Introduction to Human Sexuality Part I Chapter 3 Sexology through Time and Contemporary Sex Research

CHAPTER Chapter Sexology through Time and Contemporary Sex Research , AND EMERSON WOLFE , LEARNING OUTCOMES Explore how sexology has developed over time , and analyze the contributions of some notable sex researchers and studies that have been conducted Describe and give examples of various research methods employed in conducting sex research , and demonstrate an understanding of the strengths and limitations of each of these methods Identify criteria that would be helpful in evaluating various kinds of sex research , and apply this knowledge in evaluating current research published in professional journals as well as the popular press Discuss possible biases and ethical concerns with research Describe the role of Institutional Review Boards Sexology Sexology is the scientific study of human sexuality , including sexual behaviors , interests and function . A sexologist is a trained professional who specializes in human sexuality . There are many different ways a sexologist may work , and many different areas they may work in in clinical settings , in education , and in research . are specialists in human sexuality and hold specific knowledge and skills . They study people sexual behaviors , feelings and interactions , and assist them to reconcile any issues they have about their sexual experiences , with the aim of improving their lives ( Tilley 2015 ) Over the discipline history , there have been many obstacles . Few sciences have a similarly stuttered development as sexology . Thought by some to be purely scientific , others as prurient verging on the putrid , still others as key to the renewal of the nation and the people , sexology has had as varied a history and reception as the activities it has analyzed and recorded . 25

26 EMERSON WOLFE , The History of Scientific Investigations of Sex An image on an ancient Greek ing cup ( kissing . ca . 480 ' Public Domain The history of human sexuality is as long as human history years and counting ( Anton Swisher , 2004 ) For almost as long as we have been having sex , we have been creating art , writing , and talking about it . Some of the earliest recovered artifacts from ancient cultures are thought to be fertility totems . The Hindu Kama Sutra ( 400 to 200 CE ) ancient text discussing love , desire , and a manual for having sexual intercourse . Rules , advice , and stories about sex are also contained in the Muslim an , Jewish Torah , and Christian Bible . Books on sexuality and love , such as the Kama Sutra , the Ars , and The Perfumed Garden of Sensual Delight , have been around for centuries . But they not framed within a formal field of scientific or medical research . People have been scientifically investigating sex for only about 125 years . During the late despite the social attitudes of sexual repression in the Victorian era more liberal attitudes towards sexuality began to be presented in England and Germany . In 1886 , for instance , Richard von (

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 27 published Psychopathia , which is considered to be the leading work that established sexology as a scientific discipline . Havelock challenged the sexual taboos of his era . Ste ano Bolo Commons Within a decade or so , English medical doctor and sexologist Havelock Ellis ( challenged the sexual taboos of his era , specifically regarding masturbation and homosexuality . His 1897 book Sexual Inversion , described the sexual relations of homosexual males and is considered to be the first objective study of homosexuality . He actually coined this term and , despite the prevailing social attitudes of the time , did not consider homosexuality as a disease , as immoral , or as a crime . From 1897 to 1923 , his findings were published in a set of books titled Studies in the Psychology of Sex . Among his most noteworthy findings is that transgender people are distinct from homosexual people . studies led him to be an advocate of equal rights for women and comprehensive human sexuality education in public schools ( Tilley 2015 ) Using case studies , the Austrian neurologist Sigmund Freud ( is credited with being the first scientist to link sex to healthy development and to recognize humans as being sexual throughout their lifespans , including childhood ( Freud , 1905 ) Freud ( 1923 ) argued that people progress through five stages of psychosexual development oral , anal , phallic , latent , and genital . According to Freud , each of these stages could be passed through in a healthy or unhealthy manner . In unhealthy manners , people might develop psychological problems , such as frigidity , impotence , or .

