not pose as great a health risk when older adults were acquiring knowledge and developing attitudes and beliefs about sexual health. d) all of the above 74. Members of which group are least likely to have used a condom during their last sexual encounter? a) street youth who are sex workers b) heterosexual teens aged 14 to 16 c) heterosexual adults over the age of 50 in a non-committed relationship d) heterosexual teens aged 15 to 17 75. Doris is a 69-year-old female. Which of the following barriers to sexual health might she experience? a) a lack of privacy b) increased rates of STI infection c) a lack of interest in sexual activity d) all of the above 76. What is a consequence of withholding SHE from people with intellectual disabilities? a) It violates their rights as Canadians. b) It results in people with intellectual disabilities being less likely to have negative sexual outcomes. c) It results in people with intellectual disabilities being perceived as either childlike or sex-crazed. d) It is a necessary consequence of changing the laws regarding forced sterilization (eugenics).

77. When developing a SHE program for people with intellectual disabilities, which of the following would be most important if the goal is to promote positive sexual outcomes? a) using concrete examples that are relevant to the person's life b) using the same teaching methods that are used in comprehensive sexual education classes in most high schools Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

c) limiting the information provided to that which they need to know to stay safe d) providing comprehensive information about STIs 78. Which of the following is true about people with mild intellectual disabilities? a) They are less likely to engage in sexual activities than the rest of the population and are less likely to acquire an STI. b) They are more likely to engage in sexual activities than the rest of the population and are more likely to acquire an STI. c) They are equally likely to engage in sexual activities as the rest of the population and are equally likely to acquire an STI. d) They are equally likely to engage in sexual activities as the rest of the population and are more likely to acquire an STI. 79. Which of the following is a major issue for many people with physical disabilities? a) coping with asexuality b) coping with the lack of physical capacity for sexual activity c) coping with limited access to privacy and intimate relationships d) coping with low sexual desire 80. Compared to random samples of people, individuals with physical disabilities reported what level of sexual needs? a) higher b) lower c) equal d) much lower 81. Which of the following is NOT a systemic barrier which may impact the sexual health of individuals with disabilities? a) reduced sexual desire compared to people without known disabilities b) lower access to SHE and sexual health care c) lack of privacy d) decreased opportunities for social interaction and intimate relationships 82. Yanis has Down syndrome. Which of the following barriers to sexual health might he experience? a) a lack of SHE b) a lack of privacy c) increased risk of sexual abuse d) all of the above 83. Which of the following statements about studying SHE in school is false? a) Studying SHE in school has resulted in delayed sexual intercourse. b) Studying SHE in school has resulted in reduced rates of teen pregnancy. c) Studying SHE in school has resulted in earlier sexual intercourse. d) Studying SHE in school has resulted in less frequent sexual behaviour.

84. In a 2005 study of Grade 10 and 12 students in Canada, which of the following was listed as their most preferred source of information about healthy dating and relationships? a) school Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

b) personal experience c) parents d) peers 85. Which Candian Province or Territory had the highest condom use rates in 2009-10? a) Quebec b) Nunavut c) Ontario d) PEI 86. With regards to sexual activity in adolescents, what was the general trend for the number of students engaging in various sexual behaviours in 2002 when compared to 1989? a) The number of students engaging in various sexual behaviours was higher in 2002 than in 1989 b) The number of students engaging in various sexual behaviours was lower in 2002 than in 1989 c) The number of students engaging in various sexual behaviours was similar in 2002 than in 1989 d) The data were inconclusive when comparing these two years.

