Sexuality: much more than sex

Human sexuality is an area of people's lives that falls under the purview of psychiatry, among other disciplines or specialties. Sexuality encompasses more fields than sex, conceived as an expression of physical sexuality or as an expression of aspects of the sexual act. In recent years, the subject has aroused great interest due to several reasons.

Professional interest, as Harold I. Lief specifies in Freeman, Kaplan and Sadock's Treatise on Psychiatry, runs parallel to the remarkable social changes that have made it possible for sexual issues to be the subject of discussion in important sectors of society.

Movements such as "Women's lib" or "Gay power" tend to modify old beliefs, values and stereotypes. The traditional roles of men and women, as well as concepts that attempt to qualify homosexuality as pathological have been severely criticized.

Substantial increase in research and institutions in the area of homosexuality

There has also been a substantial increase in research on sexuality, perhaps the most significant being that carried out by Masters and Johnson, who culminated their studies on physiology initiated in the 1960s with interesting therapeutic contributions. They are recognized worldwide for their exhaustive work.

Biological studies suggesting the effect of fetal androgens on the brain organization that will govern future sexual life have also been boosted. Sociological studies have contributed to the understanding of cultural and social changes, as well as values, attitudes and behaviors. Clinical studies have focused mainly on the etiological problem of homosexuality, transsexualism and sexual dysfunctions.

A great diversity of centers and institutions have been created in the world that develop a varied work of care, research, promotion and education, in addition to creating spaces for debate, reflection, and mobilizing and sensitizing public opinion on controversial aspects of this issue.

Issues that do not have the same meaning

It is appropriate to clarify that sex, sexuality, sexual attitudes and behaviors do not have the same meaning, although they are closely interrelated.

Sex is considered as the set of characters that differentiate males from females among different species. The factors that determine sex are fundamentally biological (sex chromosome, presence of ovaries or testes, specific hormones and internal accessory structures, such as the prostate or uterus) and environmental, marked by external genital morphology and education.

Sexuality: is the set of realities that compose and define sexual behavior. Three basic dimensions are recognized: biological (genetic program, hormonal system, genital organs and nervous system), psychosocial (attitudes, cognitions, behaviors, personality), and clinical (sexual dysfunctions, paraphilias, sexual identity disorders).

Sexual attitudes are made up of opinions, feelings and behaviors related to sex. They can be synthesized in two: conservative and liberal.

Two attitudes towards sexuality: conservative and liberal

The conservative attitude has a relatively static and moralistic view of sexuality in the traditional sense. In its most rigid form, it presupposes denial of sex, obsession and guilt. When it comes to educating and informing about sex, the more radical conservatives excuse themselves for not doing so on the grounds of bad taste in dealing with these subjects, while the more progressive among them tend to integrate sexuality into a positive value system, but within the limits of their traditional thinking; they are relatively tolerant of liberal beliefs.

For their part, the liberal attitude offers a vision of sexuality based on pleasure and associated with tenderness, procreation, communication, etc. Regarding the controversial issues of sex (abortion, homosexuality, premarital sex), the position is open and in favor of sex education.

The extreme liberals are in favor of total freedom, without borders or social or moral regulation. Rational liberals are very similar to the most progressive conservatives; like the latter, they are tolerant and respectful of individual freedom, but differ from them in maintaining a more open attitude towards the various nuances of sexuality.

Sexual behaviors are expressions of behavior that make up sexual motivation. It includes masturbation as well as sexual relations, variations in sexual orientation and inclination, different behaviors according to age, and sociological and historical elements that determine different attitudes towards sex.

Numerous reports based on surveys of general population behaviors have been presented over time. The best known is the Kinsey report, which has been replicated in other countries such as France (Simon report), Great Britain (Cole report), and Spain (Serrano Vicens, Malo de Molina and Maideu report).

A concept that has nowadays been practically left behind in all senses is sexism, which implies a discriminatory attitude that divides people's roles according to their gender, assigning to women characteristics such as gentleness, sensitivity or tenderness and to men aggressiveness, hardness or leadership, all of which has determined in part the economic, labor and social division between the two sexes.

Sexology studies sexual behavior and its various dimensions, as well as clinical dysfunctions and their therapeutic possibilities. The term was first used in 1912 by the German dermatologist I. Bloch. Bloch, and subsequently evolved with contributions from psychiatry, gynecology, endocrinology, psychology and other related disciplines, so that sexology can be considered as a synthesis of research from various fields rather than as a medical specialty.

We will comment on different topics of human sexuality in future meetings.