28 EMERSON WOLFE , The American biologist Alfred ( is commonly referred to as the father of human sexuality research . was a expert on wasps but later changed his focus to the study of humans . This shift happened because he wanted to teach a course on marriage but found data on human sexual behavior lacking . He believed that sexual knowledge was the product of guesswork and had never really been studied systematically or in an unbiased way . He decided to collect information himself using the survey method , and set a goal of interviewing 100 thousand people about their sexual histories . Although he fell short of his goal , he still managed to collect 18 thousand interviews ! Many behind closed doors behaviors investigated by contemporary scientists are based on seminal work . Unlocking the secrets of the belt . Science Museum Science and Picture RESEARCH Before the late , access to reliable , based information on sex was limited . Physicians were considered authorities on all issues related to sex , despite the fact that they had little to no training in these issues , and it is likely that most of what people knew about sex had been learned either through their own experiences or by talking with their peers . Convinced that people would benefit from a more open dialogue on issues related to human sexuality , Alfred of Indiana University initiated scale survey research on the topic . The results of some of these efforts were published in two Behavior in the Human Male and Sexual Behavior in the Human were published in 1948 and 1953 , respectively ( 1998 ) In 1947 , Alfred established The Institute for Research , Sex , Gender and Reproduction at Indiana University , shown here in 2011 . The Institute has continued as a research site of important psychological studies for decades .

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 29 The staff of the Institute , 1953 ( Alfred is center ) At the time , the reports were quite sensational . Never before had the American public seen its private sexual behavior become the focus of scientific scrutiny on such a large scale . The books , which were filled with statistics and scientific lingo , sold remarkably well to the general public , and people began to engage in open conversations about human sexuality . As you might imagine , not everyone was happy that this information was being published . In fact , these books were banned in some countries . Ultimately , the controversy resulted in losing funding that he had secured from the Rockefeller Foundation to continue his research efforts ( 2004 ) Although research has been widely criticized as being riddled with sampling and statistical errors ( Jenkins , 2010 ) there is little doubt that this research was very influential in shaping future research on human sexual behavior and motivation . described a remarkably diverse range of sexual behaviors and experiences reported by the volunteers participating in his research . Behaviors that had once been considered exceedingly rare or problematic were demonstrated to be much more common and innocuous than previously imagined ( 2004 , 1998 ) Watch this from the 2004 film that depicts Alfred life and research . Among the results of research were the findings that women are as interested and experienced in sex as their male counterparts , that both males and females masturbate without adverse health consequences , and that homosexual acts are fairly common ( 2004 ) also developed a continuum known as the scale that is still commonly used today to categorize an sexual orientation ( Jenkins , 2010 ) Sexual orientation is an emotional and erotic attractions to individuals ( homosexual ) sexed individuals ( heterosexual ) or both ( bisexual )

30 EMERSON WOLFE , MASTERS AND JOHNSON RESEARCH William Masters ( and Virginia Johnson ( formed a research team in 1957 that expanded studies of sexuality from merely asking people about their sex lives to measuring people anatomy and physiology while they were actually having sex . Masters was a former Navy lieutenant , married father of two , and trained gynecologist with an interest in studying prostitutes . Johnson was a former country music singer , single mother of two , divorcee , and college dropout with an interest in studying sociology . And yes , if it piques your curiosity , Masters and Johnson were lovers ( when Masters was still married ) they eventually married each other , but later divorced . Despite their colorful private lives they were dedicated researchers with an interest in understanding sex from a scientific perspective . In 1966 , William Masters and Virginia Johnson published a book detailing the results of their observations of nearly 700 people who agreed to participate in their study of physiological responses during sexual behavior . Unlike , who used personal interviews and surveys to collect data , Masters and Johnson observed people having intercourse in a variety of positions , and they observed people masturbating , manually or with the aid of a device . While this was occurring , researchers recorded measurements of physiological variables , such as blood pressure and respiration rate , as well as measurements of sexual arousal , such as vaginal lubrication and penile tumescence ( swelling associated with an erection ) In total , Masters and Johnson observed nearly sexual acts as a part of their research ( Hock , 2008 ) Based on these observations , Masters and Johnson divided the sexual response cycle into four phases that are fairly similar in men and women excitement , plateau , orgasm , and resolution . 22 Ra I A A This graph the a phases sexual response cycle as described by Masters . In addition to the insights that their research provided with regards to the sexual response cycle and the orgasmic potential of women , Masters and Johnson also collected important information about reproductive

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 31 anatomy . Their research demonstrated the statistic of the average size of a flaccid and an erect penis ( and inches , respectively ) as well as dispelling beliefs about relationships between the size of a erect penis and his ability to provide sexual pleasure to his female partner . Furthermore , they determined that the vagina is a very elastic structure that can conform to penises of various sizes ( Hock , 2008 ) CONTEMPORARY SEX RESEARCH METHODS ETHICS Now that we have covered a great expanse of time , let us center ourselves in the present moment in which you take on the role of becoming a researcher and theorist yourself . it is your turn to create your own research and theories ! Well , before we get too far ahead of ourselves , let explore human sexuality research methods as well as ways to combat our biases . Research Methods How Should I Conduct My Research ?