87. The Canadian Guidelines for Sexual Health Education was recently updated by PHAC in 2019. In what year was this document first released? a) 1976 b) 1985 c) 1994 d) 2001 88. In a 2010 study of Toronto teens, approximately what per cent had received any formal education relating to sexual orientation? a) 25 b) 50 c) 75 d) 90 89. ________ is a universal sexual right to access comprehensive sexual health information and other resources necessary to promote healthy sexuality and avoid negative outcomes. a) sexual health education b) sexual health c) sexual health demand d) sexual health learning 90. ________ programs include information about contraception and avoidance of STIs as well as abstinence. a) All sexual health b) Abstinence-only sexual health c) Comprehensive sexual health d) Independent sexual health SHORT ANSWER QUESTIONS 1. Having respectful and rewarding relationships, self-acceptance, and access to services are all considered Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

__________ sexual health outcomes.

2. SHE programs that advocate for abstinence generally do not teach about __________.

3. Research has shown that teens who receive abstinence-only SHE have similar outcomes to teens who receive __________ SHE. 4. Mr. Meijer starts and ends every discussion in his Grade 8 sex education class with the phrase "Don't forget!

Use condoms!" By the third class all he has to say is "Don't forget" and the whole class says in unison "Use condoms!" Mr. Meijer's catch phrase shows a __________ __________, which is a characteristic of effective sex education.

5. When policy makers in the Canadian government make decisions about SHE, they are more heavily influenced by public opinion than by __________.

6. Researchers have found that people with intellectual disabilities tend to have a(n) __________ attitude about sex and sexuality.

7. Providing __________ to sex education from both formal and informal sources is an important first step toward promoting sexual health for people with disabilities.

8. Sexually transmitted infections, unintended pregnancy and sexual coercion are all __________ sexual health outcomes.

9. Canadian sex education is based on the __________ model developed by Jeffrey Fisher and William Fisher.

10. A sexual health program that makes students feel more capable of using condoms or seeking a doctor's advice concerning contraception can be said to promote __________-__________.

11. Teaching students how to use a condom effectively is an example of a __________ skill.

12. Because abstinence-only programs withhold information about sexual health they violate an individual's rights and therefore can be viewed as __________.

13. Every SHE program in Canada should undergo __________ __________ to ensure that it is adhering to the protocol.

14. Research suggests that teens prefer to get information about pregnancy and STI prevention from their __________.

15. Recent immigration to Canada from East and Southeast Asia is an example of a(n) __________-__________ factor that can affect access to sexual health information.

16. Stephen has cerebral palsy and is excused from gym class at school as a result. This may be a __________ to sexual health education for Stephen because sex ed instruction occurs in gym class.

17. A SHE program that includes information about contraception and avoidance of STIs as well as abstinence is referred to as a ________ SHE. Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

18. A SHE program focused on teaching abstinence from sexual activity until marriage and/or a later time, whereby information about contraception tends to be excluded from such programs are referred to as ________-________ SHEs..

19. The fear, dislike, and/or intolerance of transgender or gender diverse individuals is called ________.

20. Teen pregnancy rates in Canada have ________ since the 1990s.

ESSAY QUESTIONS 1. Ms. Waltz is in charge of developing a sex education program for her Grade 7 class. Describe some of the factors she should consider when developing the program in order to ensure the program helps her students have positive sexual outcomes.

2. Describe at least two reasons why abstinence-only sex education programs may be problematic.

3. Compare survey data about sexual behaviour from teens in 1989 to survey data from teens in 2002. What has changed and what has stayed the same? How should the sex education curriculum be adjusted in light of the results of the more recent survey?

4. Describe the relationship between the sex education curriculum and sexual outcomes and quality of life for SGD teens.

5. Discuss how media literacy can influence young people's perceptions of popular media content.

6. Discuss the role of peers in terms of sexual health and sexual behaviours among young people.

7. Compare and contrast comprehensive sex education and abstinence-only sex education.

8. List and describe the three main factors of the information-motivation-behavioural skills (IMB) model.

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ANSWER KEY MULTIPLE CHOICE QUESTIONS 1. a 2. a 3. a 4. c 5. a 6. b 7. d 8. a 9. a 10. d 11. a 12. c 13. c 14. b 15. c 16. a 17. d 18. a 19. a 20. a 21. a 22. a 23. a 24. a 25. d 26. d 27. a 28. a 29. a 30. a

31. d 32. a 33. a 34. b 35. a 36. c 37. c 38. a 39. a 40. a 41. d 42. c 43. b 44. d 45. a 46. a 47. c 48. a 49. a 50. a 51. c 52. a 53. c 54. a 55. a 56. a 57. c 58. a 59. a 60. d

