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next five centuries. In essence, Aquinas retrofitted the sexual theories of the pagans to Roman Catholic purposes. Aquinas asserted that sex served only one purpose in life: reproduction. Bearing children was a sacred duty. Sex merely for pleasure was a sin, even when the partners were married.

      It was only in the 19th century that belief-based ideologies began, at last, to shift in favor of the growing evidence that sex was a truly complex phenomenon. With the blossoming of medicine in the mid 19th century, some of the greatest minds of the Victorian age — most notably Sigmund Freud — set about unraveling the meaning and biology of sex. For the first time, sexual behaviors were classified, categorized, diagnosed and treated by medical doctors.

      Unfortunately, by modern standards, Victorian science was woefully unscientific. While the doctors themselves were serious men, some of their conclusions were absurd. The fatal flaw in Victorian sexology was that, in their eagerness to establish diagnostic models of sexuality, they never asked the single most important question: “What is normal sexuality?” Instead, they assumed they already knew what it was: vaginal sex in marriage for the purpose of reproduction. (I’ll call it the Reproductive Model and will use RM as short-hand from here on.)

      While they analyzed hundreds, perhaps thousands, of cases which contradicted their assumptions, rather than question the validity of those assumptions as a good scientist should, they diagnosed everyone who did not conform to their expectations as being mentally unbalanced and in need of psychiatric intervention. They assumed that women by nature do not have independent sex drives. They believed that masturbation caused debilitating disease. For decades after, women with high sex-drives, masturbators, hedonists, homosexuals, transpeople and others who defied the Victorian standard were subject to involuntary treatments and hospitalizations.

      Today, we have an exuberance of data across numerous medical specialties that prove just how wrong our predecessors were to limit their definition of normalcy to reproductive function.

      Diversity is Normal

      Think of all the people you know who have had casual sex, one-night stands, same-sex encounters, or threesomes. Add to that all the people who watch adult movies, surf porn, sext, go to strip clubs, patronize call-girls, and get happy endings at massage parlors. Then think of the tens of millions of North Americans who identify as swingers, bisexuals, gay, kinky, polyamorous or fetishist, and the scores of millions who enjoy sexual role-play, fantasies, new positions, and sensual adult toys. By Victorian standards, all of the above are deviants. Yet if you eliminate all of the above populations, just how many “normal” adults are left?

      After 20+ years of sexual research and 11 in clinical practice, I have come to realize that it’s only the tiniest minority of people who faithfully adhere to the RM by choice. Even the most conservative and religious people will grant themselves some leeway when it comes to sex. Cosmo magazine makes it sound new every time, but oral sex techniques were undoubtedly old news to adults long before Ancient Rome was founded.

      Perhaps most telling of all are the lessons of history. No matter how many repressive regimes have come and gone, no matter how many laws and religious mandates dictate sexual behaviors, no matter how much persecution a sexual minority may endure, each new generation repeats the sexual patterns of preceding ones. This suggests a biological basis that surpasses cultural expectations. It is reasonable to conclude that the reason adults may find it difficult to conform to the traditional standard is because the social standard conflicts with their biological make-up.

      I see the individual suffering that confusion about sex and normalcy causes people. I also see that knowledge, education and the simple truths about sex, delivered candidly without judgment, alleviates that pain. Throwing out some of the old beliefs about how sex “should be” and embracing the evidence about how sex is actually lived is profoundly therapeutic.

      A Universal Solution

      To move forward, we can’t keep pretending that sex is a less vital concern to the quality of human life than history or philosophy or literature. Sex is one of humanity’s central obsessions. Whether we’re browsing porn or signing petitions to stop porn, whether we’re taking tantric courses to expand our orgasmic potential or trying to pray away our lust, whether our sex lives are an oasis of joy or a pit of torment, we are all preoccupied with sex.

      Sex is with us from birth to death. Sexual events occur undetected inside your body, as our hormones fluctuate according to moods, life events and aging. Sexual emotions are happening in your home, whether you are celibate or sexually active. Sexual events occur in our private worlds — whether it’s an affair at the office, a scandal at one’s place of worship, or a sex club moving into one’s neighborhood.

      The time is overdue for a modern dialogue about sex and new models of normalcy based on the facts we know instead of the beliefs our ancestors held in the absence of knowledge.

Chapter One
Masturbation

      The Trouble with Masturbation

      The most fundamental sexual behavior known to humans has been shrouded by so many myths and dogma over time that most adults have no idea what’s normal. Even people who are reasonably open-minded about the topic still suspect that, at heart, masturbation is dangerous or unhealthy, particularly if you “do it too much.”

      “Too much” is not an objective standard. There is no such thing as “too much sex” if the person having that sex is enjoying it, remains healthy, and continues to derive pleasure from other aspects of life (career, family, spirituality, etc.). Equally important, what is too much for one person isn’t enough for another. Yet I’ve spoken to hundreds of men and women over the years who believed that something was wrong with them simply because they liked to masturbate.

      Rodger M. walked into my office, head down, jaw set. A tall serious man in his 20s, he glanced around nervously, as if checking for hidden cameras, then sank into a chair. I wondered what grim tale he would reveal — was he a rapist? A convicted child molester? I began asking basic questions while he shifted and avoided my eyes.

      He interrupted me, “Look Doc. Here’s the problem. I jerk off too much. I’m an addict.”

      Rodger had visited a website where he took an “Are you a sex addict?” quiz prepared by someone who bills himself as the preeminent expert in sex addiction, and with every answer, Rodger sank into deeper gloom. Yes, he looked at porn. Yes, he jerked off. He even looked at porn while he jerked off. According to the site, Rodger was a sex addict.

      “Really?” I asked. I ran through a series of basic questions: Was he functioning at work? Did he have a decent social life? Stable relationships? Stable finances? Did masturbation interfere with any of those? Was anyone being hurt by his behavior? At the end I said, “You’re doing great at work, you have an active social life, and you make good choices. I don’t think you’re an addict.”

      “So why do I jerk off so much?”

      “Perhaps you like it,” I smiled. “I know I do.”

      He blushed. “Yeah, yeah, I do. At least until I start worrying about it.”

      This, of course, is the biggest problem with masturbation; not the masturbation itself, which is without doubt the single most ubiquitous, universal behavior, but the guilt, the shame, the anxiety, even the despair that people suffer over it.

      I asked him how often he masturbated for it to cause him enough concern to visit a sex therapist. Rodger told me once or twice a day. I told him that I recommend that male clients have a sexual release once a day for health reasons, he laughed in surprise.

      “Medical studies have proven that men who masturbate five times a week reduce their risk of prostate


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