Psychologists and test research questions using a variety of methods . Most research relies on either experiments or correlations . in an experiment , researchers manipulate , or cause changes , in the independent variable , and observe or measure any impact of those changes in the dependent variable . The independent variable is the one under the experimenter control , or the variable that is intentionally altered between groups . The dependent variable is the variable that is not manipulated at all , or the one where the effect happens . One way to help remember this is that the dependent variable depends on what happens to the independent variable . The most important thing about experiments is random assignment . Participants do get to pick which condition they are in ( participants did choose whether they were supposed to spend the money on themselves versus others ) The experimenter assigns them to a particular condition based on the flip of a coin or the roll of a die or any other random method . When scientists passively observe and measure phenomena it is called correlational research . Here , we do not intervene and change behavior , as we do in experiments . in correlational research , we identify patterns of relationships , but we usually can not infer what causes what . importantly , with correlational research , you can examine only two variables at a time , no more and no less . Measurements These are the most common of the techniques used by sex researchers because they can be conducted through paper questionnaires , in interviews and online . The researcher will ask questions and record the responses in order to be compiled and compared with all participants in the study to reach conclusions . The questions can be , response , or use a Scale . Have you ever completed an term review for an instructor while at ?

if so , these utilize a question is asked and you are then meant to choose from a range of options , such as Strongly Disagree , Somewhat Disagree , Neither Disagree Nor Agree , Somewhat Agree , Strongly Agree . Surveys A survey is a way of gathering information , using questionnaires or the Internet . Compared to a study conducted in a psychology laboratory , surveys can reach a larger number of participants at a much lower cost . Although surveys are typically used for correlational research , this is not always the case . An experiment can be carried out using surveys as well . Surveys provide researchers with some significant advantages in gathering

32 EMERSON WOLFE , data . They make it possible to reach large numbers of people while keeping costs to the researchers and the time commitments of participants relatively low . The National Health and Social Life Survey ( conducted in 1991 , was the first nationally representative survey of sexual behavior , providing population estimates of a limited range of sexual behaviors . The answered some of these important questions ( particularly those related to the prevalence of masturbation , vaginal intercourse , anal intercourse , oral sex , and the appeal of a range of sexual experiences ) yet the survey was also limited to younger adults ( ages ) In addition to the , there have been several important national studies that have addressed sexual behavior , though each has focused on a narrow range of ages sexual behaviors . The National Survey of Family Growth ( and Youth Risk Behavior Survey ( survey younger age groups and have mostly asked about sexual behaviors related to risk of pregnancy and sexually transmitted infections ( STI ) The National Social Life , Health , and Aging Project ( addresses a limited scope of relational and sexual issues for older Americans . The National Survey of Sexual Health and Behavior ( is the largest nationally representative probability survey focused on understanding sex in the United States . Conducted by researchers at , or affiliated with , the Center for Sexual Health Promotion at the Indiana University School of Public Health , the is an ongoing study with data collected in 2009 , 2012 , 2013 , 2014 , 2015 , 2016 , and 2018 . More than people between the ages of 14 and 102 have participated in the . The has resulted in dozens of research publications and presentations . Here is a small sampling of some key findings There is enormous variability in the sexual of adults , with more than 40 combinations of sexual activity described at adults most recent sexual event . 2009 ) Many older adults continue to have active pleasurable sex lives , reporting a range of different behaviors and partner types , however adults over the age of 40 have the lowest rates of condom use . Although these individuals may not be as concerned about pregnancy , this suggests the need to enhance education efforts for older individuals regarding STI risks and prevention . 2009 ) Men are more likely to orgasm when sex includes vaginal intercourse women are more likely to orgasm when they engage in a variety of sex acts and when oral sex or vaginal intercourse is included . 2009 ) Gender plays a critical role in understanding attitudes toward bisexual individuals among heterosexual , and adults . In general , women are more likely to report positive attitudes toward bisexual individuals than men . Additionally , attitudes toward bisexual women are more positive than attitudes toward bisexual men ( 2015 see Dodge et al . Gay , lesbian and bisexual participants were less likely to report monogamy and more likely to report both open relationships and . 2012 see Levine et al . data on diverse sexual behaviors are needed to improve , educators , and the general understanding of human sexual expression . Consequently , human sexual expression can be more richly and accurately described which may also help people to feel seen or better represented in terms of their . In addition to these surveys , there are sexual surveys conducted by sex toy manufacturers , colleges and universities , as well as individual sexological researchers .