61. c 62. a 63. b 64. c 65. a 66. d 67. a 68. a 69. d 70. a 71. c 72. d 73. d 74. c 75. d 76. a 77. a 78. d 79. c 80. a 81. a 82. d 83. c 84. b 85. b 86. c 87. c 88. b 89. a 90. c

SHORT ANSWER QUESTIONS 1. positive 2. contraception 3. no 4. clear message 5. research 6. negative 7. access

8. negative 9. IMB 10. self efficacy 11. behavioural 12. unethical 13. program evaluation 14. school

15. socio demographic 16. barrier 17. comprehensive 18. abstinence only 19. transphobia 20. decreased

ESSAY QUESTIONS 1. 1. Make sure the program is accessible to all children in the school. Make sure that there is material relevant to SGD children and children with disabilities. Be aware of cultural diversity in the classroom and structure the program accordingly. For example, if there are several students who are new to Canada, Ms Waltz may wish to Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

cover anatomy in more detail as they may not have been taught this in their previous home country.

2. Make sure the content is age-appropriate. Realize that many will be choosing to try sex soon and need to know about both pregnancy and STIs. Consider having open discussions with students to find out any myths or misconceptions they may have or reasons why they may choose not to use condoms. Provide the information needed to change their minds about condom use.

3. Develop a program that includes skill-building, such as talking to a partner about using a condom, purchasing condoms, or "putting a condom on a banana."

4. Make sure she, as the teacher, knows what she is talking about in the classroom and that she is well-informed on the latest information before teaching it to students.

5. Evaluate the program to whatever extent she can, ask for student feedback and if possible have discussions with past students (in the future) to see if there were any gaps or places where improvements may be needed.

2. ETHICS: Abstinence-only programs can be viewed as unethical because they withhold some of the information people need to make informed decisions about their sexual health. Santelli et al. (2006) agree and further note that such programs are particularly inadequate for sexually experienced youth and SGD youth. Indeed, Orton (1994) remarks that abstinence-only programs stigmatize youth "in whom abstinence is impossible, unrealistic, or not desirable." Many SGD youth suffer because the heterosexist nature of abstinence-only curriculum ignores sexual diversity and may leave SGD students feeling marginalized and uninformed; even worse, SGD identities may be negatively and explicitly denounced in such programs (Fisher, 2009; Santelli et al., 2006).

EFFECTIVENESS: The long-term effectiveness of abstinence-only programs on reducing sexual behaviour among teens has not been demonstrated in the majority of studies. For example, Kohler, Manhart, and Lafferty (2008) compared sexual behaviour among US teenagers 15 to 19 years of age who had received (1) no sex education, (2) abstinence-only education, or (3) comprehensive sex education. The results indicated that, similar to a complete lack of sex education, abstinence-only education programming did not decrease the likelihood of reporting a history of sexual intercourse, pregnancy, or STIs. 3. Teens in 2002 had sex with fewer partners and appeared to start having sex at a later age but had sex more frequently than teens in 1989. Teens were more likely to have used condoms than teens in 1989 and were less likely to become pregnant. However teens in the 2000s were more likely to be infected with an STI than teens in the 1980s indicating that sex education regarding prevention of sexually transmitted infections may need to change in order to ensure the most positive outcomes for teens.

4. When sexual orientation is not a part of the curriculum, SGD teens are more likely to engage in sexual intercourse in adolescence and are more likely to have negative sexual outcomes. This is probably due to the fact that sex education that does not discuss sexual orientations other than heterosexuality alienates these teens and leaves them, essentially, without information they feel applies to then and that they can use to make good, positive choices about sex. In addition, the lack of sex education about sexual orientation may be causing homophobia and transphobia in schools as well as contributing to bullying and harassment of SGD teens. By including sexual orientation in sex education not only would there be a higher likelihood of positive sexual outcomes for SGD teens but there would also be a reduction in homophobia and transphobia in the schools, improving the quality of everyday life for these teens.