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 33 Behavioral Measurements Direct an individual or individuals engaged in a particular behavior ( are there any ethical considerations on ) device that measures where a participant is looking . Biological Measurements The brain and genitals can be measured during sexual activity to understand how the body responds . can be used to look internally at the size , structure , and shape of the genitals and brain regions while actually map the brain activity by measuring the blood flow to certain areas . One particular difficulty with and is that the participant must remain still in order to capture effective images . Some additional methods Pupil in pupils can indicate arousal , interest or cognitive strain Penile a band around the penis that can measure blood flow Vaginal a measuring device inside the vagina that uses light to detect changes in blood flow changes to body temperature because arousal creates heat Do you think any of these techniques might change your sexual responses ?

How about trying to have an orgasm in an machine ( all for the sake of science ) Here you can see a brief clip examining EEG responses to orgasm Inside the Orgasm Lab . Media Researchers develop a system to make inferences about some form of media . reliability is very important in that the researcher will train the individuals compiling the data on how to code for the same things accurately . The coders are often given examples of media and they continue to be trained until all of them match each others responses . Then , they can move on to actually conducting the research . Qualitative Methods Just as correlational research allows us to study topics we ca experimentally manipulate ( whether you have a large or small income ) there are other types of research designs that allow us to investigate these topics . Qualitative designs , including participant observation , case studies , and narrative analysis are examples of such . Although something as simple as observation may seem like it would be a part ofall research methods , participant observation is a distinct methodology that involves the researcher embedding or herself into a group in order to study its dynamics . This involves combining all previous studies on a particular topic to analyze the results altogether . This allows for an enormous sample size and a greater understanding of a particular research question . This also allows the

34 EMERSON WOLFE , researcher to include results from many different types of research methods that individual studies within the used . Possible Biases in Research Did you know that about 90 of all sex research comes from countries in the Global North , such as the United States ?

This skews data taken from sex research because culture and society influence gender and sexuality in many ways . When most of the research is coming from a small portion of the world , many of the findings will be to individuals outside of that area , and researchers need to be more inclusive of the Global South , which includes Asia , Latin America , Africa , and the Middle East ( et , 2016 ) This is the overarching issue with sex is a geographical and cultural bias . Additionally , we will look at some researcher mistakes as well as respondent mistakes that can influence outcomes . Issues in Research Researcher Too small ofa sample fewer number of participants in a study the less generalizable the research can be Convenience a sample of participants who are easy to include , such as volunteers at the Queer Resource Center where you work . It may be faster and easier to use this group of individuals , but the results will not reflect the general public within that particular population you are seeking to understand . If interviewing someone in person , the researchers biases about someone based on gender , race , age , etc . may influence the way they ask a question even when sticking to a script . Changes in tone or asking questions in a slightly different way can influence results . Direct observations are incredibly beneficial , but lab settings are often not reflective of peoples natural environments . Best practices utilize random or probability sampling so that a greater range of people have the chance of being included in the research and , if conducting an experiment , make it as naturalistic as possible ( Hyde , 2017 ) Issues in Research Participants to certain parts ofa survey or interview making the response rate across the sample inconsistent Purposeful may exaggerate or minimize the truth related to their sexual thoughts and behaviors Volunteer who are willing to participate in sex research may not share the qualities of the general public People are often not good at recalling details or recognizing their own thoughts and physiological responses is sometimes not reliable When being interviewed in person , the participants biases about the researcher in terms of gender , race , age , etc . can cause them to answer differently . These are considered extraneous factors ( Hyde , 2017 )

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 35 Ways to Reduce Issues participants twice to see if their responses are the same both times for reliability by conducting the interview twice using different interviewers Utilize a computer system to read questions to participants and record their responses Conduct research using several different methods . For instance , use a survey while participants watch some form of media while also using an device at the same time . Ethical Concerns with Sex Research Research involving human subjects must follow certain ethical standards to make sure the subjects are not harmed . Such harm can be quite severe in medical research unless certain precautions are taken . For example , in 1932 the Public Health Service began studying several hundred poor , illiterate African American men in , Alabama . The men had syphilis , for which no cure then existed , and were studied to determine its effects . After scientists found a decade later that penicillin could cure this disease , the government scientists decided not to give penicillin to the men because doing so would end their research . As a result , several ofthe men died from their disease , and some and children came down with it . The study did not end until the early , when the press finally disclosed the experiment . Several observers likened it to experiments conducted by Nazi scientists . If the subjects had been white and middle class , they said , the government would have ended the study once it learned that penicillin could cure syphilis ( Jones , 1981 )

36 EMERSON WOLFE , Fortunately , most sex research does not have this potential for causing death or serious illness , but it still can cause other kinds of harm and thus must follow ethical standards . The federal government has an extensive set of standards for research on human subjects , as do the fields of psychology , sociology and social work . a One or more interactive elements has been excluded from this version of the text . You can view them online here on . One of the most important ethical guidelines in sexology and other research concerns privacy

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 37 and confidentiality . Researchers should protect the privacy and confidentiality of their subjects . When a survey is used , the data must be coded ( prepared for computer analysis ) anonymously , and in no way should it be possible for any answers to be connected with the respondent who gave them . In field research , anonymity must also be maintained , and aliases ( fake names ) should normally be used when the researcher reports what she or he has been observing . In 1970 a sociology student conducted a study , which ultimately led much debate among social science researchers when it came to light . Laud studied male homosexual sex that took place in public bathrooms . He did so by acting as the lookout in several encounters where two men had sex the men did not know was a researcher . He also wrote down their license plates and obtained their addresses and a year later disguised himself and interviewed the men at their homes . Many sociologists and other observers later criticized for acting so secretly and for violating his subjects privacy . responded that he protected the men names and that their behavior was not private , as it was conducted in a public setting ( 1975 ) These and other studies ( 2009 ) led to increasing public awareness and concern regarding research on human subjects . In 1974 , the US Congress enacted the National Research Act , which created the National Commission for the Protection of Human Subjects in Biomedical and Behavioral Research . The commission produced The Belmont Report , a document outlining basic ethical principles for research on human subjects ( National Commission for the Protection of Human Subjects in Biomedical and Behavioral Research , 1979 ) The National Research Act ( 1974 ) also required that all institutions receiving federal support establish institutional review boards ( to protect the rights of human research subjects . Since that time , many private research organizations that do not receive federal support have also established their own review boards to evaluate the ethics of the research that they conduct . Institutional Review Boards ( Institutional Review Boards , or , are tasked with ensuring that the rights and welfare of human research subjects will be protected at all institutions , including universities , hospitals , nonprofit research institutions , and other organizations that receive federal support for research . typically consist of members from a variety of disciplines , such as sociology , economics , education , social work , and communications . Most also include representatives from the community in which they reside . For example , representatives from nearby prisons , hospitals , or treatment centers might sit on the of university campuses near them . The diversity of membership ensures that the complex ethical issues of human subjects research will be considered fully by a knowledgeable , experienced panel . Many sexological research projects involve the voluntary participation of all human subjects . In other words , we can not force anyone to participate in our research without their knowledge and consent . Researchers must therefore design procedures to obtain subjects informed consent to participate in their research . Informed consent is defined as a subject voluntary agreement to participate in research based on a full understanding of the research and of the possible risks and benefits involved . Although it sounds simple , ensuring that one has actually obtained informed consent is a much more complex process than you might initially presume . The informed consent process requires researchers to outline how they will protect the identities of subjects . This aspect of the process , however , is one of the most commonly misunderstood aspects of research . In protecting subjects identities , researchers typically promise to maintain either the anonymity or confidentiality of their research subjects . Anonymity is the more stringent of the two . When a researcher promises anonymity to participants , not even the researcher is able to link participants data with their identities . interviewing means that subjects will be visible to researchers and will hold a conversation , making anonymity impossible . In other cases , the researcher may have a signed consent form or obtain personal information on a survey and will