5. Answers may vary but should include some of the following content: Young Canadians who have access to visual media and the Internet will likely be exposed to sexual content. Whether purposefully or, more often, passively, the media is educating young people about sex, and it is not always in a positive, informative, and unbiased way. What can teens and those who care for them do to lessen the negative impact of sex-related messages from the media? One of the easiest and most effective solutions is to ensure that young people are media literate, meaning that they know how to critically assess what they see and read in the media, particularly on the Human Sexuality: A Contemporary Introduction, Third Edition © Oxford University Press Canada, 2020

Internet. Indeed, the Canadian Guidelines (PHAC, 2008) encourages educators to discuss media literacy with youth, and concerned organizations such as Media Smarts (http://mediasmarts.ca) provide aids to help educators teach students how to evaluate media sources. In the future, with the rise of mobile Internet devices and other communications technologies that offer constant access to media content, media literacy will undoubtedly become even more important as more and more young people find themselves bombarded with more and more media messages about sexuality.

6. Peers play an important role in influencing youth sexual behaviour, as perceived norms for sexual activity are closely tied to one's social environment. Young people tend to look to their peers for advice and for approval of their actions. In fact, they found that students' perceptions of whether their peers were engaging in sexual intercourse predicted initiation of intercourse. In other words, students who thought their peers were having sex were more likely to have done so themselves. Social norms about sexual behaviour are an important factor in a number of theories relating to sexual behaviour, including the IMB model.

7. Broadly speaking, there are two main types of sex education programs in North America: comprehensive programs and abstinence-only programs. Comprehensive sex education programs promote both abstaining from sexual activity and employing strategies to protect oneself from STIs and unintended pregnancy. This second goal is based on the understanding that many teenagers engage in sexual behaviour before marriage. Abstinence-only programs, on the other hand, typically solely promote postponing intercourse until marriage (or simply until later in life).

8. Answers may include some of the following information: The IMB model specifies that sexual health behaviours are initiated and maintained by three factors: 1. Information or knowledge about the behaviour, which should be easily translated into action to reduce sexual health risks and promote healthy sexuality (W.A. Fisher & Fisher, 1993). For example, education about contraceptive methods should not just stop at a definition. Imagine you were first learning about what a condom is for, and all you were given was a short description and a picture; would that be enough for you to successfully use one? Probably not: how would you know where to find a condom, which side to use, or when to put it on? It is important to include practical information, such as where condoms can be found in one's local community, and how to discuss using condoms with a partner (PHAC, 2008).

2. Motivation to apply knowledge in order to maintain sexual health, which results from the combined effect of emotional, personal, and social motivations (W.A. Fisher & Fisher, 1998; motivation). Emotional motivation is the level of comfort a person has with sexuality and specific sexual health behaviours. This level of comfort will influence whether someone will avoid or seek out information about sex. Personal motivation, on the other hand, refers to the beliefs and values a person has about practising specific sexual health behaviours. For example, if someone is not concerned about getting an STI during oral sex, he or she is less likely to use a condom in this situation. Social motivation relates to perceptions of social norms: in other words, what your friends think about engaging in a sexual health behaviour, like unsafe sex, and how much support you think you'll get from them if you engage in that behaviour. 3. Behavioural skills enabling someone to engage in sexual health behaviour, which includes objective skills (e.g., being able to negotiate condom use with a partner) as well as the feeling of being capable of performing a behaviour, termed self-efficacy (Bandura, 1989; W.A. Fisher & Fisher, 1993). So it is not just about whether you know what to do but whether you think you can do it and do it well! As seen in Figure 9.1, the IMB model assumes that information and motivation drive the development and application of related behavioural skills. These skills not only initiate sexual health behaviours, they also maintain them in order to aid in the reduction of risky sexual behaviours. Although both information and motivation are thought to influence whether behavioural skills are applied to reduce negative sexual behaviours, they are thought to be unrelated to one another. For example, although someone may not know about the risks of contracting STIs from unprotected sex, that person may not necessarily engage in appropriate sexual health behaviours if she or he feels uncomfortable discussing condom use with a partner or believes no one in her or his peer groups uses condoms.

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