38 EMERSON WOLFE , therefore know the identities of their research participants . In these cases , a researcher should be able to at least promise confidentiality to participants . Offering confidentiality means that some of the subjects identifying information is known and may be kept , but only the researcher can link identity to data with the promise to keep this information private . Confidentiality in research and clinical practice are similar in that you know who your clients are , but others do not , and you promise to keep their information and identity private . This may be difficult if the data collection takes place in public or in the presence of other research participants , like in a focus group study . Researchers also can not promise confidentiality in cases where research participants pose an imminent danger to themselves or others , or if they disclose abuse of children or other vulnerable populations . These situations fall under a social workers duty to report , which requires the researcher to prioritize their legal obligations over participant confidentiality . As you now know , researchers must consider their own ethical principles and follow those of their institution , discipline , and community . We already considered many of the ways that researchers strive to ensure the ethical practice of research , such as informing and protecting subjects , but the practice of ethical research end once subjects have been identified and data have been collected . Researchers must also fully disclose their research procedures and findings . This means being honest about subject identification and recruitment , data collection and analyzation , as well as being transparent with the study ultimate findings . The Future of Sex Research Understanding the history of sexology may be helpful in paving the way forward . In particular , note the progress with which cultural shifts curate a much different understanding of sex . For example , finding that masturbation occurs among many people AND that it seems to benefit the experience of an individual sexual awareness within their future sexual relationships was shocking when it was first presented . Now , it notjust completely acceptable , masturbation as a form of self awareness is encouraged by psychologists , and medical providers . So cultural shifts matter when it comes to what we consider acceptable in terms of research and sexual data . This , combined with an ongoing conversation around ethics , becomes important when we consider the future of research . How do we ethically continue and expand the map of neurological responses to pleasure ?

How do technologies such as augmented reality fit our paradigm ?

What does it mean to have sex with robots ?

Ok For more , check out Sex With Robots Kate Talk These questions are at the very tip of the iceberg , so to speak . What other considerations might be at play when it comes to research on all things sex ?

Licenses and Attribution Introduction to Sociology Understanding and Changing the Social World by University of Minnesota is licensed under a Creative Commons International License , except where otherwise noted . Psychology by is licensed under a Creative Commons Attribution International License , except where otherwise noted . The section on The History of Scientific Investigations of Sex was taken from the Psychology of Human Sexuality by Don Lucas and Jennifer Fox is licensed under a Creative Commons International License . Permissions beyond the scope ofthis license may be available in our Licensing Agreement . Introduction to Psychology by Philip Smith is licensed under a Creative Commons Attribution International License , except where otherwise noted . Adaptations Reformatted . Modified content for language , application to subject and cohesion . The following videos have this license All Rights Reserved . License Terms Standard YouTube license . Crash Course . 2018 ) Henrietta Lacks , the Experiment , and ethical data collection Crash course statistics ?

CHAPTER SEXOLOGY THROUGH TIME AND CONTEMPORARY SEX RESEARCH 39 Department of Health and Human Services . 2018 ) How protect human research participants . Love Sex with Robots . 2016 ) Would you have sex with a robot ?

Goldsmiths research questions . Ok References Hyde , 2017 ) Understanding human sexuality . Introduction to Sociology Understanding and Changing the Social World by University of Minnesota is licensed under a Creative Commons International License , except where otherwise noted . Psychology by is licensed under a Creative Commons Attribution International License , except where otherwise noted . The Psychology of Human Sexuality by Don Lucas and Jennifer Fox is licensed under a Creative Commons International License . Permissions beyond the scope of this license may be available in our Licensing Agreement . Tilley , 2015 ) Happy endings the ins and outs of clinical sexology . The Conversation . Introduction to Psychology by Philip Smith is licensed under a Creative Commons Attribution International License , except where otherwise noted . Introduction to Human Sexuality by Emerson Wolfe is licensed under a Creative Commons International License .